Statistical Evaluation of Telemedicine Programme Outcomes in Rural Niger State

Telemedicine programmes in rural Niger State, North Central Nigeria, have been piloted as a strategy to extend specialist healthcare access to communities where physician-to-patient ratios fall below 1 per 10,000 population. This study applies quasi-experimental statistical methods, specifically difference-in-differences estimation, to evaluate the impact of a two-year telemedicine pilot programme operating in 12 intervention local government areas compared to 14 matched control LGAs. Outcome variables include antenatal care attendance rate, hypertension diagnosis rate, child vaccination coverage, and healthcare-seeking rate for fever illness. Data are sourced from the Niger State Primary Health Care Development Agency routine information system and supplemented with community survey data from 1,100 households at baseline and endline. Propensity score matching is used to improve comparability of intervention and control groups on observable baseline characteristics. Difference-in-differences estimates indicate that the programme increased antenatal care attendance by 14.7 percentage points and child vaccination coverage by 11.2 percentage points in intervention LGAs relative to control LGAs. Hypertension case detection increased significantly in intervention areas, reflecting improved screening access. The study recommends scale-up of the telemedicine model to all rural LGAs in the state, prioritising communities with road access challenges. Keywords: telemedicine evaluation, difference-in-differences, Niger State, rural health, quasi-experimental.