Connecting Plateau's Health System

Nigeria's Digital Health Strategy 2023 to 2028 sets the national direction: a common health-data backbone (DHIS2), electronic health records and a national health identification system, aligned with the World Health Organization's Global Digital Health Strategy.

For Plateau, the challenge was to translate that direction into a state-level system that could support day-to-day management. The Ministry needed better visibility of facility performance, records that could move with patients, secure data governance and technology that could support specialist care beyond major centres. PLASCHEMA also needed a more modern approach to claims processing as enrolment grew.

The digital programme therefore had to support the wider Healthy Plateau transformation rather than operate as a separate technology project. It builds directly on the diagnostic described in Evidence Before Reform in Plateau State.

Carter organised the architecture into six connected layers: data collection; performance monitoring; the core health information system; claims and payments; telemedicine; and identity and interoperability. Each layer answers a need found in the diagnostic and can be built on its own while still connecting to the rest.

Carter sequenced the work to deliver value early. The Performance Intelligence Dashboard came first, built on data the state already held. Full electronic health records, a unified payment platform and state-wide telemedicine follow in later phases, as the underlying data matures.

Carter also went beyond the blueprint and built a working dashboard with two views: one for the Ministry, Joint Working Committee and State Executive Council, down to facility level; and one for private and development-finance investors looking at the state's health system.

Using one dataset for both audiences was deliberate: the information used to manage the system also gives investors a clearer view of it. The telemedicine design links specialists at Plateau's tertiary hospitals with general hospitals and health centres, and the data-governance approach follows the Nigeria Data Protection Act, with hosting in Nigeria and clear accountability for health data.

Plateau now has a complete digital health architecture aligned with national policy and international interoperability standards, with defined sequencing and ownership. The Performance Intelligence Dashboard was built and delivered during the assignment, giving state leadership and transformation partners a shared view of system performance from the outset.

The architecture provides a clear pathway for records, payments, telemedicine and identity and interoperability to be introduced as the preceding components mature. The dashboard also provides a common evidence base for government and potential investment partners as Healthy Plateau moves into implementation.