Publication:

Telemedicine and mobile clinical entrepreneurship as catalysts for healthcare access in Benin city, Nigeria: a sequential explanatory mixed-methods study

Background Healthcare access in Benin City, Nigeria is constrained by inadequate infrastructure, workforce shortages, and high out-of-pocket costs. Telemedicine and mobile clinical entrepreneurship represent viable delivery innovations, yet their comparative effectiveness and sustainability remain insufficiently understood.

Methods A sequential explanatory mixed-methods design was employed. Quantitative data were collected from 287 adults using a structured questionnaire and analysed with descriptive statistics, chi-square tests, ANOVA, and logistic regression. Qualitative data were obtained through in-depth interviews with 28 key informants and analysed thematically; findings were integrated at the interpretation stage.

Results Mobile clinics demonstrated stronger access outcomes, with greater reductions in travel time (66.7% vs 53.3%, p<0.001) and waiting time (71.1% vs 46.7%, p=0.013), alongside higher satisfaction (mean 3.5 vs 2.9). Adjusted odds of reporting travel-time reduction were higher for mobile clinic users (AOR 14.8, 95% CI 5.9 to 37.1) than telemedicine users (AOR 7.3, 95% CI 2.9 to 18.6). Telemedicine showed a comparative advantage for chronic disease management. Awareness remained low, with 75% of respondents unaware of any telemedicine service. Key barriers included poor infrastructure, limited training, and low insurance coverage.

Conclusions Both models improve healthcare access through complementary mechanisms. Mobile clinics effectively address geographic barriers while telemedicine supports chronic care continuity. Infrastructure investment, clinical training, and sustainable financing are critical prerequisites for long-term integration.