When we put together the first State of Health Tech report in 2018, one sector led overwhelmingly. Startups trying to help patients connect with doctors virtually had the highest number.
The reason was simple; there was a low barrier to entry, and many of the founders were doctors themselves. It was a convenient choice.
You simply layered a video conferencing tool, or if you could afford it, a chatbot on top of a service you already offered. It also seemed sexy. You got to brag that you are now a health tech entrepreneur. Quite frankly, there was also a glaring gap they were trying to fill. As of 2018, Nigeria had 3.8 doctors per 10,000 people, according to TechCabal Insights’ State of Healthtech in Nigeria 2026 report. Compare this to India, which has about 7.3 doctors per 10,000 people.
But telemedicine had a problem. Funding was falling behind. Users were not forthcoming despite the convenience these solutions promised. Consequently, investors couldn’t be convinced. Many of these startups shut down. Almost one in two of startup closures tracked between 2017 and 2021 by TechCabal Insights in the 2026 State of Health Tech Report were in the sector. In our 2018 report, the sector raised less than 5% of total funding across 23 startups.
While there was a gap, it was misunderstood. For one, how Nigerians access healthcare is different from the West, where telemedicine was invented. A combination of factors, including low health insurance penetration, relatively low broadband coverage, and cultural norms, means that patients have to make certain tradeoffs.
The stars align
In the 2026 edition of our healthtech report, not much has changed—on the surface. Telemedicine (now known as Telehealth) continues to lead in terms of startup activity. About 35% of startups in the sector are in telemedicine. It also continues to trail in terms of funding, ranking 6th out of 9 sub-sectors. However, there’s a quiet shift happening.
Between 2019 and 2026, telehealth startups raised $21.79 million, averaging $3.11 million per year. This is more than 10 times the average amount raised annually between 2014 and 2018. The funding raised was spread across 38 startups in the sub-sector. Telemedicine appears to be attracting more investor interest. But what has changed between 2018 and 2026?
First, user habits are changing significantly. Users of all ages are increasingly getting used to ordering food, rides, and clothes via their mobile apps. As AI chatbots became ubiquitous and many more people got access, patients are coming into doctors’ appointments with research in hand. These have contributed to users being comfortable using telemedicine platforms. It’s eroded some of the distrust that existed years ago.
Ikpeme Neto, CEO/Founder at Wella Health and health tech leader, believes that payment startups such as Moneipoint, OPay and PalmPay have played a significant role in shaping digital behaviour and building trust in app-based services.
“Fintech normalised the idea that a phone could be the interface for serious services. Telemedicine is now benefiting from that behavioural infrastructure,” he said.
Patients are beginning to consider telemedicine platforms a must-have. Evelyn*, a user I spoke with, explained that their telemedicine app is the first place they and their friends go when they fall ill. One study showed willingness to use telemedicine being as high as 96.2%. Since the users consider them necessary, Health Maintenance Organizations (HMOs) are paying attention. A 2025 report by the Rome Business Schools says that over 60% of healthcare providers now integrate telemedicine.
Neto tells me about the CEO of an HMO who reported growth in their telemedicine offering and was excited about prospects. HMOs are now more willing to include telemedicine as part of their offerings, either by paying, reimbursing, or operating it.
“HMOs are beginning to see it as a cost-saving tool,” he said. “A good telemedicine service can reduce unnecessary visits to physical facilities.”
Scaling telemedicine
Despite the shift the industry is experiencing, the sector has yet to produce a clear winner – a telemedicine startup built at scale.
Can telemedicine leverage the ubiquitous technology and user education to build sustainable businesses? Potentially. Armed with a clear understanding of the cultural nuances and an honest sense of the market size, the path to sustainability becomes clearer.
A clear lesson from one of the industry pioneers was leveraging telemedicine as an entry point and not the end game. Nigerian startup Reliance Health started as a telemedicine startup and quickly pivoted to provide health insurance and physical clinics. The lesson still rings true today.
According to Neto, “telemedicine’s broader potential lies in becoming the front door to everyday healthcare for millions of people who are not currently well served by the traditional system.”
Telemedicine in Nigeria is having its moment. It’s gradually transforming into a clear VC-backable commercial opportunity. Its future, however, relies on its ability to mint a winner, a clear marker of its maturity.
*The user’s real name has been withheld.
