In Nigeria, FHIR is being used in a limited number of cases today. It is not yet the main standard for health data exchange, but adoption is growing.

The main version in use is FHIR R4. Other versions are not widely active in the country.

A strong increase in FHIR adoption is expected in the coming years. This growth is driven by new national regulations and active development of local implementation guides.

Rules and Support

Nigeria has clear rules in place to support standardized health data exchange.

  • Regulation exists: Yes, there is regulation that mandates standards for electronic health data exchange.
  • FHIR is mandated: The regulation specifically requires the use of FHIR.
  • Deadlines: No formal compliance deadline has been set.
  • Fines: No fines are imposed for non-compliance.
  • Government funding: Yes, funds are available to support FHIR adoption.

In 2025, Nigeria launched the Nigeria Digital Health Architecture (NDHA) for an Interoperable Digital Health Ecosystem. You can read the relevant documents here: Nigeria Digital Health relevant documents.

Nigeria also has a strong standards committee (Health Informatics ISO TC 215). It has approved and adopted more than 40 ISO standards as national health standards. In 2026, the International Patient Summary (ISO 27269:2025) is under ballot for national adoption. Medical device standards, including AI as medical devices, are also under discussion.

National Setup

Nigeria has organized national support for health data standards.

  • National standards organization: Yes. Visit digitalhealth.gov.ng.
  • National core FHIR implementation guide: Under development. View it here: Nigeria Core FHIR IG.
  • Additional FHIR standards: A few have been developed for specific use cases.
  • National terminology server: Not yet available, but planning is underway.

The Nigeria Digital in Health Initiative (NDHI) and the Federal Ministry of Health are leading the development of the Nigeria Core FHIR IG. Their goal is to harmonize the currently fragmented national standards landscape, which also includes the Standards Organization of Nigeria.

Active Use Cases

FHIR specifications are being developed for the following areas in Nigeria:

  • Prescriptions and pharmacy
  • Immunizations
  • Connectathon activities

Nigeria's FHIR work builds on international specifications, including:

  • International Patient Summary (IPS)
  • US Core

Who Is Using FHIR

The main groups adopting FHIR in Nigeria are:

  • App developers
  • Government agencies
  • Researchers

The main driver for adoption is regulation and grants. Most FHIR software in use is open source.

In terms of how FHIR is used, the country relies most on:

  • FHIR REST API: Widely applied
  • FHIR Shorthand: Widely applied (a simple language for writing FHIR profiles)
  • SQL on FHIR: Strongly applied (a way to query FHIR data using SQL)
  • FHIR Documents: Moderately applied
  • FHIR Messaging, Bulk Data, and Questionnaires: Limited use

Tools like SMART on FHIR, CDS Hooks, Subscriptions, and FHIRcast are not yet in use.

Successes and Challenges

The main challenges to FHIR adoption in Nigeria are:

  • Unclear benefits for stakeholders
  • Lack of FHIR knowledge

Looking ahead, the new regulation mandating FHIR is expected to drive information sharing across Nigeria's health sector. This is the most anticipated use case for the near future.

On the topic of AI, the rise of AI and machine learning has not yet had a noticeable impact on FHIR efforts in Nigeria. The view in the country is that AI does not replace the need for structured data through FHIR.

Future Plans

Nigeria made more progress than expected in FHIR adoption over the past year. Key achievements include:

  • Establishment of a national standards organization
  • New regulation prescribing the use of standards in electronic health data exchange
  • Development of new FHIR standards for specific use cases
  • Expanded adoption of FHIR across the healthcare ecosystem

In the next year, the country expects to:

  • Develop a national FHIR data model
  • Create new FHIR standards for more specific use cases
  • Launch pilot projects with selected healthcare stakeholders
  • Continue expanding FHIR adoption across the ecosystem

Regarding the FHIR Community Process (FCP), one or more organizations in Nigeria are exploring becoming participants. Within 2–3 years, the country expects to have one or more approved FCP specifications.

There is strong agreement that within the next three years, Nigeria will see real benefits from FHIR adoption. These benefits include cost savings, better care coordination, and a stronger digital health ecosystem.

Contributors

  • Emeka Chukwu, Co-Convener & Technology Lead, Digital Health Interoperability Network (DHIN)

The above summary is based on the answers to the State of FHIR Survey 2026, organized by Firely and HL7 International.