Nigeria: Making Health Go Viral, The Aproko Way

Before school, Dr Chinonso Egemba sold pap at a junction in Aguda, Surulere, where he had seconds to catch a passer-by's attention. Today, as an Aproko Doctor, he uses that same skill online, making health information as easy to share as gossip.

In Nigeria, an aproko is someone who knows everybody's business and cannot keep it to themselves. Dr Egemba gave the word a health twist: what if medical information travelled through a community as quickly as gossip, shared by someone people trust?

"I'm a doctor," he said. "That's still the main thing. I just do most of my doctoring on the internet now."

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Selling pap taught him something he still applies to social media: people will not stop scrolling unless you give them a reason to. At the junction, he had seconds to attract a customer. "People are walking past, minding their business, and you have a few seconds to make them stop," Egemba said.

Social media, he said, is the same junction with a bigger crowd. Your first line decides everything. People are scrolling past. So he opens with something his audience already does. "That headache you treat with paracetamol every morning might be your blood pressure." This is more likely to make someone pause than "Today we will discuss hypertension"; they're gone."

The difference is not simply that one sounds more dramatic. It is that the second begins with something familiar and connects it to a question worth exploring.

"What took me longer to learn is that getting attention is the easy part," he said. "A shocking hook gets you one view. People come back because they left the last video feeling like they learned something and nobody talked down to them."

The patient who changed everything

The turning point was not a viral video. It was a patient.

Early in his medical career, Dr Egemba lost a patient to a stroke that should have been preventable. The patient's blood pressure had been high for a long time. Nobody had sat them down to explain what that number meant, or that one cheap tablet a day could have prevented the stroke.

"That's what stayed with me," he said. "The treatment was there. The information just never got to them in a way they could understand and act on."

So he started tracking where Nigerians actually get their health information.

The answer: WhatsApp broadcasts, social media, the man selling herbal mixture on the bus. Doctors were mostly not there, and when they were, they sounded like a textbook. Nigeria has roughly four doctors for every ten thousand people. The clinic was never going to reach everybody in time. With too few doctors to reach everyone in time, Dr Egemba began to consider another possibility: if the doctor could not get to the people, perhaps the knowledge could get there first.

Today, millions follow him on social media, where he explains health issues in everyday language with relatable stories, familiar characters, and just enough humour to keep you listening. His digital reach is hard to miss: Aproko Doctor has 2.5 million followers on X, more than 930,000 YouTube subscribers, 2.8 million TikTok followers, over 188,000 followers on LinkedIn, and 2,3 million followers on Instagram and 3,2 million followers on Facebook.

Of course, putting health information online does not automatically make it accessible.

Egemba said that the hardest to reach are people who do not consume health information in languages they understand, those whose health decisions are controlled by others, and communities whose trust in official healthcare systems has been eroded. He said that Nigeria has more than 500 languages, yet most credible health content is in English or Pidgin. For people who primarily speak Hausa, Kanuri, Fulfulde or other indigenous languages, the information they need may not be available in a language they comfortably understand.

That gap can leave people relying on whoever is available and trusted, regardless of whether that person has the medical knowledge to guide them safely. "That's why we're building health channels in indigenous languages, starting from the north," said Dr Egemba.

Language, however, is only one part of the problem.

Sometimes, the person receiving the information is not the person making the final decision.

"A young mother can understand perfectly why her child needs to be immunised. But if her husband, her mother-in-law, or the religious leader says no, it ends there. So you have to talk to the person making the decision too, not just the patient," he said. If those people oppose vaccination, the mother's knowledge alone may not be enough to change what happens.

He also pointed to the people the system has let down too many times. They don't trust anything official anymore. Even when the message is correct, it sounds like propaganda to them, Egemba said.

In such circumstances, repeating the same message more loudly is unlikely to solve anything. He said that you can't send one message to everybody and expect it to land the same way. The general messages mostly reach people who were already going to be fine.

Dr Egemba's videos may make people laugh, but the humour is carefully chosen. The purpose is serious: to help people understand their bodies, challenge medical misinformation and make better decisions about their health.

He is candid that the humour is planned. "Very deliberate," he said. "But the joke is never the point. It's like the sugar coating on a tablet. It helps people swallow it, but the medicine inside still has to be right."

Stories, he finds, do more work than statistics.

His audience follows two recurring characters, Emeka and Nkechi, as they make health decisions and deal with the results. "Somebody who will never read a leaflet on hypertension will go into the comments and fight about whether Emeka should have taken his drugs." Fear alone does not work either. If every video says a thing will kill you, he explained, viewers panic or stop watching, so "I show what can happen, and then I show what to do about it."

There is a careful balance to maintain, however. Fear can attract attention, but a constant stream of warnings that everything will kill you can leave people anxious, overwhelmed, or simply unwilling to listen. The thing he is most careful about is not laughing at people. "It's very easy to start mocking people who believe a myth," he said. "Once they feel you're laughing at them, they're gone, and they go straight to whoever is selling the myth."

His aim is not to make someone feel foolish for misunderstanding a medical issue. It is to make understanding easier.

If a funny version of a story is not medically accurate, he said, it does not get published.

That rule is especially important in a digital environment where simplified messages can quickly lose their nuance and where an entertaining falsehood may be more memorable than a careful explanation.

Fighting misinformation

Health misinformation is not merely a problem of people believing the wrong thing. It is also a problem of who gets to speak, whose voice people trust, and how quickly a claim travels.

Dr Egemba said that health professionals must do more than correct misinformation after it spreads. They need to show up in the digital spaces where myths circulate and, where possible, get ahead of them.

"First, be where the myths are," he said. "Most health professionals are not on these platforms, so other people fill that space."

He also advocates prebunking, an approach that teaches people to recognise manipulation tactics before they encounter misleading claims. "Instead of chasing every false claim after it has spread, you teach people the tricks, like fake experts, scare tactics and false choices, so they can spot them next time." A large Cambridge-led study tested short prebunking videos on YouTube and found a modest but real improvement in viewers' ability to spot manipulation. Corrections after the fact still matter, he said, "but you're always playing catch up."

When he does correct something, he avoids embarrassing anyone. He starts with what is true, mentions the myth briefly, explains why it is wrong, then repeats the truth. "Don't make the myth louder than the fact," he said.

He also wants health communicators to stop working alone.

"One doctor arguing with a viral post is easy to ignore," so he has helped build a group of Nigerian health communicators who hold themselves to common standards, sharpen their reading of research, and approach companies and platforms together. He added that health professionals can also spread inaccurate information, even unintentionally, and should be prepared to correct it publicly when they do.

His approach to health communication has not been without criticism.

"Some colleagues think a doctor making jokes online makes the profession look unserious," he said. "Some people disagree with positions I've taken. And some of it has been coordinated attacks, which is a different thing from honest disagreement."

He distinguishes between legitimate challenges to his facts, which he takes seriously, and objections to his style, which he is less inclined to abandon.

"If someone says I got a fact wrong, I take it seriously, and I move quickly. If I'm wrong, I correct it publicly. People trust you more when they see you correct yourself," he said. "If the criticism is about my style, I listen, but I'm not dropping it. The style is why the information reaches people who would never read a medical journal. What matters is that the information is accurate. It doesn't need to sound formal to be accurate."

As for attacks aimed at undermining him, Dr Egemba said that he prefers to keep working, provide his sources, and let the quality of his work speak for itself.

However, one of his biggest challenges is deciding what to leave out.  The easier the topic, the easier it is to understand, but this also means that important details are missed.  Every time you simplify, you're dropping something. If I say "too much salt raises your blood pressure," that's useful and mostly true, but I've left out genetics, kidney function, age, and stress. So I ask myself, if I leave this out, will it change what the person does? If yes, it stays, even if fewer people watch. If no, I can cut it."

That balance can be difficult on social media, where certainty often attracts more attention than nuance. He said he tries to be clear about what people can do while remaining honest about what medicine does not always explain with certainty.  "Know your blood pressure number" is clear. Why your number is different from your friend's is where the nuance comes in.

There is also the limitation of communicating through a screen.

In a clinic, he can tell when someone hasn't understood. Online, someone with a completely different condition might follow advice meant for someone else. "So I say who the advice is for, and I say clearly when you need to see a doctor and not just watch a video," he said.

From viral videos to digital healthcare

Dr Egemba's work has also expanded beyond content creation into the infrastructure needed to connect people with care.

He leads the Aproko Doctor Foundation as Executive Director, runs the Aproko Doctor Academy, which trains health professionals in communication, and co-founded Awadoc, a digital primary care platform.

Scaling digital health tools across Nigeria and Africa requires more than a good idea or a successful pilot. He said that many projects disappear when donor funding runs out because their creators have not established who will pay to keep them running.

"A lot of them are pilots that never become anything," he said. A donor funds a year of work, the pilot succeeds, the money ends, and the tool disappears. He points to Uganda, where in 2012 the health ministry grew so tired of uncoordinated mobile health pilots that it paused new ones. "A pilot can show that something works," he said. "It almost never answers who will pay for it."

Payment is a particularly difficult challenge in Nigeria, where a large share of healthcare costs comes directly from people's pockets. According to WHO figures, roughly seven out of every ten naira comes straight from people's pockets. "If your tool is waiting for an insurer or the government to pay, you're building for a system that mostly isn't there yet," he said.

Trust is another barrier.

"People also don't just download a health app because it exists. They use what someone they trust recommended. Plenty of good tools fail because nobody trusts them," he said.

Then comes the physical gap. An app can help assess a patient's symptoms in seconds, but the patient may still need tests, medication or an in-person consultation. Thousands of doctors have left Nigeria in recent years. "If a digital tool isn't connected to real pharmacies, labs and clinicians, it can't finish the job," he said. Access is uneven too. He said broadband reaches about 56% of Nigerians this year, so many people are still offline, and the cost of data and power remains a barrier.

Dr Egemba said that digital health developers must think beyond building the technology. Funders, he said, should support things that can grow and plug into the health system, not just new ideas. Builders should figure out how they'll reach people and who will pay before adding features. Governments need clear rules on data and standards so good tools can connect to public systems.

These considerations have shaped Awadoc, the primary care platform he co-founded. Built around WhatsApp, a service many people already use, it connects users to partner pharmacies, laboratories and clinicians.

"People already use it," he said. "Behind it are partner pharmacies, labs and clinicians. More than 200,000 people have registered, and most of them came because they heard about it from someone they already trusted."

Making prevention part of everyday life

For all the platforms, programmes and videos, Dr Egemba's ultimate goal is relatively simple: he wants people to think about their health before something goes wrong.

"I want people to start thinking about their health before something hurts," he said. "Right now, for a lot of people, health starts when there's pain, and by then it's expensive or too late."

He wants people to know their blood pressure numbers as readily as they know their phone numbers, check product labels before making purchases and recognise the warning signs of a stroke well enough to act immediately. More than that, he wants people to understand that knowledge of their own bodies should not be the exclusive preserve of medical professionals.

"Whether you're in Aguda, Kano or Soweto, it's your body; you should understand it," he said.

Dr Egemba hopes more doctors and nurses come to see communication as part of the work. "I'm one person," he said. "If many more health workers learn to explain things well and people trust them, that can change a lot."