Telemedicine holds significant potential to transform healthcare delivery in rural Nigerian communities; however, its adoption remains constrained by various barriers. This study explores patient-level barriers, including technological access, health literacy, and cultural attitudes, as well as provider-level challenges such as training, infrastructure, and organizational support. Additionally, it investigates the role of socio-economic factors and community dynamics in shaping perceptions of telemedicine. Using qualitative interviews with 39 participants (24 patients and 15 providers), the study identifies key obstacles, including the high cost of devices and internet data, unreliable connectivity, low health literacy, and cultural stigma surrounding remote healthcare consultations. The findings align with Rogers' Diffusion of Innovation theory, revealing that barriers related to relative advantage, complexity, and compatibility significantly affect the adoption process. Strategies to mitigate these barriers include subsidizing technology costs, implementing digital literacy programs, providing culturally tailored telemedicine models, and ensuring better infrastructure and technical support for healthcare providers. Recommendations also emphasize the importance of community-centered engagement to enhance acceptance and usage. This study highlights the need for systemic interventions and participatory approaches to design context-specific solutions that address both patient and provider challenges. Future research should focus on participatory action research to develop and implement effective interventions for telemedicine adoption in rural areas.
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