Implementation of Non-communicable Diseases Interventions in Primary Health Care Facilities and at the Community Level in Nigeria: A call to Action and Partnership.

Schizophrenia is a severe, chronic mental disorder characterized by disturbances in thought, perception, and behavior, often requiring long-term antipsychotic medication for stabilization and relapse prevention. However, medication non-adherence remains one of the most persistent challenges in schizophrenia management, with global estimates ranging between 40–60% [,]. Non-adherence contributes to relapse, re-hospitalization, poor social functioning, increased suicide risk, and higher healthcare costs [–]. In Nigeria, as in many low- and middle-income countries (LMICs), adherence rates are particularly poor due to stigma, low health literacy, poor doctor-patient communication, irregular clinic attendance, and limited resources [,]. A study in South-West Nigeria found that nearly two-thirds of patients with schizophrenia demonstrated poor adherence to prescribed medications []. Similarly, studies in Ghana and Kenya have reported adherence levels below 50% [,]. Digital health interventions offer innovative strategies to tackle this problem. With mobile phone penetration exceeding 90% in Nigeria [], SMS-based interventions provide a scalable, low-cost method of enhancing adherence. Previous studies in chronic conditions like HIV, diabetes, and hypertension in sub-Saharan Africa have demonstrated improved adherence outcomes with SMS reminders [–].