D-G reflects on progress, challenges of Nigeria’s health insurance


Dr Kelechi Ohiri, the Director-General, National Health Insurance Authority (NHIA), reviewed the progress and challenges of Nigeria’s health insurance scheme since its inception in 1999.

This is because in spite of advancements, significant issues such as low coverage, uneven distribution, and persistent quality concerns continue to hinder the scheme’s effectiveness.

Ohiri reviewed the scheme on Friday in Abuja at the NHIA Strategic Stakeholders Engagement, in collaboration with Nigeria Universal Health Coverage Forum and Local Health System Sustainability (LHSS) Project Nigeria.

The News Agency of Nigeria (NAN) reports that the NHIA Act was signed into law on May 19, 2022, repealing the National Health Insurance Scheme Act of 2004 which addresses some of the challenges of the old law, by providing for mandatory health insurance and establishing the Vulnerable Group Fund.

It also transforms the NHIA into a promoter, integrator and regulator of all health insurance schemes in Nigeria.

The review of the NH
IA by the director-general is, therefore, in line with the desired goal of achieving Universal Health Coverage (UHC) in Nigeria with the theme ‘The NHIA Act: Two Years After – Reflections and Future Direction.’

The review was to reflect on the past, assess the present situation and share a common vision for the future of health insurance in the country.

Ohiri, therefore, underscored the transformative shift introduced by the NHIA Act, which mandates health insurance for all Nigerians, establishes state-specific schemes, creates a vulnerable group fund, and enhances the NHIA’s regulatory functions.

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He pointed out that while 62 per cent of the formal public and private sectors are covered, the large informal sector lags with only one per cent coverage.

He said that expanding healthcare access to the informal sector and vulnerable populations remain a critical objective.

He explained that going forward, NHIA’s vision to achieve universal health cove
rage would focus on enforcing mandatory insurance, increasing public awareness and trust in the system, improving quality standards and market efficiency, as well as operationalise funds dedicated to vulnerable groups.

He reiterated NHIA’s commitment to transparency, setting robust standards and regulating the fragmented health insurance landscape.

He, however, noted that achieving these goals require collective efforts from stakeholders.

He called for regular hosting of interactive stakeholder sessions, saying ‘we must come together routinely to address challenges in Nigeria’s health insurance landscape through consistent dialogue and collaboration.’

Dr Bolanle Olusola-Faleye, the Chief of Party, LHSS, said it was an opportunity for essential investments in Nigeria’s Health Sector Renewal Initiative, particularly on financial risk protection for the poor and vulnerable.

The NHIA strategic stakeholders engagement panel discussion was moderated by Gafar Alawode, the Director of DGI Consult Limited, which
featured representatives from Health Maintenance Organisations (HMOs), state health insurance schemes, and Civil Society Organisations (CSOs).

Alawode said that the panel aimed to foster collaboration to enhance coverage in alignment with NHIA’s vision for health insurance in Nigeria.

Dr Francis Ukwuije, the Health Economist, WHO Nigeria, stressed the importance of prioritising data on key health insurance programme outputs, such as healthcare service usage, to support informed decision-making.

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Meanwhile, Dr Mustapha Lecky, the Chairman, Health System Reform Coalition of Nigeria (HSRCN), said the organisation is collaborating with other groups to achieve their mandates.

Lecky said that as an umbrella of coalition, HSRCN believes in collaboration, partnerships, support, planning and strategic approach.

He called for more deliberate engagements to drive advocacy and progress under the NHIA Act.

Earlier on Friday at the Ministerial Sectoral Brie
fing to mark the first anniversary of President Bola Tinubu’s administration, Prof. Ali Pate, the Coordinating Minister of Health and Social Welfare, highlighted key achievements of NHIA.

Pate said ‘the NHIA is being repositioned to increase insurance coverage for all Nigerians, with particular focus on the poor and vulnerable. Currently, 1.8 million Nigerians are covered through the Vulnerable Groups Fund at the NHIA.’

He added that ‘forthcoming reforms will strengthen NHIA, which will target expanding private health insurance for the informal sector and strengthening Health Maintenance Organisations (HMOs), in collaboration with State Social Health Insurance Agencies (SSHIA).’

He also said that ‘the NHIA’s involvement in funding and equipping primary healthcare centres will ensure they provide skilled birth attendants and essential services.

‘It will support training programmes for health workers, ensuring they have the necessary skills and infrastructure to deliver quality care, particularly in rural a
reas.

Source: News Agency of Nigeria