Health insurance enrolment in Nigeria has risen above 23 million, with the National Health Insurance Authority expanding financial protection for patients with cancer, HIV/AIDS and tuberculosis, as well as strengthening maternal and newborn healthcare programmes.
The Director-General and Chief Executive Officer of the NHIA, Dr Kelechi Ohiri, disclosed this at the inaugural Civil Society Organisation-led Mid-Year Review of the National Health Sector Reforms in Abuja.
Ohiri said the authority was moving beyond a focus on enrolment figures to ensuring that health insurance membership translated into access to healthcare, financial protection and measurable health outcomes.
He said the effectiveness of the insurance system should increasingly be assessed by the protection available to beneficiaries when they require medical treatment, rather than simply by the number of people registered.
Expanded cancer protection
The NHIA has introduced additional financial support for cancer patients through a cost-sharing arrangement with pharmaceutical company Roche for selected oncology medicines.
Under the arrangement, Roche covers 50 per cent of the cost, the NHIA contributes 30 per cent, while eligible patients pay the remaining 20 per cent.
The authority has also introduced support ranging from up to N400,000 to full coverage for eligible radiotherapy patients, complementing existing cancer benefits that include mammography, CT and MRI scans, bone scans, cancer-related diagnostic tests and radiotherapy.
Ohiri said the partnership demonstrated how collaboration among government, insurers, healthcare providers and pharmaceutical companies could help reduce the financial burden associated with expensive medical conditions.
He said cancer care illustrated the importance of ensuring that insurance coverage provided meaningful financial support when beneficiaries became ill.
HIV and TB coverage expands
Beyond cancer, the NHIA is using the Global Fund Resilient and Sustainable Systems for Health grant to extend insurance protection to people living with HIV and patients receiving treatment for tuberculosis.
As of September 3, 2026, more than 51,000 people had been enrolled under the programme in Anambra, Ebonyi, Gombe and Kwara states.
The beneficiaries comprise more than 46,000 primary beneficiaries and approximately 3,700 household members.
More than 38,000 of the primary beneficiaries are people living with HIV, while over 7,400 are patients with drug-sensitive tuberculosis and 594 are receiving treatment for drug-resistant TB.
Ohiri said the NHIA had begun accrediting more than 2,000 healthcare facilities ahead of the implementation of the Global Fund GC8 programme, with plans to expand HIV and TB insurance coverage nationwide in 2027.
Maternal, newborn interventions
The authority also reported progress in maternal and newborn healthcare through its Comprehensive Emergency Obstetric and Newborn Care and Fistula-Free programmes.
According to Ohiri, more than 93,000 women and newborns have been reached through the interventions. The figure includes 79,221 women, 7,500 newborns and 6,044 women treated for obstetric fistula.
The programmes are being implemented across the 36 states and the Federal Capital Territory through 286 CEmONC-empanelled facilities and 22 National Obstetric Fistula Centres and partner facilities.
More than 40,000 women have also been enrolled through the Basic Health Care Provision Fund.
Ohiri said participating maternal health facilities recorded a 22 per cent reduction in case fatality, from 1,042 in the 2024 baseline to 810 as of August 2026.
The wider insurance expansion under the BHCPF has also brought more than 2.7 million poor and vulnerable Nigerians into coverage, according to the NHIA.
Patient protection and provider accountability
Alongside expanding coverage, the authority said it had intensified efforts to protect beneficiaries and improve healthcare provider compliance.
Ohiri disclosed that 3,878 enrollee complaints had been resolved, with more than N14.2 million refunded to affected beneficiaries.
The NHIA has also issued 368 warning letters to healthcare providers and suspended nine facilities over identified infractions.
Inspection teams have been deployed to healthcare facilities to monitor compliance with the authority’s one-hour treatment authorisation policy and other patient-protection requirements.
The reforms have also affected payments to healthcare providers. According to the NHIA, capitation has increased by 93 per cent, while fee-for-service reimbursements have risen by 378 per cent.
More than 7,500 healthcare facilities have also undergone digital assessment under the SafeCare quality framework as part of efforts to strengthen standards across the health insurance delivery system.
Ohiri said the reforms represented a shift from focusing primarily on policy and enrolment towards access, quality assurance, provider accountability, patient rights and financial protection.
However, he acknowledged that despite the increase in enrolment, millions of Nigerians remained outside the health insurance system.
He said the more than 23 million people currently covered represented significant progress but also highlighted the scale of the remaining gap in the drive towards universal health coverage.
The NHIA said its next phase would therefore focus on expanding enrolment while ensuring that existing beneficiaries receive reliable access to quality healthcare and meaningful financial protection.
