Lagos — The National Health Insurance Authority (NHIA) has recorded a significant increase in health insurance coverage, with enrolment exceeding 22 million Nigerians, reflecting the growing impact of mandatory health insurance and ongoing reforms aimed at achieving Universal Health Coverage (UHC).
Speaking at the Annual General Meeting of the Nigerian Association of Insurance and Pension Editors (NAIPE) in Lagos, NHIA Director-General Dr. Kelechi Ohiri said health insurance enrolment has reached 22.03 million, representing a 35 per cent year-on-year increase driven by stronger collaboration across the public and private sectors.
According to him, Nigeria’s health insurance reforms have entered a new phase focused on implementation, with greater emphasis on expanding access to healthcare, strengthening consumer protection and improving the quality of services delivered to enrollees.
“Our challenge is no longer developing policies or legislation,” Ohiri said. “The priority now is ensuring effective implementation that translates government commitment into accessible healthcare for Nigerians.”
He attributed the growth in enrolment to closer partnerships with State Social Health Insurance Agencies (SSHIAs), increased engagement with Ministries, Departments and Agencies (MDAs), employers, organised labour, Health Maintenance Organisations (HMOs) and the gradual enforcement of the mandatory health insurance provisions contained in the NHIA Act.
Consumer protection measures strengthened
The NHIA also reported significant progress in protecting health insurance consumers through enhanced regulatory oversight and faster complaint resolution.
Ohiri disclosed that the Authority has resolved 3,878 complaints, representing an 87 per cent resolution rate, with 95 per cent of cases concluded within prescribed timelines.
He added that affected enrollees have received refunds exceeding ₦14.2 million, while sanctions have been imposed on healthcare providers found to have breached operational standards.
As part of broader service improvements, the Authority has introduced new performance benchmarks, including a one-hour target for the commencement of treatment for enrollees requiring urgent medical care.
Higher provider payments to improve healthcare delivery
To strengthen healthcare service delivery, NHIA has also reviewed provider reimbursement rates.
Capitation payments have increased by 93 per cent, while fee-for-service reimbursements have risen by 378 per cent, measures expected to improve the financial sustainability of healthcare facilities and support investment in medical personnel, equipment and infrastructure.
The Authority further disclosed that 7,592 healthcare facilities have undergone assessment under the SafeCare quality improvement framework as part of efforts to standardise service delivery nationwide.
Focus on vulnerable populations
Beyond expanding insurance coverage, NHIA said it continues to prioritise vulnerable groups through targeted interventions.
The Authority reported that more than 48,500 pregnant women have benefited from healthcare support programmes, alongside expanded maternal and newborn health services, implementation of the Vulnerable Group Fund and improved healthcare access for pensioners and retirees.
According to Ohiri, these initiatives are designed to ensure that financial barriers do not prevent vulnerable Nigerians from accessing essential healthcare services.
Insurance reforms gathering momentum
The NHIA Director-General described the transition from the former National Health Insurance Scheme (NHIS) to the National Health Insurance Authority as a major institutional reform that has strengthened regulation, accountability and strategic purchasing within Nigeria’s health insurance ecosystem.
He noted that the legal framework established by the NHIA Act has created a stronger foundation for expanding insurance coverage and improving governance across the sector.
For Nigeria’s insurance industry, the continued growth in health insurance enrolment represents a significant milestone in efforts to deepen insurance penetration and reduce out-of-pocket healthcare spending. Industry observers say sustained collaboration between government, HMOs, healthcare providers and employers will be critical to maintaining the momentum toward universal health coverage and strengthening confidence in the country’s health insurance system.
