Health insurance enrolment under the National Health Insurance Authority (NHIA) has risen above 23 million Nigerians, as the authority expands financial protection for patients dealing with cancer, HIV/AIDS and tuberculosis.
The Director-General and Chief Executive of the NHIA, Dr Kelechi Ohiri, disclosed this in Abuja at the inaugural Civil Society Organisation-led Mid-Year Review of the National Health Sector Reforms.
Ohiri said the authority was moving beyond establishing the policy and legislative framework for universal health coverage to ensuring that insurance membership translated into access to healthcare, financial protection and measurable health outcomes.
He said the effectiveness of the insurance system should no longer be assessed primarily by the number of Nigerians with insurance records, but by whether those records provide meaningful protection when illness occurs.
New Support for Cancer Treatment
The shift is particularly evident in cancer care, where the NHIA has introduced 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 financial support ranging from up to N400,000 to full coverage for eligible radiotherapy patients.
The intervention complements existing cancer benefits covering services such as mammography, CT and MRI scans, bone scans, cancer-related diagnostic tests and radiotherapy.
Ohiri said the early results of the partnership demonstrated the potential for collaboration among government, insurers, healthcare providers and pharmaceutical companies to reduce the financial burden associated with high-cost diseases.
“For us, coverage has to mean something when people become ill. Cancer is one of the clearest examples of why health insurance matters,” he said.
He stressed that the issue was not only whether a treatment or service was listed under an insurance package, but whether patients and their families could realistically afford the cost of care.
HIV, TB Coverage Expands
Beyond cancer care, the NHIA is using the Global Fund Resilient and Sustainable Systems for Health (RSSH) grant to extend financial 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 intervention across Anambra, Ebonyi, Gombe and Kwara states.
The beneficiaries include more than 46,000 primary beneficiaries and about 3,700 household members.
Of the primary beneficiaries, more than 38,000 are people living with HIV, while over 7,400 are patients receiving treatment for drug-sensitive TB and 594 are being treated for drug-resistant TB.
Ohiri also disclosed that the NHIA had begun accrediting more than 2,000 healthcare facilities ahead of the Global Fund GC8 implementation, with plans to expand HIV/AIDS and TB insurance coverage nationwide in 2027.
Maternal and Newborn Care Records Gains
The authority’s maternal and newborn health interventions have also reached more than 93,000 women and newborns through its Comprehensive Emergency Obstetric and Newborn Care (CEmONC) and Fistula-Free programmes.
The beneficiaries include 79,221 women, 7,500 newborns and 6,044 women treated for obstetric fistula.
The programmes operate across the 36 states and the Federal Capital Territory through 286 CEmONC-empanelled facilities, as well as 22 National Obstetric Fistula Centres and partner facilities.
More than 40,000 women have also been enrolled through the Basic Health Care Provision Fund (BHCPF).
Ohiri said participating maternal health facilities had recorded improvements in outcomes, with case fatality declining by 22 per cent from 1,042 in the 2024 baseline to 810 as of August 2026.
The wider insurance expansion has also brought more than 2.7 million poor and vulnerable Nigerians into coverage through the BHCPF.
NHIA Strengthens Patient Protection
As enrolment has grown, the authority has also intensified efforts to enforce patients’ rights and improve the quality of healthcare available to enrollees.
Ohiri disclosed that the NHIA had resolved 3,878 complaints from enrollees and refunded more than N14.2 million to affected beneficiaries.
The authority 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 NHIA’s one-hour treatment authorisation policy and other requirements relating to patient protection and quality of care.
Provider Payments Increase
The reforms have also affected payments to healthcare providers, with capitation increasing by 93 per cent and fee-for-service reimbursements rising by 378 per cent.
In addition, more than 7,500 healthcare facilities have undergone digital assessment under the SafeCare quality framework as the NHIA seeks to strengthen standards across the health insurance delivery chain.
Ohiri said the reforms reflected a broader shift away from measuring progress solely through enrolment figures towards a system focused on access, provider accountability, quality assurance, patient rights and financial protection.
“We have moved from policy and legislation to measurable implementation. The next task is to move from coverage to reliable access, from reliable access to better health outcomes, and from insurance membership to genuine financial protection,” he said.
Coverage Gap Remains
Despite the growth in enrolment, Ohiri acknowledged that more than 23 million Nigerians covered under the system represented only part of the country’s population.
He said millions of Nigerians remained outside the health insurance system, making sustained expansion and improved service delivery necessary to advance universal health coverage.
“We have made substantial progress, but we are not where we need to be. Over 23 million Nigerians covered is significant, but it also tells us how much work remains,” he said.
The structure keeps the enrolment milestone as the main news while giving the cancer, HIV/TB, maternal health, patient protection and provider-payment reforms distinct sections.
