President Bola Ahmed Tinubu has ordered all Ministries, Departments, and Agencies (MDAs) to enroll their employees in the National Health Insurance Authority (NHIA) scheme, a directive seen as a decisive step toward achieving universal health coverage (UHC) in Nigeria.
The move addresses one of the country’s biggest healthcare challenges—low insurance penetration. Fewer than 10% of Nigerians are covered, while out-of-pocket spending still accounts for more than 70% of total health expenditure, according to the World Bank.
Although the NHIA Act 2022 made insurance mandatory and created a Vulnerable Group Fund (VGF) to subsidise the poor, implementation has been slow. Tinubu’s order now seeks to change that by making compliance a requirement for core government functions.
The Five Game-Changing Measures
- MDAs must ensure all staff are enrolled in the NHIA scheme, with the option of supplementary private coverage.
- Companies bidding for government contracts must show valid NHIA insurance certificates.
- Licenses and permits will be tied to proof of coverage.
- A digital verification system will be developed to authenticate certificates and curb fraud.
- MDAs must establish internal monitoring systems to enforce compliance.
Speaking at the recent National Health Financing Policy Dialogue in Abuja, NHIA Director-General Dr. Kelechi Ohiri said the digital verification platform will provide reliable data and reduce fraudulent practices.
Why It Matters
Analysts say the order tackles a historic weakness—lack of enforcement. By linking insurance to employment, procurement, and licensing, the government is shifting coverage from aspiration to necessity, while also building trust in a system long plagued by inefficiency.
Experts warn, however, that challenges remain. Weak digital infrastructure, inequitable healthcare resources, and low adoption in the informal sector—where coverage is just 3.4%—could slow progress. Effective management of the Vulnerable Group Fund will also be critical to avoid excluding the poorest Nigerians.
What Comes Next
Nigeria now has the legal mandate, an equity mechanism, and a framework for enforcement. What is left, experts say, is disciplined execution.
“If faithfully implemented, this directive could mark the turning point where Nigerians begin to break free from the out-of-pocket trap,” one health analyst observed.
