20 years after launch, health insurance covers less than 10% of Nigerians

The National Health Insurance Authority (NHIA) said 23.06 million people were covered as of October 2026, up from 16.20 million in late 2023.

The figure represents about 9.5 per cent of Nigeria’s estimated 243.8 million population as of Thursday, October 29, 2026, according to Worldometer, a website that publishes population estimates. This suggests that more than nine in every 10 Nigerians are not captured in the health insurance coverage figure.

The Director-General of the NHIA, Kelechi Ohiri, disclosed the figures at the 11th edition of the Future of Health Conference 2026, organised by Nigeria Health Watch in Abuja on Thursday, October 29.

Ohiri said expanding health insurance coverage must translate into access to quality healthcare, the availability of essential medicines, and protection against excessive out-of-pocket expenditure.

The conference, themed “From Innovation to Impact: The Future of Health is Now”, brought together policymakers, health professionals, innovators, development partners and other stakeholders to discuss ways to improve healthcare delivery.

The ICIR reports that the National Health Insurance Scheme (NHIS), which was later transformed into the National Health Insurance Authority (NHIA), was launched in 2005.

The organisation has struggled under successive leaderships to enrol Nigerians in the scheme, with progress remaining slow.

The low enrolment of Nigerians in the scheme has hampered the country’s efforts to achieve universal health coverage. It also contributes to high out-of-pocket healthcare spending, self-medication, exploitation by private healthcare facilities and preventable deaths, among other consequences.

Ohiri said enrolment under the Basic Health Care Provision Fund gateway increased from 2.64 million in the second quarter of 2026 to 3.18 million in the third quarter.

He said all enrollees under the gateway had undergone biometric verification using their National Identification Numbers to strengthen accountability.

The NHIA also reported an increase in enrolment under its Global Fund-supported health insurance initiative for key populations in Gombe, Anambra, Ebonyi and Kwara states. Enrolment rose from 25,815 in the fourth quarter of 2025 to 58,447 in the third quarter of 2026.

The NHIA said it had introduced digital tools to help enrollees understand their benefits and exercise their rights.

“These include the MyNHIA mobile application, an online self-enrolment portal and quick response codes providing information on covered consultations, diagnostic services and medicines.

“The authority reported receiving and tracking 2,209 complaints from enrollees, healthcare facilities and health maintenance organisations, with 82 per cent resolved within 48 hours,” he said.

He said the NHIA secured refunds for some enrollees who were improperly charged by healthcare facilities, while it issued formal warnings and delisted providers over persistent non-compliance.

Ohiri said the authority’s maternal and newborn health programmes had reached 96,068 beneficiaries as of October 2026.

He said the maternal emergency care programme had treated 80,906 women across 263 accredited facilities, while the Fistula Free Programme had reached 6,059 women across 19 specialised facilities.

The neonatal emergency care programme had also reached more than 9,103 newborns, he added.

To improve healthcare quality, the NHIA is transitioning from static provider accreditation to an empanelment model that assesses facilities based on clinical quality, financial sustainability, data integrity and governance.

Ohiri also highlighted Nigeria’s National Health Technology Assessment Roadmap, Framework and Process Guidelines, which are intended to support evidence-based decisions on healthcare benefits, treatment options and resource allocation.

He said the reforms aligned with the Federal Government’s Strategic Health Sector Blueprint introduced in 2023 to improve health outcomes, reduce financial hardship and expand access to essential healthcare.

Ohiri said the ultimate test of health financing reforms would be whether Nigerians could obtain timely, quality healthcare without being pushed into financial hardship.

On her part, the Managing Director of Nigeria Health Watch, Vivianne Ihekweazu, said the conference provided a platform for discussions on major challenges facing the health sector over the past decade.

She said the sector needed to move beyond discussions about potential innovations and address the financing, policy, procurement and data systems required to scale effective solutions.

Ihekweazu cited a review of digital innovations in maternal and newborn health in Nigeria, which found that none of the 10 interventions assessed had achieved sustained scale.

She said the challenge was not necessarily that the interventions had failed, but that many lacked institutional ownership and clear pathways into routine healthcare delivery.

Ihekweazu urged stakeholders to prioritise sustainability and wider implementation from the outset rather than allow promising innovations to remain isolated pilot projects.

Mustapha Usman is an investigative journalist with the International Centre for Investigative Reporting. You can easily reach him via: musman@icirnigeria.com. He tweets @UsmanMustapha_M

Save my name, email, and website in this browser for the next time I comment.

This site uses Akismet to reduce spam. Learn how your comment data is processed.

We invite you to support us to continue the work we do. Your support will strengthen journalism in Nigeria and help sustain our democracy.

We need your support to produce excellent journalism at all times.