Nigeria’s health insurance rolls have grown to just over 22 million people, a 35 percent jump year on year, according to National Health Insurance Authority Director General Kelechi Ohiri, who told the Nigerian Association of Insurance and Pension Editors that the authority has moved past policy formulation into the harder work of actually delivering measurable improvements in healthcare access and quality.
Nigeria has the policy, Nigeria has the legislation, Ohiri told the association’s annual meeting in Lagos, the decisive variable now is implementation, consistent, rigorous and accountable execution that turns political commitment into real healthcare access. He credited the enrolment growth to stronger partnerships with State Social Health Insurance Agencies, deeper engagement with ministries, departments and agencies, organised labour, employers and the private sector, and the gradual rollout of mandatory health insurance provisions under the NHIA Act, arguing the transformation of the old National Health Insurance Scheme into the NHIA represents a fundamental institutional reform that strengthened regulation, consumer protection and strategic purchasing.
On the enrollee experience specifically, Ohiri said the authority has strengthened its complaints management system, introduced faster resolution timelines, intensified compliance monitoring of health maintenance organisations and providers, and enforced sanctions where standards were breached, resulting in 3,878 resolved complaints, an 87 percent resolution rate, with 95 percent closed within prescribed timelines, more than N14.2 million refunded to enrollees, and sanctions against non compliant facilities. He pointed to a new one hour treatment commencement standard for enrollees needing urgent care as evidence that insurance coverage is starting to translate into timely, quality care, alongside reforms benefiting healthcare providers themselves, including a 93 percent increase in capitation payments and a 378 percent jump in fee for service reimbursements, changes he said are letting providers invest in staff, equipment and infrastructure. He noted that 7,592 healthcare facilities have now been assessed under the SafeCare quality framework as part of an effort to institutionalise continuous quality improvement nationwide.
Ohiri also highlighted targeted support for vulnerable groups, including more than 48,500 pregnant women, expanded maternal and newborn healthcare, a dedicated Vulnerable Group Fund and enhanced attention to pensioners and retirees, arguing that Universal Health Coverage only succeeds if it reaches every Nigerian regardless of income or location. He tied the authority’s reforms to President Tinubu’s Renewed Hope Agenda and the wider health sector reforms coordinated by Coordinating Minister of Health and Social Welfare Muhammad Ali Pate, listing further initiatives underway, including new healthcare provider compliance officers, memorandums of understanding with community pharmacies to eliminate medicine stock outs, a new one hour referral authorisation policy, an enrollee charter, a revised claims management protocol and stronger real time compliance monitoring, while acknowledging that substantial work still remains before Universal Health Coverage is fully achieved.
