NHIA Coverage Hits 22 Million, Health Insurance Enrolment Grows 35%

By LOVETH-AZODO CHIJIOKE, Lagos

Nigeria has recorded a significant increase in health insurance coverage, with more than 22 million citizens now enrolled under various health insurance schemes as the implementation of mandatory health insurance continues to gather pace nationwide.

The Director-General of the National Health Insurance Authority (NHIA), Dr. Kelechi Ohiri, disclosed this in Abuja while addressing members of the Nigerian Association of Insurance and Pension Editors (NAIPE) at the association’s Annual General Meeting. He said the Authority’s reform initiatives are beginning to deliver tangible results by expanding access to healthcare, improving service delivery and strengthening consumer protection.

Ohiri revealed that total enrolment has risen to 22.03 million, representing a 35 per cent increase over the previous year. He attributed the growth to closer collaboration with State Social Health Insurance Agencies (SSHIAs), Ministries, Departments and Agencies (MDAs), organised labour, employers, development partners and the phased implementation of the mandatory health insurance provisions contained in the NHIA Act.

According to him, the country has already established the legal and policy framework needed to achieve Universal Health Coverage (UHC), adding that the focus must now shift to effective execution.

He said: “Nigeria has the policy. Nigeria has the legislation. The decisive variable is now implementation—consistent, rigorous and accountable execution that converts political commitment into healthcare access for real Nigerians.”

The NHIA boss explained that the transition from the former National Health Insurance Scheme (NHIS) to the National Health Insurance Authority has strengthened the institution’s regulatory capacity, improved accountability and enhanced consumer protection, while providing a stronger foundation for expanding healthcare coverage across the country.

He noted that protecting the interests of enrollees remains central to the Authority’s reform agenda, with greater oversight of Health Maintenance Organisations (HMOs) and healthcare providers as well as a more responsive complaints resolution system.

Providing an update on consumer protection, Ohiri said the Authority has resolved 3,878 complaints, representing an 87 per cent resolution rate, while 95 per cent of the cases were concluded within the prescribed timelines. He added that over ₦14.2 million has been refunded to enrollees, with sanctions imposed on healthcare providers and HMOs found to have violated operational standards.

To improve the quality of healthcare delivery, the Authority has also introduced new service benchmarks, including a one-hour response target for patients requiring emergency medical attention under the scheme.

He further disclosed that capitation payments to healthcare providers have been increased by 93 per cent, while fee-for-service reimbursements rose by 378 per cent to enable providers improve infrastructure, procure equipment and strengthen manpower.

In addition, 7,592 healthcare facilities have undergone assessment under the SafeCare quality improvement programme to enhance service standards nationwide.

Ohiri also highlighted interventions targeted at vulnerable groups, including healthcare support for more than 48,500 pregnant women, expansion of maternal and newborn health services, implementation of the Vulnerable Group Fund and increased attention to the healthcare needs of pensioners and retirees.

He said the reforms are in line with President Bola Tinubu’s Renewed Hope Agenda and complement ongoing health sector reforms being coordinated by the Coordinating Minister of Health and Social Welfare, Professor Muhammad Ali Pate.

While acknowledging that the journey towards Universal Health Coverage is still ongoing, Ohiri expressed confidence that the progress already recorded demonstrates that sustained collaboration, stronger implementation and greater accountability will accelerate access to quality healthcare for millions of Nigerians.