Why health insurance is ineffective in Nigeria – NHIA boss

The Director General of the National Health Insurance Authority (NHIA), Kelechi Ohiri, has said that low coverage, uneven distribution, and persistent quality concerns have continued to hinder the effectiveness of health insurance in the country despite notable advancements.

Ohiri said this at the NHIA’s strategic stakeholders engagement in collaboration with Nigeria Universal Health Coverage Forum and Local Health System Sustainability Project (LHSS), Project Nigeria in Abuja.

The NHIA boss noted that while 62 per cent of the formal public and private sectors are covered by health insurance, the large informal sector lags with only one per cent of coverage.

He observed that expanding access to this informal sector and vulnerable populations remains a critical objective of the NHIA.

The event with the theme, “The NHIA Act: Two Years After – Reflections and Future Direction” was designed to reflect on the past, assess the present situation, and share a common vision for the future of health insurance in Nigeria.

The NHIA boss noted that the transformative shift introduced by the NHIA Act 2022, which mandates health insurance for all Nigerians, establishes state-specific schemes, created a vulnerable group fund, and enhanced the NHIA’s regulatory functions.

He expressed the NHIA’s vision to achieve universal health coverage by: “Enforcing mandatory insurance, increasing public awareness and trust in the system.improving quality standards and market efficiency and operationalising funds dedicated to vulnerable groups”.

Ohiri reiterated NHIA’s commitment to transparency, setting robust standards, and regulating the fragmented health insurance landscape stressing that achieving these goals requires collective effort from all stakeholders.

He called for regularly hosting interactive stakeholder sessions, stating “We must come together routinely to collectively address challenges in Nigeria’s health insurance landscape through consistent dialogue and collaboration.

Also speaking, Chief of Party, LHSS, Dr Bolanle Olusola-Faleye, said that it was an opportunity for significant investments in Nigeria’s Health Sector Renewal Initiative, particularly focusing on financial risk protection for the poor and vulnerable.

The NHIA strategic stakeholders engagement panel discussion, moderated by Gafar Alawode, Director of DGI Consult Limited, featuring representatives from Health Maintenance Organizations (HMOs), state health insurance schemes, and Civil Society Organizations (CSOs).

Alawode said that the panel aimed to foster collaboration to enhance coverage in alignment with NHIA’s vision for health insurance in Nigeria.

Dr Elaine Baruwa said that enrollment was merely a step towards the ultimate goal of translating enrollment into tangible health benefits

Baruwa called for compelling business case for health investments that appeal to financial decision-makers.

Dr Francis Ukwuije, Health Economist, WHO Nigeria, stressed the importance of prioritising data on key health insurance programme outputs, such as healthcare service usage, to support informed decision-making.