ABUJA, NIGERIA — Nigeria’s health insurance coverage remains below 10 per cent of the country’s population. This is despite a 42.35 per cent increase in the number of people covered since late 2023.
The National Health Insurance Authority said 23.06 million people were covered as of October 2026. This is up from 16.20 million in late 2023.
The figure represents about 9.5 per cent of Nigeria’s estimated 243.8 million population. This suggests that more than nine in every 10 Nigerians are not captured in the health insurance coverage figure.
The Conference
The Director-General of the NHIA, Kelechi Ohiri, disclosed the figures at the 11th edition of the Future of Health Conference 2026. The event was organised by Nigeria Health Watch in Abuja on Thursday, October 29.
Ohiri said expanding health insurance coverage must translate into access to quality healthcare. It must also ensure the availability of essential medicines and protection against excessive out-of-pocket expenditure.
The conference was themed “From Innovation to Impact: The Future of Health is Now.” It brought together policymakers, health professionals, innovators, and development partners.
History of the Scheme
The National Health Insurance Scheme, later transformed into the National Health Insurance Authority, was launched in 2005. The organisation has struggled under successive leaderships to enrol Nigerians in the scheme.
The low enrolment has hampered the country’s efforts to achieve universal health coverage. It also contributes to high out-of-pocket healthcare spending and preventable deaths.
Enrolment Increase
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. This is 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.
Digital Tools and Complaints
The NHIA said it had introduced digital tools to help enrollees understand their benefits. These include the MyNHIA mobile application, an online self-enrolment portal, and quick response codes.
The authority reported receiving and tracking 2,209 complaints from enrollees, healthcare facilities, and health maintenance organisations. It said 82 per cent were resolved within 48 hours.
Ohiri said the NHIA secured refunds for some enrollees who were improperly charged. It also issued formal warnings and delisted providers over persistent non-compliance.
Maternal and Newborn Health
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. 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.
Quality Assurance
To improve healthcare quality, the NHIA is transitioning from static provider accreditation to an empanelment model. This model assesses facilities based on clinical quality, financial sustainability, data integrity, and governance.
Ohiri also highlighted Nigeria’s National Health Technology Assessment Roadmap. The guidelines are intended to support evidence-based decisions on healthcare benefits and resource allocation.
Call for Sustainability
The Managing Director of Nigeria Health Watch, Vivianne Ihekweazu, said the conference provided a platform to discuss major challenges facing the health sector.
She said the sector needed to move beyond discussions about potential innovations. It must address the financing, policy, and data systems required to scale effective solutions.
Ihekweazu cited a review of digital innovations in maternal and newborn health. The review found that none of the 10 interventions assessed had achieved sustained scale.
She said the challenge was not necessarily that the interventions had failed. Instead, many lacked institutional ownership and clear pathways into routine healthcare delivery.
Ihekweazu urged stakeholders to prioritise sustainability and wider implementation from the outset. This would prevent promising innovations from remaining isolated pilot projects.
What This Means
The low coverage of health insurance is a major concern. It means millions of Nigerians are exposed to financial hardship when seeking healthcare.
The NHIA’s efforts to increase enrolment are commendable. But more needs to be done to achieve universal health coverage.
What Happens Next
The NHIA will continue to implement reforms. It will also work with stakeholders to expand coverage.
For now, the focus is on improving access to quality healthcare. The coming years will reveal whether Nigeria can achieve its health coverage targets.
