The NHIA is poised in ensuring that Nigerians can access the health care they need to lead healthy lives, writes PETER T. UDO-AKPAN
The National Health Insurance Authority (NHIA) closed 2024 with notable achievements, marking a year of transformative strides in making healthcare more accessible and affordable for Nigerians. Under the renewed mandate provided by the NHIA 2022 Act and the leadership of the Bola Ahmed Tinubu administration, the NHIA addressed long-standing gaps in health insurance coverage and healthcare delivery, setting a strong foundation for even greater progress in 2025.
During a recent meeting with health correspondents, held on the eve of Universal Health Coverage Day, the NHIA’s Director-General, Dr. Kelechi Ohiri, delivered a comprehensive overview of the authority’s achievements and unveiled its strategic plans for the coming year. The DG reflected on the state of health insurance at the start of 2024, describing a fragmented system with low coverage and limited support for vulnerable populations. These challenges required bold interventions, and the progress made in just one year underscored the effectiveness of the NHIA’s approach.
One of the most significant milestones of 2024 was the nationwide rollout of state health insurance programs. With Akwa Ibom launching its AriseHealth initiative in September 2024, every state in the federation is now participating in providing social health insurance. This expansion culminated in an enrollment growth to 19.18 million Nigerians by the third quarter of 2024, a remarkable addition of over two million new participants in just nine months. Representing 8.9% of the population, this growth signals a determined step toward achieving Universal Health Coverage (UHC) and ensuring that no Nigerian is left behind in accessing financial protection for health services.
At the heart of the NHIA’s work in 2024 was a commitment to prioritizing the most vulnerable populations. In a country where many still face immense barriers to accessing basic healthcare, the authority took deliberate steps to bridge these gaps. The free Vesicovaginal Fistula (VVF) Treatment Initiative targeted 2.4 million low-income women living with obstetric fistula, a condition that not only causes physical pain but often leads to ostracism. By covering the costs of treatment, NHIA restored dignity and health to thousands of women, proving that targeted interventions can change lives. Additionally, the authority launched a free cesarean section initiative in partnership with the Federal Ministry of Health, ensuring that pregnant women in need of life-saving surgery were not hindered by financial constraints. This initiative exemplified the government’s commitment to reducing maternal and newborn mortality while removing cost-related obstacles to care.
In its drive to support other vulnerable groups, the NHIA secured $669 million from the Global Fund to combat HIV/AIDS and tuberculosis. These funds enabled the implementation of pilot programs in five states—Kwara, Gombe, Ebonyi, Anambra, and Lagos—where marginalized groups received health insurance coverage tailored to their needs. These pilot projects not only addressed immediate healthcare needs but also laid the groundwork for a national rollout, with lessons learned set to inform broader implementation in the years ahead.
Healthcare providers, often at the forefront of delivering essential services, also benefited from the NHIA’s reforms. Recognizing their struggles with operational costs and inflation, the authority increased capitation payments by 60% and fees-for-service by 40%. These adjustments aimed to ease the financial strain on providers while ensuring that patients received quality care. In collaboration with organizations such as PharmAccess, the NHIA introduced digital tools to improve healthcare quality through data-driven decision-making. This partnership allowed for more effective healthcare quality assessments and enhanced provider accreditation processes, aligning with global best practices.
The DG’s briefing also highlighted the authority’s efforts to improve accountability and responsiveness, with the Acting Director, Enforcement, Dr. Abdulhamid Habid Abdullah providing an in-depth overview of the authority’s enforcement initiatives. In 2024, NHIA resolved 1,327 complaints from citizens, achieving a 78% resolution rate within 21 days. Complaints ranged from denial of care to out-of-pocket payments and delays in referrals. In addressing these issues, NHIA mandated refunds totaling ₦3,084,000, issued warnings to 69 stakeholders, and delisted six non-compliant facilities. These actions demonstrated the authority’s unwavering commitment to upholding standards and ensuring that Nigerians receive the care they deserve.
Transparency and good governance were also central to NHIA’s accomplishments. With ₦12.9 billion allocated for health sector reforms under the Basic Healthcare Provision Fund, the authority enhanced its capacity to deliver on its mandate. These reforms not only improved service delivery but also bolstered public trust in the health insurance system, a critical factor in achieving sustained progress.
As the NHIA turns its attention to 2025, the authority has set ambitious goals to build on the successes of the previous year. Central to its plans is a continued focus on increasing enrollment, with a target to surpass 20 million enrollees by year-end. This goal will be achieved through a combination of public awareness campaigns, the enforcement of health insurance mandates, and a concerted effort to rebuild trust in the system. Ensuring that all Nigerians, regardless of socioeconomic status, have access to financial protection for healthcare remains a top priority.
The authority also plans to scale its programs for vulnerable groups, leveraging lessons from pilot initiatives to expand nationwide. Maternal and child health will continue to be a focal point, with efforts to remove financial barriers to life-saving interventions such as cesarean sections and ensure that no woman dies needlessly during childbirth. Collaborations with stakeholders like the National Primary Health Care Development Agency (NPHCDA) will further strengthen these initiatives, ensuring that basic primary care and skilled birth attendants are accessible across the country.
Technology will play a pivotal role in NHIA’s strategy for 2025. The authority plans to deploy an electronic platform to enhance transparency, improve service delivery, and make health insurance more accessible to Nigerians. This platform will also facilitate real-time feedback and enable more effective citizen engagement. The NHIA recognizes that partnerships with the media will be instrumental in achieving its goals. By working closely with journalists and broadcasters, the authority aims to increase public awareness about health insurance benefits and encourage more Nigerians to take advantage of the opportunities available to them.
The NHIA’s vision for 2025 extends beyond immediate targets. The authority is committed to fostering an efficient and sustainable health insurance system that can support Nigeria’s broader social and economic development. Achieving Universal Health Coverage by 2030 remains the ultimate goal, and the NHIA is determined to lead this charge with innovative solutions, inclusive policies, and a steadfast dedication to equity and quality.
As the authority builds on the momentum of 2024, its achievements serve as a testament to what can be accomplished with clear vision, collaboration, and a relentless focus on the needs of the people. The NHIA stands poised to deliver even greater impact in 2025, ensuring that every Nigerian, regardless of circumstance, can access the health care they need to lead healthy and fulfilling lives.
Udo-Akpan is a public affairs analyst
