NHIA Enrolment Hits 23m, Expands Disease Cover

• Ohiri: critical measure of insurance system should no longer be the number of Nigerians carrying insurance records, but whether those records provide meaningful protection when illness strikes

James Emejo in Abuja

Director General/Chief Executive, National Health Insurance Authority (NHIA), Dr. Kelechi Ohiri, said total health insurance enrolment has risen to over 23 million, adding that it is scaling up maternal and newborn healthcare interventions.

He said the authority had also expanded financial protection for Nigerians confronting cancer, HIV/AIDS and tuberculosis (TB).

He spoke at the inaugural Civil Society Organisation (CSO)-led Mid-Year Review of the National Health Sector Reforms in Abuja.

Ohiri said the authority was increasingly shifting its focus from putting the policy and legislative framework for universal health coverage in place to ensuring that insurance membership translated into actual access to healthcare, financial protection and measurable outcomes.

According to him, the critical measure of the insurance system should no longer be the number of Nigerians carrying insurance records, but whether those records provide meaningful protection when illness strikes.

The shift is particularly evident in cancer care, where the NHIA had introduced a cost-sharing arrangement with pharmaceutical company Roche for selected oncology medicines.

Under the arrangement, Roche bears 50 per cent of the cost, the NHIA contributes 30 per cent, while patients pay the remaining 20 per cent.

NhIA had also introduced support ranging from up to ₦400,000 to full coverage for eligible radiotherapy patients, complementing existing cancer benefits covering services including mammography, CT and MRI scans, bone scans, cancer-related diagnostic tests and radiotherapy.

Ohiri said the early results from the partnership demonstrated the potential of collaboration between government, insurers, healthcare providers and pharmaceutical companies to reduce the financial burden associated with high-cost diseases

He said, “For us, coverage has to mean something when people become ill. Cancer is one of the clearest examples of why health insurance matters.”

He added that the issue was not merely whether a service was covered but whether patients and their families could bear the cost of treatment.

Beyond cancer, the NHIA is using the Global Fund Resilient and Sustainable Systems for Health (RSSH) grant to extend financial protection to people living with HIV and patients receiving treatment for TB.

As of September 3, 2026, more than 51,000 people had been enrolled under the intervention across Anambra, Ebonyi, Gombe and Kwara States.

The beneficiaries comprise more than 46,000 primary beneficiaries and about 3,700 household members.

Of the primary beneficiaries, more than 38,000 are people living with HIV, while over 7,400 are patients with drug-sensitive TB and 594 are receiving treatment for drug-resistant TB.

He furtuer disclosed that the NHIA had also begun accrediting more than 2,000 healthcare facilities in preparation for the Global Fund GC8 implementation, with plans for nationwide expansion of HIV/AIDS and TB insurance coverage in 2027.

The authority’s maternal and newborn health interventions have also recorded measurable gains, with more than 93,000 women and newborns reached through its Comprehensive Emergency Obstetric and Newborn Care (CEmONC) and Fistula-Free programmes.

The figure comprises 79,221 women, 7,500 newborns and 6,044 women treated for obstetric fistula.

The programmes operate nationwide across the 36 states and the Federal Capital Territory through 286 CEmONC-empanelled facilities and 22 National Obstetric Fistula Centres and partner facilities.

More than 40,000 women have also been enrolled through the Basic Health Care Provision Fund (BHCPF).

Ohiri said the intervention was producing improvements in maternal outcomes, with case fatality at participating maternal health facilities declining by 22 per cent, from 1,042 recorded in the 2024 baseline to 810 as of August 2026.

The wider insurance expansion had also brought over 2.7 million poor and vulnerable Nigerians into coverage through the BHCPF.

While enrolment has expanded, the Authority has simultaneously intensified efforts to enforce patients’ rights and improve the quality of services provided to enrollees.

According to Ohiri, the NHIA has resolved 3,878 complaints from enrollees and refunded more than ₦14.2 million to affected beneficiaries.

It has also issued 368 warning letters to healthcare providers and suspended nine facilities over identified infractions.

Inspection teams have been deployed to healthcare facilities to monitor compliance with the Authority’s one-hour treatment authorisation policy and other requirements relating to patient protection and quality of care.

The reforms have also affected payments to healthcare providers, with capitation increasing by 93 per cent and fee-for-service reimbursements rising by 378 per cent.

In addition, more than 7,500 healthcare facilities have undergone digital assessment under the SafeCare quality framework as the NHIA seeks to strengthen standards across the health insurance delivery chain.

Ohiri said the reforms indicated that the insurance system was beginning to move beyond enrolment statistics towards a broader framework covering access, provider accountability, quality assurance, patient rights and financial protection.

He said, “We have moved from policy and legislation to measurable implementation. The next task is to move from coverage to reliable access, from reliable access to better health outcomes, and from insurance membership to genuine financial protection,” he said.

However, the NHIA chief acknowledged that the 23-million-plus enrolment figure, while representing substantial growth, also underscored the scale of the remaining coverage gap.

He said millions of Nigerians were still outside the health insurance system, making sustained expansion and improved service delivery essential to achieving universal health coverage.

He said, “We have made substantial progress, but we are not where we need to be. Over 23 million Nigerians covered is significant, but it also tells us that there are many more Nigerians who are still outside the system.”