The push to bring affordable healthcare to millions of Nigerians gained significant momentum this week, with a clear deadline now in sight. The National Health Insurance Authority (NHIA) and the Healthcare Federation of Nigeria (HFN) have jointly set 2026 as the target year to massively scale up enrollment, particularly targeting the vast informal sector.
A Turning Point for Health Coverage
This decisive move was agreed upon during a private sector roundtable held in Lagos on Wednesday, December 4, 2025. Participants unanimously concluded that the current health insurance system requires a fundamental overhaul to survive and thrive. The consensus highlighted three critical pillars for success: strict enforcement of existing laws, robust digital infrastructure, and a concerted effort to restore public confidence in the scheme.
With Nigeria's population estimated at 220 million and growing by over six million annually, speakers stressed that the rapid expansion of health insurance is not just a goal but an unavoidable necessity. NHIA Director General, Dr. Kelechi Ohiri, declared that the Authority has reached a pivotal moment. "We must move from plans to real protection for households," he stated.
Ohiri emphasized that legislation alone is insufficient. "Mandatory health insurance will not succeed on legislation alone. Enforcement, awareness and, most importantly, restoring trust are essential," he said. He called for private sector collaboration, noting, "Government cannot do this alone. To reach the informal sector at scale, we must unlock the innovation and operational agility the private sector brings."
The Digital Backbone and Private Sector Role
HFN President, Mrs. Njide Ndili, described the Lagos meeting as the first in a series designed to align government and private sector priorities in health financing. She reiterated HFN's support for NHIA's reforms, emphasizing that the drive for universal health coverage must be inclusive and innovation-driven.
A stark warning came from Dr. Leke Oshunniyi, former chairman of the Health and Managed Care Association of Nigeria. He argued that progress is impossible without an integrated digital platform, calling technology "the real elephant we must eat in little bits."
"Any law without enforcement is just good advice," Oshunniyi said. "We need a platform that aggregates data from telcos, NIMC, FRSC, tax authorities and providers. Without that digital backbone, every other effort is floating in the air." He pointed to the success of fintech companies in serving millions as proof that large-scale digital systems are achievable in Nigeria.
The roundtable produced several key recommendations to achieve the 2026 target:
- Firm enforcement of the NHIA Act.
- Development of a unified national data system.
- Creation of micro-insurance products tailored for informal workers.
- Expansion of telemedicine services for remote communities.
- Utilization of market-led enrollment channels.
- Improvement of service quality in primary healthcare centers.
- Integration of fintech tools to simplify payments.
Rebuilding Trust and Funding High-Cost Care
A major focus was on rebuilding shattered trust in the health insurance system. This requires transparent claims processes, improved service quality, and stringent quality checks across all healthcare providers, both public and private.
To translate talk into action, the meeting concluded with an agreement to establish a joint NHIA-HFN working group. This group will focus on technology and data integration, map scalable private-sector innovations, and support the upcoming Informal Sector Coverage Fund. A follow-up implementation meeting with the NHIA Director General is scheduled for January 2026.
In a related presentation, Prof. Bode Falase of LASUTH highlighted the critical need for insurance to evolve and cover advanced, high-cost procedures. He shared data from the Nigeria Open-Heart Surgery Registry, which has recorded 1,916 surgeries across 28 centers between 2004 and 2025, with Nigerian teams now performing 58% of them.
He noted that a procedure like mechanical mitral valve replacement costs about ₦8.5 million at LASUTH, underscoring why the insurance system must be designed to fund such care. Falase also appealed for sustainable funding for the registry itself, which currently relies on a small grant and voluntary reporting.
