Nigeria enrolls 2 million people in 9 months as health insurance coverage hits over 19 million

Nigeria has enrolled two million people in nine months of 2024, bringing the total number of enrollees in the national health insurance programs to 19.18 million.

The Director-General and CEO of the National Health Insurance Agency, Dr. Kelechi Ohiri disclosed this in an interview with Nairametrics.

According to him, this represented a coverage of about 8.9% of the population at the end of the third quarter of 2024 compared to an enrollment base of about 16 million in Q4 2023.

“This data reflects enrollment growth from the first quarter through the end of the third quarter. We have achieved significant growth, adding approximately 2 million Nigerians to the health insurance program,” he explained.

Ohiri said the total national enrollment now stands at about 19.18 million people. “This marks a remarkable growth over the past nine months. It is an important step forward as we aim to expand coverage and improve access to essential healthcare services across the country.”  

“This rapid increase emphasizes a turning point in the nation’s healthcare system, with more citizens seeking the protection and affordability health insurance offers, as the National Health Insurance Authority (NHIA) intensifies its push toward universal health coverage (UHC),” he added.

Comparison with previous years and ongoing challenges 

This growth is encouraging when compared to previous years, which saw slower rates of enrollment expansion. However, challenges persist as Nigeria strives to meet its health coverage goals.

Pressing issues such as funding shortfalls and limited access to health facilities have hindered broader coverage.

NHIA CEO further noted that currently, 84 HMOs are accredited in Nigeria, although this number fluctuates based on the NHIA’s periodic review process.

“We occasionally delist HMOs that do not meet standards, while new applications bring fresh HMOs into the fold,” he said, “For example, in January, 10 new HMOs received accreditation, ensuring more robust service delivery across the board.” 

Revised tariff to enhance healthcare quality 

In addition to expanding enrollment, NHIA has implemented a recent review of service tariffs to ensure quality care at different healthcare levels. This includes a 40% increase in professional fees for secondary and tertiary care services, which apply when patients are referred to higher care levels.

“This fee-for-service increase reflects the need to keep up with rising costs of healthcare to ensure good quality of healthcare services, which are essential for better patient outcomes at hospitals,” he explained.

At the primary care level, where capitation payments directly support hospitals, there has been a 60% increase in tariffs. This rise is expected to improve services at the primary level, which often serves as the first point of contact for many Nigerians seeking healthcare.

Evaluating true costs of healthcare 

While the tariff adjustments mark an essential improvement, NHIA is also conducting two actuarial evaluation studies to better understand the true cost of healthcare services in Nigeria.

“These studies will provide insights that will help us make data-driven decisions to align our health insurance system with the needs and challenges of our healthcare landscape,” he noted.

Focus on compliance and sustainable enrollment targets 

Also, interviewing one of the HMO providers, Dr. Lekan Ewenla, Managing Director and Chief Executive Officer of Ultimate Health HMO, said this administration is deeply concerned about the well-being of Nigerians, most especially regarding their enrollment in the health insurance program.

• While Dr. Ewenla refrained from disclosing the exact increase in health insurance enrollment, he affirmed that recent improvements have driven significant growth. “Health insurance in Nigeria is no longer at the low 5% enrollment level we once saw,” he stated.
• Ewenla noted that the enrollment rate is steadily increasing as regulatory bodies have tackled issues that previously hindered growth. “These improvements include a recent adjustment to statutory payments for health insurance risk managers.” 

According to him, another priority is to improve compliance with mandatory enrollment in health insurance schemes. “We are suggesting to the regulatory agency the need for stricter compliance measures, making enrollment mandatory for all Nigerians,” Dr. Ewenla added. “Unfortunately, a lack of respect for laws in Nigeria is partly why the program has lagged behind expectations.”