Nigeria’s health insurance enrolment increased to 23.06 million people in the second quarter of 2026, up from 16.2 million in late 2023, the Director-General of the National Health Insurance Authority (NHIA), Kelechi Ohiri, has said.

Mr Ohiri disclosed this on Thursday while delivering the keynote address at the 11th Future of Health Conference organised by Nigeria Health Watch in Abuja.

He said enrolment across federal, state and private health insurance schemes grew by 42.35 per cent over the period.

However, Mr Ohiri said increasing enrolment alone would not guarantee access to healthcare or protect Nigerians from financial hardship.

“We constantly face the reality of a difference between an insurance coverage record and genuine financial risk protection,” he said.

“An insurance card in a citizen’s pocket is meaningless if it does not grant immediate access to a functional facility, guarantee essential medicines, protect against catastrophic out-of-pocket expenses, and deliver dignity during medical emergencies.”

Improving access and accountability

Mr Ohiri said the NHIA had introduced measures to help enrollees understand their benefits, access support and hold healthcare providers accountable.

These include the MyNHIA mobile application and an online self-enrolment portal. He said the authority also distributed enrollee charters and benefit package details through interactive QR codes at accredited health facilities nationwide.

According to him, the codes enable enrollees to check the consultations, diagnostic services and medicines covered by their insurance packages.

Mr Ohiri said the NHIA also strengthened its complaints management system to address grievances involving enrollees, healthcare facilities and health maintenance organisations (HMOs).

Mr Ohiri said the NHIA received and tracked 2,209 complaints through social media, telephone calls, walk-in desks, call centres and letters.

He said 82 per cent of the complaints were resolved within 48 hours, adding that the authority secured direct refunds for enrollees who had been improperly charged by healthcare facilities.

The NHIA also issued formal warnings to facilities and delisted providers for persistent non-compliance, he said.

“That is how regulation converts coverage into genuine financial protection,” Mr Ohiri said.

Targeting vulnerable populations

The NHIA boss said the authority was expanding insurance access for vulnerable Nigerians through targeted programmes supported by public subsidies, grants and public-private partnerships.

He said under the Basic Health Care Provision Fund (BHCPF) Gateway, enrolment increased from 2.6 million people in the second quarter of 2026 to 3.2 million in the third quarter, representing a 20.5 per cent increase.

He added that all the enrollees under the gateway had been biometrically verified using their National Identification Numbers (NINs).

Mr Ohiri also highlighted a programme established in partnership with the Global Fund to provide health insurance coverage for key population groups living with or affected by major infectious diseases in Gombe, Anambra, Ebonyi and Kwara states.

He said enrolment under the programme increased from 25,815 beneficiaries in the fourth quarter of 2025 to 58,447 in the third quarter of 2026.

He said women accounted for 68 per cent of the enrollees, while all beneficiaries had been biometrically verified using their NINs.

Future of Health is Now

The conference, themed “From Innovation to Impact: The Future of Health is Now”, brought together stakeholders to discuss how innovations, investments, research and policies can translate into measurable improvements in healthcare delivery.

Mr Ohiri said health innovations must solve practical problems, generate evidence, remain financially sustainable and become integrated into existing systems to achieve impact at scale.

He said the NHIA’s reforms were intended to build a health financing system that protects Nigerians from financial hardship while improving access to healthcare.

“The future of health is not a distant vision,” he said.

“Through strategic purchasing, rigorous evidence, and commitment to equity, the future of health is happening right now.”

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In her remarks, the Managing Director of Nigeria Health Watch, Vivianne Ihekweazu, said Nigeria must look beyond the development of health innovations to the financing, policies, procurement processes and data systems needed to sustain them and expand their reach.

Mrs Ihekweazu said the 11th edition of the conference provided an opportunity to reflect on lessons from more than a decade of discussions on universal health coverage, healthcare financing, technology and the role of the private sector in strengthening Nigeria’s health system.

She said innovations would only deliver meaningful health outcomes if policymakers prioritised scale and sustainability from the outset.

Citing a review of digital innovations in maternal and newborn health in Nigeria, she said none of the 10 interventions examined had achieved sustained scale, largely because they lacked clear ownership within the health system and a pathway into routine service delivery.

The federal government says it has disbursed N249.6 billion to the Basic Health Care Provision Fund (BHCPF) in the past three years, representing 77.1 per cent of the N323.6 billion disbursed since the fund was established in 2019.

The government also plans to expand direct financing to at least 17,600 primary healthcare facilities and provide health insurance coverage for about 90,000 Nigerians in correctional facilities.

The Minister of State for Health and Social Welfare, Iziaq Salako, disclosed this on Wednesday in Abuja during a ministerial briefing on three years of implementation of the fund under President Bola Tinubu’s administration.

Established under the National Health Act 2014, the BHCPF is designed to improve access to essential healthcare, particularly for poor and vulnerable Nigerians.

Mr Salako said the fund had become a key instrument for implementing the Nigeria Health Sector Renewal Investment Initiative, launched in December 2023 to strengthen healthcare delivery and financing.

Disbursements and allocations

According to Mr Salako, total releases to the fund stood at N422.3 billion as of September 2026, with N323.6 billion disbursed.

He said the Ministerial Oversight Committee approved an additional N40.76 billion at its meeting on 14 October. The approval is expected to raise cumulative disbursements to N364.3 billion, including N290.2 billion under the Tinubu administration, according to the statement.

Speaking on the latest allocation, Mr Salako said N19.87 billion would go to the National Health Insurance Authority, N18.34 billion to the National Primary Health Care Development Agency, N2.04 billion to emergency medical treatment and N509.48 million to the Nigeria Centre for Disease Control and Prevention.

He said the allocations would support health insurance, primary healthcare services, emergency medical response and disease surveillance.

Mr Salako added that the government was working with the National Assembly to increase the fund’s statutory allocation from one per cent to two per cent of the Consolidated Revenue Fund.

Health insurance and primary healthcare

On financial protection, Mr Salako said national health insurance enrolment increased from about 16.2 million people in 2023 to 23.06 million by the third quarter of 2026.

He said the BHCPF had supported insurance coverage for 3,182,943 vulnerable Nigerians with National Identification Numbers.

The fund, he added, had also supported free surgeries and rehabilitation for women with vesicovaginal fistula, emergency caesarean sections and other emergency obstetric and newborn care interventions for 96,068 women and babies.

Mr Salako said the oversight committee had also approved health insurance coverage for approximately 90,000 Nigerians in correctional facilities, with implementation expected to expand access to essential healthcare for inmates.

On primary healthcare delivery, he said direct facility financing currently supports 8,309 PHCs across the 36 states and the Federal Capital Territory.

He said the government planned to include a further 5,212 facilities, bringing the projected total to 13,521. However, the government’s broader target is to expand direct financing to at least 17,600 facilities.

Mr Salako added that the number of facilities attaining Level 2 readiness increased from 1,748 in 2024 to 3,202 in the third quarter of 2026.

He also said PHC attendance rose from 34.55 million in 2023 to 43.06 million by the second quarter of 2026.

Emergency services and health workers

On emergency medical services, Mr Salako said operational structures had been established in all 36 states and the FCT.

Through the Rural Emergency Service and Maternal Transport arrangements, emergency transport services had been established in 171 of the 172 local government areas covered by the Maternal and Newborn Mortality Reduction Innovation Initiative. The government plans to extend the initiative to 200 local government areas by December 2026.

He said the emergency response system had recorded 168,571 ambulance service episodes since 2023, covering obstetric emergencies, neonatal and under-five emergencies, road traffic injuries, snakebites, burns and other urgent medical conditions.

Mr Salako said 78,054 frontline health workers had been trained towards a national target of 120,000.

He also said the oversight committee approved phased salary support for 13,800 community-based health workers and skilled birth attendants. Under the arrangement, the federal government would cover eligible salary costs in full in the first year, 67 per cent in the second year and 33 per cent in the third year, before state governments assume full responsibility.

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He said the committee had also approved the operationalisation of MEDIPOOL, a pooled procurement mechanism intended to improve access to essential medicines and health commodities, subject to quality assurance and accountability safeguards.

Accountability and next steps

Mr Salako urged state governments to fulfil their counterpart financing obligations and ensure sustainable funding for primary healthcare services. He commended Katsina State for releasing N240.79 million to its State Health Insurance Agency to support expanded coverage.

He said the Ministry of Health and Social Welfare was strengthening financial accountability through the implementation of the updated BHCPF Guidelines 2.0 and collaboration with the Independent Corrupt Practices and Other Related Offences Commission to track the use of public funds.

He emphasised that timely reporting, transparent payments, and expenditure verification were necessary to ensure funds reached healthcare facilities and translated into services for patients.

Mr Salako said the government remained committed to increasing domestic health financing and improving access to essential healthcare, particularly for vulnerable Nigerians.