Health insurance enrolment in Nigeria has increased to more than 22 million, but millions of citizens remain outside the insurance system, underscoring the challenge of achieving universal health coverage.
The National Health Insurance Authority, NHIA, said 22.03 million Nigerians were enrolled in health insurance schemes as of July 2026.
The figure represents a 35 per cent increase over the previous year.
The increase has been driven largely by federal and state-backed health insurance programmes, with state social health insurance agencies accounting for a significant portion of enrolment.
The NHIA’s fourth-quarter 2025 dashboard recorded about 9.74 million beneficiaries under state schemes and approximately 7.07 million under NHIA-managed programmes.
Despite the increase, health insurance coverage remains relatively low compared with Nigeria’s population.
Millions of Nigerians continue to pay directly for consultations, drugs, laboratory tests, hospitalisation and other medical services.
The burden is particularly significant for low-income households and informal-sector workers whose incomes are often irregular.
A recent study on health insurance among Nigerian women also identified inequalities in coverage, with enrolment more concentrated among wealthier, better-educated and urban residents.
Researchers called for greater subsidies and targeted interventions for poorer and underserved populations.
The National Health Insurance Authority Act, signed into law in 2022, replaced the former National Health Insurance Scheme and provided a framework for expanding insurance coverage among Nigerians and legal residents.
Stakeholders, however, say increasing enrolment alone will not guarantee universal health coverage.
The Managing Director and Chief Executive Officer of SUNU Health Nigeria Limited, Dr Moyosore Olomola, identified income volatility, inadequate healthcare provider networks and low public trust as major obstacles.
He said many workers earned seasonal, irregular or cash-based incomes, making conventional premium payment systems difficult.
Olomola called for flexible premium collection methods, improved healthcare infrastructure in underserved areas and stronger accountability among health maintenance organisations and providers.
Experts have warned that Nigeria’s continued reliance on out-of-pocket healthcare payments can expose families to catastrophic financial hardship.
Stakeholders therefore urged government to focus not only on enrolment but also on making insurance affordable, accessible and dependable.
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