Nigeria Sets Ambitious Target: 44 Million Health Insurance

Healthcare in Nigeria has long been a difficult journey for many families. From high hospital bills to the struggle of finding affordable treatment, millions of Nigerians pay for healthcare directly from their pockets. This “out-of-pocket” spending has been a source of financial strain, often pushing households into poverty whenever a loved one falls ill. Now, the Federal Government is making a bold move to change that story.

The government has announced its plan to enroll at least 44 million Nigerians into the National Health Insurance Scheme (NHIS) by 2030. The idea is simple but powerful: the more people covered by health insurance, the fewer families will face devastating medical costs alone.

The announcement was made by Dr. Iziaq Salako, Minister of State for Health and Social Welfare, during the opening of the National Health Financing Policy Dialogue in Abuja. The event brought together policymakers, experts, and stakeholders to deliberate on how to reshape Nigeria’s health financing system and build a future where universal health coverage becomes a real thing

Salako explained that the dialogue was more than a gathering of officials—it was about creating concrete strategies that would guide health reforms in the years ahead. He described the theme, “Reimagining a New Era of Health Financing,” as a reflection of Nigeria’s determination to secure sustainable and innovative solutions for its health sector.

According to him, President Bola Ahmed Tinubu has repeatedly emphasized that a strong health system is vital for national growth. Under his directive, the government has been working on interconnected policies designed to strengthen health financing, reduce dependence on external aid, and ensure every Nigerian has access to quality care.

Nigeria has been steadily increasing its health budget in recent years. From N434 billion in 2018, the allocation rose to N1.2 trillion in 2021. For 2025, the proposed figure stands at N2.48 trillion, representing 5.18% of the federal budget. This is a significant improvement, more than double the 2021 figure, but still falls short of the 15% benchmark agreed upon under the Abuja Declaration of 2001.

Salako pointed out that even with these improvements, Nigeria still spends less on health relative to its needs. In 2024, the National Assembly had to increase the health budget by N300 billion following the suspension of U.S. aid, while state governments also raised their contributions. Overall, health spending as a share of GDP has risen from 3.4% in 2013 to just over 5% in 2024—a positive trend, but one that highlights how much work remains.

One of the key pillars of reform is the National Health Insurance Act of 2012, which makes health insurance mandatory for all Nigerians. The law also established the Vulnerable Group Fund, designed to support citizens who cannot afford premiums.

To reinforce this, the government is relying heavily on the Basic Health Care Provision Fund (BHCPF), a financing framework introduced in the 2014 National Health Act. The BHCPF is funded by one percent of Nigeria’s consolidated revenue and is meant to support the poor and vulnerable. Salako revealed that the government plans to push for an increase in this allocation to at least two percent, a move that could significantly expand coverage for low-income households.

Under the Presidential Performance Agreement, the Ministry of Health has been tasked with enrolling 44 million Nigerians into health insurance by 2030. Currently, out-of-pocket spending accounts for about 70% of all healthcare costs in Nigeria—an alarmingly high figure compared to global standards. Reducing this burden, Salako explained, is at the heart of the government’s push.

He acknowledged the challenges ahead, including systemic inefficiencies, fragmented programs, and the lack of reliable health data. Yet, he stressed that the government is focused on strengthening frameworks, expanding coverage, and ensuring sustainability.

Salako urged Nigeria to learn from countries like Ghana, where strong political commitment, innovative financing, and a decentralized approach have produced better health outcomes. He called for Nigerian stakeholders to embrace collaboration, share best practices, and forge partnerships that can transform the aspirations for universal health coverage into real results for citizens.

The minister emphasized that beyond targets and numbers, the ultimate goal is to create a financing framework that is transparent, inclusive, and sustainable. Every Nigerian, he said, should be able to walk into a hospital or clinic without the fear that the cost of treatment could ruin their financial future.

The National Health Insurance Authority (NHIA) has reported steady progress in recent years. According to its Director-General, Dr. Kelechi Ohiri, the number of Nigerians enrolled in health insurance rose from 16.7 million to 19.2 million in less than a year—an impressive 14% increase. In 2024 alone, the NHIA enrolled two million people through federal and state programs, surpassing the year’s target.

This growth, while encouraging, is still far from the vision of nationwide coverage. With a population of over 200 million people, even the 44 million target by 2030 will cover only a fraction of Nigerians. Yet, experts believe it is a realistic step forward, especially if backed by strong political will and adequate financing.

For everyday citizens, the promise of expanded health insurance could mean fewer heartbreaking stories of families selling assets to pay for surgery or skipping treatment because it is unaffordable. It could mean pregnant women having safer deliveries, children receiving timely vaccinations, and patients with chronic illnesses getting consistent care without financial hardship.

The government’s strategy also has economic implications. A healthier population means increased productivity, fewer workdays lost to illness, and reduced poverty levels. By protecting people from catastrophic health expenses, insurance also frees up household income for education, housing, and investment in small businesses.

The target is ambitious, but the stakes are high. Nigeria cannot afford to leave healthcare largely in the hands of individuals and families. Out-of-pocket spending has already pushed countless households into poverty, and without reform, that cycle will continue.

By aiming for 44 million enrollees, the government is signaling its intent to break this pattern. If the plans succeed, Nigeria could finally take a major step toward universal health coverage—a dream that has remained elusive for decades.

For now, the challenge is clear: turn policies into action, keep health financing sustainable, and ensure that when Nigerians walk into hospitals, they are met with care, not crippling costs.