PRESIDENT Bola Tinubu has ordered the compulsory implementation of health insurance across all Ministries, Departments, and Agencies (MDAs) in line with the National Health Insurance Authority (NHIA) Act of 2022.
A statement on Wednesday, September 3, by his Special Adviser on Information and Strategy, Bayo Onanuga, said the directive was part of efforts to expand coverage and cut down on Nigerians’ out-of-pocket medical expenses.
The president, through a directive issued to the Secretary to the Government of the Federation, noted that all civil servants must be enrolled in the NHIA health insurance plan.
He also said that contractors and service providers dealing with the government must show proof of valid NHIA-issued health insurance certificates before they could qualify for procurement processes.
“First, all MDAs must enroll their employees in the National Health Insurance Authority (NHIA) health insurance plan. Where desired, MDAs may take up supplementary private insurance coverage in accordance with the NHIA Act.
“All entities participating in public procurement must present a valid NHIA-issued Health Insurance Certificate as part of their eligibility documentation.
“This certificate confirms compliance with the mandatory health insurance requirement and serves as a condition precedent for continuing any procurement-related engagement,” the statement read.
Many Nigerians face the challenge of paying more for drugs and medical care. Some of the reasons are ballooning inflation and exit of pharmaceutical companies from the country because of skyrocketing costs of doing business.
For instance, in 2023, a major pharmaceutical firm, GlaxoSmithKline(GSK), producer of prescribable medicine such as Augmentin and Amoxil, disclosed its strategic plan to stop the commercialisation of its prescription medicine and vaccines in Nigeria and transition to a third-party distribution model for its pharmaceutical products, citing foreign exchange concerns.
Meanwhile, while pushing for stricter implementation, Tinubu also called for constructive engagement with the private sector to ensure businesses are not unfairly burdened by the mandatory health coverage requirement.
The Presidency explained that the measure was intended to widen health insurance coverage, protect workers, and promote accountability, noting that universal access to healthcare remained a central goal of the NHIA Act.
Out-of-pocket expenditure remains the dominant mode of healthcare financing in Nigeria, accounting for more than 70 percent of total health spending. It is among the highest in the world.
This system leaves millions of Nigerians unable to afford basic services, forcing many into debt or reliance on traditional medicine and unregulated drug vendors.
Signed into law in 2022, the NHIA Act makes health insurance compulsory for all Nigerians and places responsibility on the NHIA to deliver universal health coverage. However, nearly three years on, enrollment levels remain worryingly low.
According to the Minister of Health and Social Welfare, Muhammad Pate, less than 10 per cent of the Nigerian population enrolled in health insurance.
The low coverage, according to reports, could be attributed to most Nigerians working in the informal sector and are not on payroll systems, making regular deductions for premiums nearly impossible.
Reports also cited distrust in government programmes, poor awareness, and skepticism fueled by corruption and service failures on the low coverage.
Mustapha Usman is an investigative journalist with the International Centre for Investigative Reporting. You can easily reach him via: musman@icirnigeria.com. He tweets @UsmanMustapha_M