The National Health Insurance Authority (NHIA) in Nigeria has taken significant steps to address complaints from enrollees regarding services provided under the country's health insurance system. According to a statement issued by the agency, over N14.2 million has been refunded to affected enrollees, and nine healthcare facilities have been suspended. This move is part of the NHIA's efforts to strengthen patient protection and ensure that healthcare providers adhere to the required standards.
The NHIA received and resolved 3,878 complaints from enrollees, a significant increase in the number of grievances being addressed. In addition to the refunds and suspensions, the authority also issued 368 warning letters to healthcare providers. These actions were disclosed by the NHIA's Director-General and Chief Executive Officer, Dr. Kelechi Ohiri, during the inaugural Civil Society Organisation-Led Mid-Year Review of Nigeria's National Health Sector Reforms in Abuja.
The NHIA has been working to improve the quality of healthcare services and ensure that insurance coverage translates into access to healthcare and financial protection for enrollees. To monitor compliance with its policies, inspection teams have been deployed to healthcare facilities to enforce the one-hour treatment authorization policy and other patient-protection and quality-of-care requirements. This move aims to enhance the overall quality of care provided to patients.
The enforcement measures come as national health insurance enrollment has increased significantly, from about 16 million at the beginning of the current administration to more than 23 million. Furthermore, over 2.7 million poor and vulnerable Nigerians have received support through the Basic Health Care Provision Fund. These developments indicate a substantial expansion of healthcare coverage in Nigeria.
The NHIA has also made progress in expanding support for cancer patients through a cost-sharing partnership with pharmaceutical company Roche for selected oncology medicines. Under this arrangement, Roche covers 50% of the cost, the NHIA bears 30%, while patients pay 20%. Eligible radiotherapy patients can also receive financial support ranging from N400,000 to full coverage. Additionally, the authority has covered other cancer services, including mammography, CT and MRI scans, bone scans, diagnostic tests, and radiotherapy.
In addition to cancer care, the NHIA has also made significant strides in its HIV and tuberculosis (TB) program. As of September 3, 2026, more than 51,000 people have been covered under this program across Anambra, Ebonyi, Gombe, and Kwara states. This includes over 38,000 people living with HIV, over 7,400 drug-sensitive TB patients, and 594 drug-resistant TB patients. The NHIA has also begun accrediting over 2,000 healthcare facilities ahead of a planned nationwide expansion of HIV/AIDS and TB coverage in 2027.
Despite the progress made, Dr. Ohiri acknowledged that most Nigerians remain outside the health insurance system. He emphasized that while over 23 million Nigerians covered is significant, it also highlights that there are many more Nigerians who are still outside the system. The NHIA aims to continue expanding healthcare coverage and improving the quality of care provided to patients. Key initiatives, such as the expansion of maternal and newborn healthcare, have reached over 93,000 women and newborns, with a 22% decline in case fatality at participating maternal health facilities.
Key points
- The NHIA has refunded N14.2m to enrollees and suspended nine healthcare facilities following complaints over services provided under Nigeria's health insurance system.
- National health insurance enrollment has increased from 16 million to over 23 million, with over 2.7 million poor and vulnerable Nigerians receiving support through the Basic Health Care Provision Fund.
- The NHIA has expanded support for cancer patients through a cost-sharing partnership with Roche, covering 50% of the cost of selected oncology medicines.
