The National Health Insurance Authority (NHIA) is shifting towards locally generated research to guide health financing reforms in Nigeria. According to NHIA Director-General, Dr. Kelechi Ohiri, the country can no longer depend mainly on episodic studies designed and commissioned outside Nigeria. Ohiri made this statement at the inaugural Nigeria Health Finance Research and Learning Forum in Abuja, themed “Evidence and Learning for Nigeria’s Health Financing Future: Building a Locally Led Research and Learning Ecosystem.”
The NHIA is targeting evidence-driven reforms to expand health insurance coverage and strengthen financial protection for Nigerians. Ohiri stated that for far too long, health financing initiatives in Nigeria have been shaped by well-meant studies designed, commissioned, analysed, reported, synthesised, and presented from outside the country. He argued that episodic research cannot build the enduring policy foundation needed in Nigeria to sustain and inform long-term reforms and policies.
The new approach will place Nigeria in the driver’s seat in defining its research questions, commissioning studies, and embedding learning directly into implementation. Ohiri emphasized that research sovereignty does not mean isolating Nigeria from global support and partners but rather putting the country in the driver’s seat in terms of defining its own questions and priorities. International partnerships will remain important but should support domestic priorities and build Nigeria’s research capacity.
The NHIA has commissioned five studies on embedded learning and will examine lessons from health financing experiences in Ethiopia, Ghana, and India. The two-day forum aims to review these studies and provide a platform for policymakers and researchers to benefit from. Ohiri stated that evidence must serve reform, and the authority’s reform agenda must be supported and based on evidence that transforms health financing into an economic infrastructure that protects Nigerian households.
The NHIA Act 2022 made health insurance mandatory in Nigeria, and the Federal Government has strengthened enforcement by linking valid compliance certificates to the whole-of-government approach. Ohiri identified mandatory health insurance coverage, equity, quality of care, and sustainability of health insurance as key areas of the authority’s research agenda. The NHIA is studying ways to improve quality of care, reduce waiting times for patients, and enhance the sustainability of health insurance.
Nigeria’s health insurance landscape remains highly fragmented, with 37 government health insurance schemes and over 95 private health insurance companies. Ohiri stated that this fragmentation raises questions about sustainability, and one of the areas of research focus is enhancing the sustainability of health insurance and financial protection. The NHIA has identified 15 studies linked to its strategic priorities and is working with national research institutions, universities, and other partners to develop a broader health financing research ecosystem.
The NHIA plans to establish a national health financing observatory, a national research agenda for health financing, 15 research action plans, and regional collaboration frameworks. The World Health Organisation (WHO) representative, Pavel Ursu, commended Nigeria for establishing the research and learning forum, saying it provides an opportunity to translate global commitments into concrete country-level action. The Nigerian Institute of Social and Economic Research (NISER) also emphasized the need for relevant evidence developed within Nigeria to guide health financing decisions.
Key points
- The NHIA is shifting towards locally generated research to guide health financing reforms in Nigeria.
- The authority has identified mandatory health insurance coverage, equity, quality of care, and sustainability of health insurance as key areas of its research agenda.
- The NHIA plans to establish a national health financing observatory and develop a broader health financing research ecosystem.
