Healthcare providers have called for urgent reforms to Nigeria’s health insurance system, urging flexible payment plans, faster reimbursements, and wider coverage for informal sector workers amid high out-of-pocket spending.
The Healthcare Providers’ Association of Nigeria made the call on Tuesday during the 2026 Annual Scientific Conference and Annual General Meeting of its Lagos State chapter, held at the Lagos Chamber of Commerce and Industry building.
The conference was themed, “Expanding Health Insurance Coverage in Nigeria: Improving Community-based Insurance Schemes in the Informal Sector.”
Delivering the keynote, the Chief Executive Officer of Drugstoc Limited, Dr Chibuzo Opara, said Nigeria must move beyond enrolment figures to ensure that insured Nigerians could access quality healthcare and prescribed medicines without financial hardship.
Opara, who was represented by the company’s Head of Business, Damilare Ojo, said health insurance enrolment had risen to about 22 million, representing barely 10 per cent of the population, while out-of-pocket payments accounted for more than 71 per cent of healthcare expenditure.
Opara said that extending coverage to traders, artisans, transport workers and small business owners required flexible contributions that reflected their irregular earnings, alongside group enrolment arrangements through trusted associations.
He also called for greater integration of community pharmacies into insurance networks, noting that their accessibility made them important entry points for healthcare. However, he stressed the need for clear referral pathways and defined professional responsibilities.
The Drugstoc Limited CEO stated that delayed reimbursements were putting financial pressure on healthcare providers, who often had to wait between 60 and 90 days for payment while borrowing costs eroded their earnings.
He urged insurers and regulators to review capitation rates in line with prevailing economic realities without making premiums unaffordable for enrollees.
Speaking through a representative, the Lagos Zonal Director of the National Health Insurance Authority, Femi Adeoye, said that inadequate insurance coverage had forced many families to delay treatment or abandon care because of cost.
“Insurance is not merely a prepayment; it is a lifeline. It is a social protection tool, and a strategic investment in Nigeria’s health and development,” he said.
Adeoye said sustainable financing, stronger participation by healthcare professionals and improved service delivery were essential to ensuring that expanded coverage translated into accessible care.
The President of HCPAN, Dr Austin Aipoh, called for a fresh actuarial study to determine the actual cost of healthcare delivery, citing rising expenses for medicines, electricity and facility operations.
He also urged the government to increase healthcare funding, adding that providers could help expand enrolment by educating patients about the benefits of insurance.
The outgoing chairman of HCPAN’s Lagos State chapter, Pharm. Biola Paul-Ozieh, stressed that coverage remained inadequate despite the mandatory health insurance provision in the National Health Insurance Authority Act, 2022.
She identified delayed reimbursements, outdated tariffs, the exclusion of some healthcare professionals from insurance networks and limited coverage for vulnerable groups as major challenges.
Paul-Ozieh called for innovative community-based insurance schemes to bring more informal sector workers into the system.
