By Isaac Atunlute
Despite a national health insurance scheme, the Nigerian health system has long been characterised by out-of-pocket spending—that is, individuals paying directly at the point of service.
A recent insurance scheme in Kaduna State will let residents access good healthcare without the burden of bankruptcy.
The state government has hailed the initiative as a measure to ease the financial strain on low-income families seeking quality healthcare.
So far more than 15,000 residents—mostly pregnant women and children under the age of five—have been enrolled in the health insurance scheme.
This new health insurance scheme follows huge investment—increased personnel and improved infrastructure—in the state’s general hospitals and primary healthcare centres, all catering to the local population.
Additionally, the scheme has benefited from partnerships with global agencies such as UNICEF, the Gates Foundation, and the Clinton Health Access Initiative. The last plugged in over 20,000 women into the scheme.
Outside of development agencies, some of the beneficiaries were sourced by community rulers, NGO founders, and civil society organisations, highlighting the prominent role of collaboration in the programme.
Solutions beyond Kaduna
Kaduna’s move resonates with similar models across the country. KwaraCare, managed by the Kwara Health Insurance Agency, offers a subsidised equity health plan tailored to low-income families and vulnerable groups.
In Lagos the Ilera Eko programme provides subsidised packages for those in the informal sector, such as traders and artisans, many of whom fall outside formal protection systems more often than not.
According to the National Health Act, the basic health care provision fund is financed by an annual federal government grant amounting to at least one % of the national revenue.
This ensures dedicated funding for essential health services, especially for vulnerable populations.
Constructing a more secure system
According to the Kaduna State Government, the impact of the enrollment programme would be most felt at the primary health level, where most vulnerable households seek care.
With a particular focus on maternal, newborn, and child-health services, the programme hopes to reduce preventable deaths and build long-term resilience in the health system.
Yet it isn’t without challenges. Insurance schemes in Nigeria typically face troubles of sustainability, especially when donor funding peters out.
Whether the model can be scaled across the country depends on various factors such as ensuring prompt payment to hospitals, managing fraud, and on boarding more residents.
While that remains to be seen, Kaduna’s example in framing health insurance as a public good shows that it can shield vulnerable households from both illness and poverty.
The Nigerian health system has historically been dominated by out-of-pocket expenses, but a recent insurance scheme launched in Kaduna State aims to change that by providing affordable healthcare access to residents without the financial burden. This initiative, benefiting over 15,000 residents including pregnant women and young children, is backed by investments in state healthcare infrastructure and partnerships with global agencies. The scheme is also supported by local community leaders and civil society organizations, demonstrating collaborative efforts in improving healthcare access.
Elsewhere in Nigeria, similar models like KwaraCare and Lagos's Ilera Eko programme offer subsidized health plans to low-income families and those in the informal sector. Under the National Health Act, a basic healthcare provision fund supported by federal grants ensures essential health services for vulnerable populations.
Kaduna's program primarily targets maternal, newborn, and child health, aiming to reduce preventable deaths and strengthen health system resilience. However, challenges such as sustainability, prompt hospital payments, fraud management, and engaging more residents need to be addressed to scale the model nationwide. Kaduna's approach illustrates the potential of health insurance to protect vulnerable households from both illness and poverty.
