The Managing Director of SUNU Health Nigeria Ltd., Dr Moyosore Olomola, has called for stronger legislation and closer collaboration among key stakeholders to expand health insurance coverage and accelerate the achievement of Universal Health Coverage (UHC) in Nigeria.
According to a report by the News Agency of Nigeria (NAN), Olomola made the call during an interview in Abuja on Sunday, where he stressed the need for greater cooperation between the National Health Insurance Authority (NHIA), private Health Maintenance Organisations (HMOs), healthcare providers and lawmakers.
He noted that Nigeria currently has about 22 million health insurance enrollees, a figure that remains significantly below the NHIA’s target of 44 million beneficiaries by 2030.
Olomola said the relationship between the NHIA and private HMOs should evolve beyond regulation into a genuine partnership, describing HMOs as critical delivery partners in achieving Universal Health Coverage.
According to him, the NHIA has made commendable progress in strengthening the health insurance sector through improved accreditation standards, enforcement of minimum capital requirements for HMOs and the ongoing digitisation of its operations.
He, however, maintained that government cannot achieve its 2030 enrolment target without a sustainable and well supported private HMO sector.
The SUNU Health Managing Director called for a transparent tariff review mechanism that reflects healthcare inflation, stronger enforcement of mandatory employer enrolment under the NHIA Act and predictable funding through the Basic Health Care Provision Fund.
He also advocated the establishment of a formal dispute resolution mechanism between HMOs and the NHIA to resolve disagreements and promote stronger collaboration within the sector.
Olomola further urged lawmakers to establish a provider accountability framework that would sanction healthcare providers who deny services to insured patients or demand unauthorised payments.
He argued that such practices undermine public confidence in the health insurance system and discourage enrolment.
According to him, healthcare providers that violate NHIA regulations should face clearly defined sanctions, including suspension of accreditation, delisting from the scheme and public disclosure of their infractions.
He disclosed that the proposals were presented during a recent engagement with the Chairman of the House of Representatives Committee on Health Services, Hon. Amos Magaji, as part of efforts to secure legislative support for reforms that would remove barriers to expanding health insurance coverage.
Olomola acknowledged the progress made by the NHIA in expanding health insurance but noted that structural challenges, including inadequate funding, unsuitable premium models for workers in the informal sector, inconsistent commitment by some state governments and poor compliance by healthcare providers, continue to slow enrolment.
He urged lawmakers to strengthen legal and regulatory measures that would hold defaulting healthcare providers accountable, saying incidents where insured patients are denied treatment or forced to pay out of pocket erode public trust in the scheme.
Olomola commended the NHIA for recent reforms, including tariff reviews, increased domestication of state health insurance laws and improved engagement with private HMOs, describing the initiatives as important foundations for expanding healthcare coverage nationwide.
He observed that nearly 80 per cent of Nigeria’s workforce earns irregular, seasonal or cash based incomes, making conventional monthly or annual premium payment structures unsuitable for many citizens.
To address the challenge, he said SUNU Health has introduced community based enrolment initiatives involving trade associations, cooperatives and religious organisations, alongside weekly USSD micro premium payments, hybrid catastrophic health insurance packages and telemedicine services through its partnership with MobiHealth.
According to Olomola, the collaboration with MobiHealth enables enrollees to consult doctors remotely and obtain prescriptions from partner pharmacies, improving access to quality healthcare, particularly for people living far from healthcare facilities.
He further noted that Nigeria’s out of pocket health expenditure remains above 70 per cent of total health spending, underscoring the need for a unified national health insurance database, stronger state financing, digital claims processing and greater transparency across the health sector.
Olomola expressed confidence that Nigeria possesses the demographic advantage, regulatory framework and political commitment required to achieve Universal Health Coverage, adding that disciplined implementation and genuine public private sector collaboration are essential to meeting the country’s healthcare goals.
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