National Health Insurance in Nigeria: A Legal Analysis and Inclusivity of the Vulnurable Group


A functional and efficient health care system can improve the overall well-being and productivity of its citizenry and cause positive improvements on the socio and economic life of especially the less privileged. No wonder, governments across the world pay huge attention to healthcare in terms of funding and legislation. Nigeria is one of the nations that has found interest in building its national health care system with particular attention to the vulnerable group via insurance. To achieve this objective, in 2020 the Minister of Health unveiled the Nigeria’s Health Sector Roadmap guided by the 2019 president’s “Health Sector Next Level Agenda.”  One of the key components of the agenda includes the implementation of a mandatory Universal Health Insurance in collaboration with State governments and the Federal Capital Territory (FCT) administration. This effort followed the signing into law in May 2022 by the president the National health Insurance Authority Act, 2021 (NHIA) otherwise referred to as ‘Authority’. This law provides the framework for a health insurance scheme that enlists the States in achieving health insurance for every one including 83 million poor Nigerians classified as vulnerable group. It was a build-on on government’s earlier effort in 1999 to promote, regulate and integrate health insurance schemes in Nigeria among other related matters which failed. This law, like its predecessor was geared towards an effective implementation of a national health insurance policy that will ensure the attainment of universal health coverage in Nigeria and particularly targeted to ameliorate the suffering of the vulnerable in accessing quality health care in Nigeria; the focus of this paper. Almost two years into its existence, the new law is yet to be seen in the lives of the vulnerable but has continued to exist in the law books. This and more will be examined in this article. An introduction of the concepts and an analysis of the extant law in question will be made. In conclusion, findings were made amongst others that the NHIA is net on ground as envisaged and lacks the necessary structures to implement its set objectives of providing health care for residents and the vulnerable in Nigeria. Recommendations were made that the Nigerian government and its relevant health ministries at the federal, state and local government levels can engage with trusted international health partners and donor organizations for assistance to set and manage for an agreed period, Nigerian health care structures for ease of system implementation; review and update the law on health insurance in Nigeria that has become weak in handling current health issues plaguing the society simultaneously invest in government owned insurance institutions across Nigeria which has become moribund to aid effective implementation of the health scheme.