Posted on: Tue 23-06-2026

Nigeria's healthcare financing crisis has come under renewed scrutiny, with industry leaders warning that nearly 93 percent of the population remains without health insurance coverage, leaving millions vulnerable to catastrophic health expenditures and preventable health outcomes.

The alarming disclosure emerged during the 5th Stakeholders Engagement Forum organised by Hallmark Health Services Limited in Lagos, where healthcare executives, policymakers, regulators, providers, and employers gathered to examine pathways toward a more sustainable healthcare system.

Held under the theme "Collaborating for Sustainable Healthcare Systems," the forum painted a sobering picture of a healthcare sector grappling with inadequate insurance coverage, rising operational costs, workforce shortages, inflationary pressures, and declining public trust.

 

A Health System Under Pressure

Speaking at the event, Chairman of Hallmark HMO, Eddie Efekoha, described Nigeria's healthcare sector as being at a critical crossroads.

According to him, healthcare challenges extend beyond infrastructure and financing to the everyday realities faced by Nigerians struggling to access affordable and quality care.

He noted that the sector is simultaneously confronting escalating healthcare costs, increasing demand for services, migration of healthcare professionals, regulatory transitions, and rapid digital transformation.

"The decisions stakeholders make today will determine whether future generations inherit a resilient healthcare system or one that struggles under mounting pressure," he stated.

 

Out of Pocket Spending Continues to Drive Financial Hardship

One of the most striking concerns raised at the forum was Nigeria's continued dependence on out-of-pocket healthcare financing.

Olumide Ajomale, Board Advisor and Chief Executive Officer of Facilitation and Training Services Limited, revealed that approximately 71 percent of healthcare expenses in Nigeria are paid directly by individuals and families at the point of service.

Health economists have long identified out-of-pocket expenditure as one of the leading causes of healthcare-related poverty, particularly in low- and middle-income countries where insurance penetration remains low.

Ajomale argued that the underlying challenge is not merely affordability but trust.

Many Nigerians, he observed, remain reluctant to enrol in health insurance schemes due to concerns about service quality, delayed access to care, administrative bottlenecks, and uncertainty regarding benefit utilization.

"The absence of trust creates a chain reaction across the entire healthcare value chain," he explained.

 

Rebuilding Trust Across the Healthcare Ecosystem

Stakeholders at the forum emphasized that restoring confidence in the healthcare system requires a patient-centred approach that prioritizes transparency, responsiveness, and accountability.

Experts stressed that healthcare providers must improve service delivery standards, Health Maintenance Organisations (HMOs) must simplify processes and enhance customer experience, while regulators should strengthen oversight mechanisms that promote collaboration rather than fragmentation.

Participants also highlighted the growing importance of healthcare data analytics in improving decision-making, resource allocation, disease surveillance, and population health management.

According to Ajomale, healthcare organisations that merely collect data without leveraging it for predictive planning and strategic interventions risk becoming increasingly ineffective in a rapidly evolving healthcare environment.

 

Financial Sustainability Remains a Major Challenge

The forum also examined the financial realities confronting Nigeria's health insurance industry.

Healthcare providers continue to face rising operational costs driven by inflation, increasing prices of pharmaceuticals and medical consumables, foreign exchange fluctuations, and workforce shortages.

At the same time, HMOs struggle to balance premium contributions with growing healthcare utilization among enrollees.

Industry experts explained that while healthcare needs are continuous and recurrent, premium adjustments often lag behind rising service costs, creating significant financial pressures across the system.

This imbalance, stakeholders noted, threatens the long-term sustainability of healthcare financing unless innovative financing mechanisms and stronger stakeholder collaboration are adopted.

 

The Case for Universal Health Coverage

With only an estimated seven percent of Nigerians enrolled in health insurance schemes, experts warned that achieving Universal Health Coverage (UHC) remains a significant challenge.

The low insurance penetration rate means that millions of households continue to rely on personal savings, loans, or delayed treatment to manage health emergencies.

Public health specialists at the forum argued that expanding health insurance coverage is essential not only for improving healthcare access but also for protecting households from financial hardship and strengthening overall health system resilience.

 

A Call for Collective Action

The forum concluded with a consensus that no single stakeholder can resolve Nigeria's healthcare challenges independently.

Government institutions, healthcare providers, HMOs, employers, development partners, and citizens must work collaboratively to address longstanding barriers to healthcare access and financing.

Participants further encouraged Nigerians to adopt healthier lifestyles, seek preventive healthcare services, and enrol in health insurance schemes before medical emergencies occur.

As Nigeria continues its pursuit of Universal Health Coverage, stakeholders maintain that collaboration, innovation, financial sustainability, and public trust will remain the pillars upon which a stronger and more inclusive healthcare system must be built.

For healthcare professionals, policymakers, and industry leaders, the message from Lagos was unmistakable: Nigeria's healthcare crisis is no longer a future concern—it is a present reality requiring urgent and coordinated action.

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