States Push for Mandatory Health Insurance as Experts Chart Path to Universal Health Coverage
Akure, Ondo State, June 9, 2026
Health insurance leaders, policymakers, development partners and government officials have called for mandatory health insurance coverage across all states of the federation as part of renewed efforts to achieve Universal Health Coverage (UHC) in Nigeria.
The call was one of the major outcomes of the Maiden National Summit of State Social Health Insurance Agencies (SSHIAs), held from June 8 to 9 at the International Culture and Event Centre (The Dome), Akure, Ondo State.
The summit, convened by the Forum of Chief Executive Officers of SSHIAs, brought together stakeholders from across Nigeria’s health sector to deliberate on the theme, “Economic Realities and the Universal Health Coverage Dream: Mobilising States for a Scalable Health Insurance Future.”
Participants examined strategies for reducing catastrophic healthcare spending, strengthening sustainable health financing, and deepening collaboration between the National Health Insurance Authority (NHIA), state health insurance agencies, and development partners.
Declaring the summit open, Ondo State Governor, Lucky Orimisan Ayedatiwa, reaffirmed the importance of expanding health insurance coverage as a critical pathway to improving healthcare access and protecting citizens from financial hardship. Earlier, the Ondo State Commissioner for Health, Dr. Olabanji Awolowo Ajaka, welcomed delegates and stakeholders to the state, while goodwill messages were delivered by the Senior Special Adviser to the President on Health, Dr. Salma Ibrahim, and other development partners.
In his keynote address, health financing expert Dr. Simeon Onyemaechi traced the evolution of health insurance in Nigeria from federal initiatives to state-led programmes, highlighting persistent challenges confronting the sector. These include high out-of-pocket healthcare expenditure, rising healthcare costs, widespread poverty, inadequate funding, weak health financing systems, low insurance coverage among informal sector workers, governance concerns, and disparities in implementation across states.
He also identified limited political commitment, weak technical capacity, inadequate ICT infrastructure, enrolment challenges in the informal sector, concerns over service quality, provider accountability, fraud, and sustainability as major obstacles to achieving universal health coverage nationwide.
The summit featured technical sessions and panel discussions led by renowned health sector experts. Presentations focused on the evolution of state health insurance schemes, strategies for expanding coverage, innovations and best practices among state agencies, enforcement of mandatory health insurance, strengthening primary healthcare systems, domestic resource mobilisation, and lessons from successful state health insurance programmes.
At the end of deliberations, participants unanimously recommended stronger political commitment by state governments to universal health coverage and endorsed mandatory health insurance for all residents across Nigeria.
The summit further called for the establishment of a legal framework for health insurance in the Federal Capital Territory (FCT), harmonisation of federal and state health insurance schemes, and stronger regulatory oversight to ensure effective implementation.
Stakeholders also advocated the adoption of mixed financing models combining government budgetary allocations, mandatory insurance contributions, targeted subsidies for vulnerable populations, and innovative funding mechanisms such as earmarked levies and public-private partnerships.
To expand coverage, delegates urged state agencies to prioritise enrolment of informal sector workers, rural communities, women, children, and persons with disabilities through simplified digital registration systems and community-based structures.
The summit emphasised the need for increased investment in primary healthcare centres, including infrastructure upgrades, workforce development, improved availability of essential medicines, and stronger referral systems.
Participants also recommended reforms in provider payment mechanisms to improve accountability, reduce fraud, and ensure timely reimbursement to healthcare providers.
In addition, state governments were urged to establish Health Trust Funds and deploy integrated digital health information systems to support enrolment, claims management, performance monitoring, and transparency in health insurance administration.
The participants commended the Forum of CEOs of SSHIAs and the Ondo State Government for providing a platform that encouraged collaboration, knowledge sharing, and strategic dialogue among stakeholders.
They reaffirmed their commitment to strengthening state social health insurance systems and advancing universal health coverage through sustainable, equitable, and people-centred healthcare financing and service delivery mechanisms.
The communiqué was jointly signed by the Chairman of the Forum of CEOs of SSHIAs, Mr. Mohammed Safana, and the Secretary of the Forum, Dr. Vetty Agala.
