article · World Journal of Public Health
This narrative review assessed the potential of Nigeria’s National Health Insurance Authority (NHIA) to achieve universal health coverage (UHC). It synthesised peer-reviewed literature, policy documents, and expert consultations to identify implementation challenges and policy gaps. The review found significant obstacles including limited public awareness, underfunded health budgets, poor infrastructure, a shortage of healthcare workers, and concerns about service quality. Socioeconomic factors like widespread poverty and high out-of-pocket payments further complicate these issues. Despite its potential, the NHIA's effectiveness is hindered by these structural problems. To improve its impact, the study recommends multi-sectoral reforms, including sustainable financing, stronger governance, strategic investments in health systems and workforce, integration with essential services, and community engagement. Addressing these gaps is crucial for Nigeria's progress towards UHC.
This research highlights critical issues affecting access to healthcare for millions in Nigeria. Understanding these barriers is essential for policymakers and health organisations to develop effective strategies, ensuring more equitable and comprehensive health services for all citizens and improving public health outcomes.
The abstract does not indicate an application pathway for commercialisation, as it focuses on policy analysis and systemic reforms within Nigeria's public health insurance framework.
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This narrative review examines the potential of Nigeria’s National Health Insurance Authority (NHIA) to achieve universal health coverage (UHC), with a focus on implementation challenges and policy gaps. The study synthesizes peer-reviewed literature (2013-2023), policy documents, and grey literature sourced using Boolean search strategies across PubMed, Scopus, Web of Science, and Google Scholar. Expert consultations with public health specialists further informed the analysis. The review highlights major barriers including limited public awareness and trust, underfunded health budgets, poor infrastructure, a critical healthcare workforce shortage, and concerns about service quality. Socioeconomic obstacles—such as widespread poverty and high out-of-pocket payments—compound these issues. Despite its potential, the NHIA’s effectiveness is constrained by these structural challenges. To enhance impact, the study recommends multi-sectoral reforms: sustainable financing beyond donor dependency, strengthened governance and accountability, strategic investments in health systems and workforce, integration of NHIA with essential services, and broad-based community engagement. Addressing these gaps is essential for the NHIA to fulfill its mandate and advance Nigeria’s progress toward UHC.
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DOI: 10.11648/j.wjph.20251003.13
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