Nigeria's health insurance coverage stays below 10% despite state efforts
Nigeria’s health insurance sector covers less than 10% of its over 220 million population, with only 21.73 million residents enrolled in various schemes as of Q4 2025, according to the National Health Insurance Authority. Delta State leads with 2.93 million enrollees, driven mostly by its State Social Health Insurance Agency (SSHIA), while Taraba State trails with just 213,935. The top two states, Delta and Lagos, together account for 5.68 million enrollees—26.14% of national coverage. Lagos stands out for its private HMO market, hosting 1.18 million of the country’s 2.17 million private HMO enrolments. Most northern states rely on SSHIA, the Basic Health Care Provision Fund (BHCPF), and community‑based models, whereas southern states show more diversified mixes including federal formal sector and tertiary institution schemes. Despite legal mandates for universal coverage, out‑of‑pocket spending remains the dominant financing method, leaving the majority of Nigerians uninsured. Authorities say closing the gap will require stronger state programmes, expanded community‑based models, and greater private sector participation, especially in urban centres.