The National Health Insurance Authority (NHIA) has refunded more than N14.2 million to health insurance enrollees and suspended nine healthcare facilities following complaints over services provided under Nigeria’s health insurance system.
The authority also issued 368 warning letters to healthcare providers after resolving 3,878 complaints, according to a statement released on Sunday.
NHIA Director-General and Chief Executive Officer, Dr Kelechi Ohiri, disclosed the figures in Abuja during the inaugural Civil Society Organisation-Led Mid-Year Review of Nigeria’s National Health Sector Reforms.
The authority said the enforcement measures formed part of efforts to strengthen patient protection and improve the quality of healthcare available to people enrolled in the national health insurance system.
According to the NHIA, inspection teams have been deployed to healthcare facilities to monitor compliance with its one-hour treatment authorisation policy, as well as other patient-protection and quality-of-care requirements.
The authority said the measures were necessary to ensure that increased health insurance coverage translated into meaningful access to healthcare.
Ohiri said the NHIA was moving beyond policy development and legislation to focus on implementation and measurable improvements in healthcare delivery.
“We have moved from policy and legislation to measurable implementation. The next task is to move from coverage to reliable access, from reliable access to better health outcomes, and from insurance membership to genuine financial protection,” he said.
The enforcement measures come as health insurance enrolment in Nigeria has increased from about 16 million at the beginning of the current administration to more than 23 million.
The NHIA also said more than 2.7 million poor and vulnerable Nigerians have received support through the Basic Health Care Provision Fund.
The authority said recent reforms had contributed to a 93 per cent increase in capitation and a 378 per cent rise in fee-for-service reimbursements.
More than 7,500 healthcare facilities have also undergone digital assessment under the SafeCare quality framework, according to the agency.
The authority has also expanded support for cancer patients through a cost-sharing partnership with pharmaceutical company Roche for selected oncology medicines.
Under the arrangement, Roche covers 50 per cent of the cost, while the NHIA pays 30 per cent and patients contribute the remaining 20 per cent.
Eligible radiotherapy patients can also receive financial support ranging from N400,000 to full coverage.
Other cancer-related services covered under the programme include mammography, CT and MRI scans, bone scans, diagnostic tests and radiotherapy.
Ohiri said the expansion was aimed at ensuring that health insurance provided meaningful financial protection when patients required expensive medical treatment.
“For us, coverage has to mean something when people become ill. Cancer is one of the clearest examples of why health insurance matters,” he said.
The NHIA said more than 51,000 people had been covered under its HIV and tuberculosis programme across Anambra, Ebonyi, Gombe and Kwara states as of September 3, 2026.
The beneficiaries include more than 38,000 people living with HIV, over 7,400 drug-sensitive tuberculosis patients and 594 patients with drug-resistant TB.
The authority has also begun accrediting more than 2,000 healthcare facilities ahead of a planned nationwide expansion of HIV/AIDS and TB coverage in 2027.
The expansion is expected to increase access to treatment and health insurance support for people living with the conditions.
In maternal and newborn healthcare, the NHIA said its interventions had reached more than 93,000 women and newborns.
The figure includes 79,221 women, 7,500 newborns and 6,044 women treated for fistula.
The authority also reported a decline in case fatality at participating maternal health facilities.
According to the NHIA, fatalities declined by 22 per cent, from 1,042 in the 2024 baseline to 810 as of August 2026.
Despite the reported expansion in coverage and reforms, Ohiri acknowledged that a large proportion of Nigerians remain outside the health insurance system.
READ MORE: 10 Simple Habits of People Who Always Seem Happy and Productive
He said the increase to more than 23 million enrollees represented progress but also highlighted the scale of the remaining challenge.
“We have made substantial progress, but we are not where we need to be. Over 23 million Nigerians covered is significant, but it also tells us that there are many more Nigerians who are still outside the system,” Ohiri said.
The NHIA said its ongoing reforms would continue to focus on expanding coverage, strengthening patient protection, improving healthcare quality and ensuring that insurance membership provides genuine financial protection to Nigerians.
The latest figures highlight the NHIA’s increasing focus on enforcement, healthcare quality and patient protection as Nigeria works to expand health insurance coverage and improve access to essential medical services.
