0
0
UNIVERSAL HEALTH COVERAGE: SOCIAL HEALTH INSURANCE AGENCIES ADVOCATE ESTABLISHMENT OF HEALTH TRUST FUND
The Social Health Insurance Agencies in Nigeria has called for coverage expansion priorities to include informal workers, rural populations, women, children, and persons with disabilities.
This was part of the communiqué at the end of the two-day summit of the agencies held in Akure the Ondo State capital.
The summit also urged simplication of enrolment systems, including digital platforms and community-based structures to improve access and reduce exclusion.
It was also decided that Primary Healthcare Centres should serve as the foundation of service delivery.
The summit equally advocated that Government investments should focus on infrastructure upgrades, essential medicines, workforce development, and strong referral systems to ensure continuity and quality of care.
Part of the communiqué was also that State Governments should establish Health Trust Fund as a matter is priority.
(Full Details of the Communiqué)
COMMUNIQUE ISSUED
AT THE MAIDEN NATIONAL SUMMIT OF SOCIAL HEALTH INSURANCE AGENCIES (SSHIAs)
HELD AT THE
INTERNATIONAL CULTURE AND EVENT
CENTRE (THE DOME)
AKURE, ONDO STATE
ON
MONDAY 8TH – TUESDAY 9TH, 2026
1.0 INTRODUCTION
1.1 The maiden edition of the National Summit of State Social Health Insurance Systems was held on the 8th and 9th June, 2026, at the International Culture and Event Centre, the Dome, Akure, Ondo State.
1.2 The programme, coordinated by the Forum for CEOs of SSHIAs in Nigeria brought together Government Officials, Regulatory Agencies, Financial Institutions, Development Partners, Policy makers and Stakeholders from the Health Cluster for a robust engagement and discussions on the theme: “Economic Realities and the Universal Health Coverage Dream: Mobilising States for a Scalable Health Insurance Future”.
2.0 OBJECTIVES OF THE SUMMIT
The Summit was designed with the following key objectives:
• To deliberate on strategies to reduce catastrophic expenditure on health services
• To identify sustainable financing models
• To foster deeper collaboration between NHIA, State Agencies and Partners
3.0 HIGHLIGHTS OF THE PROGRAMME
3.1 The event commenced with a welcome address by the Honourable Commissioner for Health of Ondo State, Dr. Olabanji Awolowo Ajaka, who welcomed participants and delegates to Ondo State for the Summit. The Summit was declared open by the Governor of Ondo State, His Excellency, Governor Lucky Orimisan Ayedatiwa; while goodwill messages were delivered by Dr. Salma Ibrahim, the Senior Special Adviser to the President on Health and other critical partners.
3.2 The keynote address was presented by Dr. Simeon Onyemaechi. He x-rayed the historical development of health insurance schemes and its evolution from Federal intentions to State-led programmes. His address highlighted the following issues:
• High out-of-pocket healthcare expenditure and rising healthcare costs.
• Persistent poverty and economic challenges limiting access to healthcare.
• Historically low health insurance coverage, especially among informal sector and vulnerable populations.
• Weak health financing mechanisms and inadequate funding for healthcare.
• Variation in the implementation and performance of State Social Health Insurance Schemes (SSHIAs).
• Inadequate political will, technical capacity and ICT infrastructure in some States.
• Trust and ownership issues
• Challenges in enrolling the Informal sector populations and integrating health financing programmes.
• Impact of COVID-19 on health insurance expansion and healthcare access.
• Wide disparities in Health Insurance coverage across States.
• Challenges associated with governance, political commitment and sustainability.
• Concerns regarding quality of care, provider accountability, including fraud and service delivery
The issues raised in his address formed the bedrock of further discussions at the summit.
3.3 During the Technical sessions, four (4) panels were held while papers and presentations were delivered. They include:
S/N Presentations Presenter /Moderator
1 Evolution of State Social Health Insurance Schemes in Nigeria: From Federal Pilot to State-Led UHC Drive Dr. Vetty Agala
2 Expanding Coverage: Scalable Strategies that Shift UHC from Paper to People Dr. Kelechi Ohiri
3 Best Practices/Innovations from SSHIAs Dr. Divine Igwe
4 Enforcement of Mandatory Health Insurance at the Sub-National Level Dr. Adeniyi Ogini
5 Custodians of Care: Strengthening Primary Healthcare Quality through Local Ownership and Accountability Chief Mrs Moji Makanjuola
6 Improving Access to Affordable and Quality Healthcare through Innovative Contributory Health Insurance Scheme
The Success story of DSCHC Olorogun Dr. Isaac Akpoveta
7 Financing the Future: Domestic Resource Mobilisation for Sustainable Health Insurance Dr. Vetty Agala
4.0 RECOMMENDATIONS AND IMPLEMENTATION ROADMAP FOR SUSTAINABLE UNIVERSAL HEALTH COVERAGE (UHC)
At the end of presentations and discussions, it was agreed as follows:
• That State Governments should strengthen its political commitment to UHC. There must be a mandatory health insurance cover for all residents of the States of Nigeria.
– There should be an established law for the Federal Capital Territory (FCT)
– There should be a clear legal and institutional framework that ensures effective implementation of Health Insurance laws. There should be a mandatory Formal sector coverage for States and Local Governments
– Federal and sub-National Health Insurance schemes should be harmonised, with strong regulatory oversight and firm political commitment to mandatory coverage, including the informal sector.
• That SSHIAs should adopt a mixed financing model which combines government budgetary allocations, mandatory health insurance contributions, and targeted subsidies for the vulnerable groups.
– There should be a consistent release of counterpart funds and the State equity funds by the States
– Additional resources can be mobilised through innovative mechanisms such as earmarked levies and Public Private Partnerships (PPP) to ensure a long-term financial stability.
• That SSHIAs should ensure that coverage expansion prioritises inclusion of informal workers, rural populations, women, children, and persons with disabilities. Simplified enrolment systems, including digital platforms and community-based structures, should be deployed to improve access and reduce exclusion.
• That Primary Healthcare Centres serve as the foundation of service delivery. Government investments should focus on infrastructure upgrades, essential medicines, workforce development, and strong referral systems to ensure continuity and quality of care.
• That provider payment systems should be reformed to improve efficiency and accountability and reduce fraud. Capitation and performance-based models should be strengthened, alongside timely reimbursement mechanisms to maintain providers’ participation and reduce service disruption.
• That SSHIAs must ensure robust data systems and monitoring frameworks are in place. Integrated digital health information systems should support enrolment tracking, claims management, and performance monitoring. Continuous evaluation and independent oversight will ensure transparency, improve outcomes, and support ongoing reform.
• That State Governments should establish Health Trust Fund as a matter is priority.
5.0 APPRECIATION
Participants commended the organizers and host of the Maiden National Summit of State Social Health Insurance Agencies (SSHIAs) for creating a platform that fostered collaboration, knowledge sharing, and strategic dialogue. The participants reaffirmed their commitment to strengthening state social health insurance systems and advancing Universal Health Coverage through sustainable, equitable, and people-centered health financing and service delivery mechanisms.
Issued this 9th Day of June, 2026.
_______________________ _______________________
Mr. Mohammed Safana Dr. Vetty Agala
Chairman, Secretary,
Forum of CEOs of SSHIAs Forum of CEOs of SSHIAs
Communique Drafting Committee:
1. Dr. Godwin Iyiala
Director General, Cross River State Health Insurance agency
2. Dr. Divine Igwe
Executive Secretary, Ebonyi State Health Insurance Agency
Vice Chairman, Forum of CEOs of SSHIAs
3. Dr. Adekunle Aledare
Executive Secretary, Kogi State Health Insurance Agency
Vice Chairman, Forum of CEOs of SSHIAs
4. Catherine O. Ogunjebi, LLM
Director, Legal Services, Ondo State Contributory Health Commission
5. Yusuf Abubakar, PhD
Planning Research and Statistics, Ondo State Contributory Health Commission
6. Christianah Akinmoladun
Network Management, Ondo State Contributory Health Commission
About The Author
