Nigeria has long put UHC at the center of its health agenda, and new reforms at the federal and state levels have the potential to advance Nigeria’s progress. These reforms will need to overcome significant challenges, including high out-of-pocket expenses, low budget allocations and expenditures at all levels of government, and limited coverage through health insurance and other demand-side financing mechanisms. The Government of Nigeria is working with local and international partners to overcome these challenges, improve health financing, and expand coverage of basic primary care services for the poor and most vulnerable.

The launch of Nigeria’s National Health Insurance Scheme (NHIS) in 1999 marked the first milestone toward UHC in Nigeria. The 2006 National Health Policy redesigned the NHIS, aiming to protect families from medically-triggered financial hardship; limit rising healthcare costs; equitably distribute healthcare costs and health facilities among income groups; ensure quality and efficiency; and harness private sector participation.

In March 2014, stakeholders attending the Presidential Summit on UHC in Abuja adopted the UHC Declaration, affirming that health is a fundamental human right and that the government is responsible for guaranteeing healthcare for all Nigerians.

These federal policies have also translated to reform efforts at the state level. Multiple state governments have passed or are in the final stages of passing state-sponsored health insurance bills to provide financial risk protection and access to quality care for their residents. Finally, the National Primary Health Care Revitalization Initiative aims to make at least one PHC center per ward fully functional, ensuring that all Nigerians have access to the essential package of basic health services at the PHC level.