..implores States to establish Health Trust Funds

Participants at the maiden National Summit of State Social Health Insurance Systems (SSHIAs) have called for mandatory health insurance coverage for all residents of Nigeria as part of efforts to achieve Universal Health Coverage (UHC) and reduce the burden of out-of-pocket healthcare expenses.

The summit, held from June 8 to 9, 2026, at the International Culture and Event Centre (The Dome), Akure, Ondo State, brought together government officials, regulatory agencies, financial institutions, development partners, policymakers and stakeholders in the health sector.
The event, coordinated by the Forum of Chief Executive Officers of State Social Health Insurance Agencies (SSHIAs), was themed “Economic Realities and the Universal Health Coverage Dream: Mobilising States for a Scalable Health Insurance Future.”

According to the communiqué issued at the end of the summit, participants agreed that state governments should strengthen their political commitment to Universal Health Coverage by ensuring mandatory health insurance coverage for all residents.
The communiqué stated: “There must be a mandatory health insurance cover for all residents of the States of Nigeria.”
Participants also recommended the establishment of a legal framework for health insurance in the Federal Capital Territory (FCT) and called for stronger institutional mechanisms to ensure effective implementation of health insurance laws across the country.
They further stressed the need to harmonise federal and sub-national health insurance schemes, with robust regulatory oversight and political commitment to mandatory coverage, including for workers in the informal sector.
The summit identified several challenges confronting health insurance coverage in Nigeria, including high out-of-pocket healthcare expenditure, rising healthcare costs, persistent poverty, weak health financing mechanisms, inadequate funding, and disparities in health insurance coverage among states.
Delivering the keynote address, Dr. Simeon Onyemaechi examined the evolution of health insurance schemes in Nigeria and highlighted concerns over inadequate political will, limited technical capacity, poor ICT infrastructure in some states, trust issues, and challenges associated with enrolling informal sector populations.
He also pointed to governance concerns, sustainability challenges, and issues relating to quality of care, provider accountability, fraud and service delivery.
The communiqué noted that the issues raised during the keynote address formed the basis for subsequent deliberations and technical sessions.
Participants agreed that State Social Health Insurance Agencies should adopt a mixed financing model combining government budgetary allocations, mandatory health insurance contributions and targeted subsidies for vulnerable groups.
According to the communiqué, “Additional resources can be mobilised through innovative mechanisms such as earmarked levies and Public Private Partnerships (PPP) to ensure a long-term financial stability.”
The summit also urged state governments to ensure the consistent release of counterpart funds and state equity funds to support health insurance programmes.
On expanding coverage, participants recommended that informal workers, rural communities, women, children and persons with disabilities should be prioritised through simplified enrolment systems, digital platforms and community-based structures.
The communiqué further underscored the importance of Primary Healthcare Centres as the foundation of healthcare delivery.
It stated: “Government investments should focus on infrastructure upgrades, essential medicines, workforce development, and strong referral systems to ensure continuity and quality of care.”
Participants also called for reforms in provider payment systems to improve efficiency, strengthen accountability and reduce fraud. They recommended strengthening capitation and performance-based payment models, alongside timely reimbursement mechanisms to sustain provider participation and minimise service disruptions.
To improve transparency and performance monitoring, the summit advocated integrated digital health information systems to support enrolment tracking, claims management and programme evaluation.
The summit further recommended that state governments establish Health Trust Funds as a matter of priority to strengthen healthcare financing.

At the end of the summit, participants commended the organisers and hosts for creating a platform that encouraged collaboration, knowledge sharing and strategic dialogue among stakeholders.
They reaffirmed their commitment to strengthening state social health insurance systems and advancing Universal Health Coverage through sustainable, equitable and people-centred health financing and service delivery mechanisms.
The communiqué was signed by Chairman of the Forum of CEOs of SSHIAs, Mohammed Safana, and the Secretary, Vetty Agala.