Key points
- SUNU Health wants stronger legislation to accelerate universal health coverage in Nigeria.
- The company says closer collaboration between the NHIA, HMOs, healthcare providers and lawmakers is essential.
- It also called for sanctions against healthcare providers that deny services to insured patients.
Main story
The Managing Director of SUNU Health Nigeria Ltd., Dr Moyosore Olomola, has called for stronger legislation to expand health insurance coverage and accelerate Nigeria’s progress towards Universal Health Coverage (UHC).
Speaking in an interview with the News Agency of Nigeria (NAN), Olomola said achieving universal health coverage would require closer collaboration between the National Health Insurance Authority (NHIA), private Health Maintenance Organisations (HMOs), healthcare providers and the National Assembly.
He noted that Nigeria currently has about 22 million health insurance enrollees, only half of the NHIA’s target of 44 million beneficiaries by 2030.
According to Olomola, the relationship between the NHIA and private HMOs should evolve beyond regulation into a stronger partnership that improves healthcare financing and expands access to quality services.
He commended the NHIA for reforms, including tighter accreditation standards, enforcement of minimum capital requirements for HMOs, tariff reviews, digitisation of processes and greater engagement with private operators.
However, he said more reforms were needed, including a transparent tariff review mechanism linked to healthcare inflation, stronger enforcement of mandatory employer enrolment under the NHIA Act, predictable funding through the Basic Health Care Provision Fund and a formal dispute resolution framework between HMOs and the regulator.
Olomola also called for legislation establishing a provider accountability framework, arguing that healthcare providers who deny treatment to insured patients or demand unauthorised payments should face sanctions, including suspension from NHIA accreditation and public disclosure.
He said the proposals were presented during a recent engagement with the Chairman of the House of Representatives Committee on Health Services, Hon. Amos Magaji, as part of efforts to remove barriers to health insurance expansion.
Olomola identified funding constraints, unsuitable premium structures for informal workers, uneven commitment by state governments and poor compliance among healthcare providers as key obstacles to expanding coverage.
He added that SUNU Health is addressing the needs of informal sector workers through community-based enrolment involving cooperatives, trade associations and religious organisations, alongside weekly USSD micro-premium payments and telemedicine services delivered through its partnership with MobiHealth.
Olomola noted that Nigeria’s out-of-pocket healthcare spending remains above 70 per cent of total health expenditure, underscoring the need for stronger health insurance systems, digital claims processing, improved state financing and greater transparency.
The issues
Nigeria’s low health insurance coverage continues to expose millions of citizens to high out-of-pocket medical costs. Expanding enrolment will require not only stronger legislation and regulatory reforms but also improved provider accountability, sustainable financing and insurance products tailored to the country’s large informal workforce.
What’s being said
HMOs are not the NHIA’s adversaries; we are the delivery infrastructure for UHC. Without a sustainable private HMO sector, government cannot achieve its target of 44 million enrolled lives by 2030. — Dr Moyosore Olomola, Managing Director, SUNU Health Nigeria Ltd.
Nigeria has the demographic foundation, the regulatory architecture and growing political will to achieve universal health coverage. What is needed now is disciplined execution and a private sector that sees itself as a genuine partner in a national health mission. — Dr Moyosore Olomola.
What’s next
Attention will shift to whether lawmakers and the NHIA adopt the proposed legislative and regulatory reforms as Nigeria works towards increasing health insurance enrolment to 44 million by 2030.
Bottom line
SUNU Health says achieving universal health coverage will depend on stronger legislation, closer public-private collaboration and reforms that make health insurance more accessible, accountable and sustainable.
