Health
Nigeria’s health insurance gap leaves millions vulnerable, experts warn
Wale Akinselure
Health experts on Wednesday raised the alarm over Nigeria’s low health insurance coverage, warning that millions of Nigerians are being pushed into poverty by rising out-of-pocket medical expenses.
They said fewer than 10 per cent of Nigerians are covered by health insurance, leaving the vast majority to bear the full cost of healthcare whenever they fall ill.
The experts spoke at the 21st Annual Scientific Conference and Faculty Gathering of the Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, where they called for increased investment in healthcare financing, wider health insurance coverage and greater deployment of artificial intelligence to improve healthcare delivery.
Delivering the keynote address titled, “Advancing Universal Health Coverage in Nigeria: Progress, Challenges and Future Directions,” a former President of the Society of Gynaecology and Obstetrics of Nigeria, Prof Oluwarotimi Akinola, said Nigeria remained far from attaining Universal Health Coverage because it had failed to develop a sustainable healthcare financing model.
He lamented that the country’s health insurance coverage was still below 10 per cent, leaving many Nigerians vulnerable to catastrophic healthcare spending.
Akinola said, “Health insurance coverage in Nigeria is actually less than 10 per cent. Nigeria has one of the highest out-of-pocket health expenditures.
“If you fall sick two or three times, some illnesses will make you wretched because they consume your savings.”
Comparing Nigeria with other countries, he noted that while Ghana had about 40 per cent health insurance coverage and China about 95 per cent, Nigeria continued to lag.
“We are far from where we ought to be because we haven’t worked out the model that we want to use. There are different pathways to achieving Universal Health Coverage, but we have not chosen one that suits our peculiar circumstances,” he added.
The don identified underfunding as a major impediment to quality healthcare delivery, saying the sector continued to suffer from inadequate infrastructure, a shortage of manpower and the migration of health workers abroad.
“You cannot have an advancing health system when there is no money. Underfunding has resulted in weak infrastructure, inadequate staffing, brain drain, recurring strikes and dependence on donor funding,” he said.
According to him, achieving Universal Health Coverage goes beyond treating illnesses in hospitals and requires investment in preventive healthcare and the social determinants of health.
“Health is not only in the hospital. It is about water, sanitation, housing, nutrition and the environment. We cannot continue to concentrate only on treating diseases without addressing what causes them,” Akinola said.
He also described artificial intelligence as an important tool for improving healthcare delivery but stressed that it could not replace the need for sustainable healthcare financing.
“AI is one of the pathways. It can improve planning, diagnosis and service delivery, but we still have to develop a healthcare system that works for Nigeria,” he said.
Also speaking, the Vice-Chancellor of the University of Lagos, Prof Folasade Ogunsola, said out-of-pocket healthcare spending was unsustainable and urged the government to expand health insurance coverage to enable more Nigerians to access quality healthcare at an affordable cost.
Represented by the Deputy Vice-Chancellor (Development Services), Prof Foluso Lesi, Ogunsola said preventive healthcare remained critical in reducing the financial burden on households.
“Universal Health Coverage is imperative so that more people are covered and can access healthcare at little cost. Out-of-pocket healthcare expenses are not sustainable. Nigerians should also adopt healthier lifestyles by eating well, exercising regularly and maintaining good mental health,” she said.
On the role of artificial intelligence, the vice-chancellor said the technology had become indispensable in healthcare but would complement, rather than replace, health professionals.
“AI has come to stay. It makes healthcare delivery more efficient, but it will not replace humans. Healthcare workers must embrace AI for diagnosis and routine healthcare services,” she added.
The Dean of the Faculty of Clinical Sciences, UNILAG, Prof Olufemi Fasanmade, said artificial intelligence could help bridge the gap in healthcare delivery, particularly in underserved communities where access to doctors remained limited.
“There are many communities where there are no doctors at all. AI can bridge that gap through telemedicine and remote consultations, allowing specialists in urban centres to provide care to patients in rural areas,” he said.
Fasanmade noted that AI was already improving disease diagnosis, patient monitoring and healthcare planning, but warned that ethical principles must guide its deployment.
“There are issues of data privacy, confidentiality, accountability and accuracy. If an AI tool makes a wrong diagnosis, who takes responsibility? These are ethical concerns that must continue to be addressed as the technology evolves,” he said.
Similarly, the Provost of the College of Medicine, Prof Ademola Oremosu, represented by the Deputy Provost, Prof Daniel Odebiyi, urged healthcare professionals to embrace artificial intelligence.
“Anybody not talking about AI is not doing himself or herself any good. AI enhances precision in diagnosis. It is not taking anybody’s job; it is making healthcare easier, faster and more accurate,” he said.
A Consultant Orthopaedic Surgeon and member of the Local Organising Committee, Dr Olasode Akinmokun, said AI had demonstrated the capacity to improve diagnostic accuracy and reduce medical errors.
“There have been studies showing that AI-assisted interpretation of X-rays produced better diagnoses than human assessment alone. Integrating AI into our healthcare system will improve patient outcomes,” he said.
He, however, appealed to the government to improve the welfare and conditions of service of healthcare workers to stem the continued migration of professionals abroad.
The conference also featured a presentation by Professor of Global Health Informatics at the Warwick Medical School, University of Warwick, United Kingdom, Olalekan Uthman, titled “Artificial Intelligence in Clinical Academic Settings: Innovations, Applications and Ethical Considerations.”
Other dignitaries at the event included the Chief Medical Director of the Lagos University Teaching Hospital, Prof Wasiu Adeyemo, represented by the Chairman, Medical Advisory Committee, Prof Deji Oluwole, and the Chairman of the Local Organising Committee, Prof. Kehinde Okunade.
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