The Federal Government has called on state governments and private sector players to match its increased investments in health financing by committing more funds to reduce the burden of out-of-pocket spending, which continues to push millions of Nigerians into poverty.

Coordinating Minister of Health and Social Welfare, Prof. Muhammad Pate, made the appeal on Monday at the National Dialogue on Health Financing in Abuja, themed “Reimagining the Future of Health Financing in Nigeria.” He expressed concern over decades of underfunding in the sector, noting that Nigerian families currently bear nearly 70% of healthcare costs out-of-pocket.

“For over two decades, our health system has been dominated by out-of-pocket spending by households and communities, a structure that has left millions vulnerable to financial hardship whenever illness strikes,” Pate said.

He stressed the need for stronger collaboration between the federal government, subnational governments, civil society, development partners, and private investors to overhaul Nigeria’s health financing architecture. Pate noted that the Tinubu administration had significantly increased health sector funding over the past two years and urged states to match this effort while the private sector works with the National Health Insurance Authority (NHIA) to create larger risk pools.

“We cannot continue to build a healthcare system on someone else’s taxpayer resources,” Pate said. “We must mobilize our own funds, invest more, and make every naira count. Good healthcare anywhere in the world is not cheap—it must be paid for.”

The minister highlighted Nigeria’s four-pillar health strategy—governance and accountability, improved health outcomes, unlocking the health value chain, and resilience and health security—as the foundation for reforms. He also cited progress in expanding health insurance coverage, with over four million Nigerians enrolled under NHIA in the past 18 months.

Pate emphasized the transformative potential of the 2022 Health Insurance Act, which mandates universal coverage and strengthens NHIA reforms. He called for employers and individuals to enroll workers and families, stressing that a larger risk pool is crucial to reducing catastrophic health costs.

The minister pointed to interventions such as free caesarean sections and expanded fistula care as key initiatives targeting vulnerable groups, adding that states must complement federal efforts to ensure sustainability. On identity barriers, he revealed that NHIA was collaborating with relevant agencies to issue National Identification Numbers (NINs) to enrollees, particularly pregnant women in need of emergency services.

Minister of State for Health, Dr. Iziaq Salako, underscored the importance of legislative and policy reforms to address inadequate budgetary allocations, systemic inefficiencies, and poor data management. He urged Nigeria to learn from Ghana and Kenya’s health financing models, which he said demonstrated the need for political commitment, innovative funding mechanisms, and community engagement.

NHIA Director-General, Dr. Kelechi Ohiri, said Nigeria must confront longstanding challenges such as high out-of-pocket spending and weak coordination among federal, state, and local governments. He noted that global health financing is shifting from reliance on development assistance to domestic resource mobilization, emphasizing the need for smarter financing to address Nigeria’s double burden of infectious and non-communicable diseases.

Ohiri highlighted reforms, including an upward review of service tariffs and new mandates requiring hospitals to treat patients even without referral codes from Health Maintenance Organisations (HMOs), aimed at rebuilding trust in the system.

“In less than a year, over 10,000 women have benefited from emergency obstetric care, and about 3,000 women with obstetric fistula have been treated across 20 centers nationwide,” he said. “We are also working to reduce out-of-pocket expenditure for the poor, with about 2.7 million Nigerians enrolled under the Basic Healthcare Provision Fund.”

He emphasized that the current administration has made equity a cornerstone of its reforms, with over 200 hospitals enrolled in the emergency obstetric programme and more expected to join.