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By Dr. Blessing Oyiza Onuigbo, MD
It started with a mother crying on the phone. Her son had just been diagnosed with appendicitis, and she needed urgent surgery approval. But she didn’t understand how her insurance plan worked, who to call, or what her benefits even covered. She wasn’t asking for much, just a chance to save her child’s life without bankrupting her family.
Working behind the scenes of Nigeria’s health insurance system, I have seen too many of these moments, some resolved, others heartbreaking. As a medical doctor and former Claims Operations Executive in a private healthcare organization, I have sat on both sides of the healthcare divide: with patients and behind the administrative curtain. What I have seen is that Nigeria needs a complete rethink of how we structure and deliver health coverage.
The hidden crisis: Low insurance, high out-of-pocket pain
In Nigeria, only about 3–5% of the population is covered by any form of health insurance. The rest pay out of pocket, often delaying or skipping care entirely because they simply can’t afford it. A medical emergency doesn’t just threaten lives; it threatens livelihoods.
The National Health Insurance Authority (NHIA) has laid out goals for wider coverage, but for many citizens, insurance is still misunderstood, distrusted, or entirely out of reach. Fragmented systems, limited provider networks, and inconsistent claims processing have eroded faith in the system.
What I learned working in the system
When I worked at Reliance Health, I witnessed firsthand the growing potential of tech-enabled, patient-centered insurance models. With better communication, direct provider relationships, and faster claims handling, we started rebuilding trust where the traditional system had failed.
But even in a forward-thinking organization, I saw how fragile the system could be, especially when it relied on patients to navigate complex structures on their own. Too often, they didn’t understand the fine print, the process, or the power of their coverage.
I realized that medical training alone wasn’t enough. If I wanted to help fix the broken system, I needed to understand the financial, operational, and policy engines behind it. That’s why I chose to pursue an MBA/MHA in the United States to gain the tools I need to help rebuild health systems, both in Nigeria and globally.
We need more than hospitals, we need systems that work
Nigeria’s health system doesn’t just need more hospitals or clinics; it needs functional, transparent systems that protect patients before they become critical. That means:
• Expanding community-level insurance education
• Leveraging technology to simplify enrollment and claims
• Building partnerships between private insurers and public systems
• Training a new generation of clinician-administrators who can speak both languages: care and cost
Universal health coverage isn’t a dream; it is a necessity. Countries with fewer resources than Nigeria have made strides by focusing on scalable insurance models that fit their population. We can too.
A Mission that goes beyond one country
As I train in healthcare management, I carry the stories of families, individuals I have worked with, their frustrations, their fears, and small victories into every case study and classroom discussion. My goal is not just to lead; it is to design systems that work for people, not against them.
Because no mother should cry over whether her insurance will answer the phone in time.
