Tinubu Orders Mandatory Health Insurance Across MDAs, Links Compliance to Procurement and Licensing‎

By Abiola Adigun

President Bola Ahmed Tinubu has directed full enforcement of the National Health Insurance Authority (NHIA) Act, 2022, mandating all Ministries, Departments, and Agencies (MDAs) to enrol their staff in the national health insurance scheme.
The directive, issued through the Secretary to the Government of the Federation (SGF), requires MDAs to comply with five key measures designed to expand health coverage, safeguard workers, and strengthen accountability in government transactions.
Under the new order, no company or individual can participate in public procurement, obtain licenses, or renew permits without presenting a valid NHIA-issued Health Insurance Certificate. The NHIA is also expected to launch a digital platform to enable real-time verification of these certificates, curbing fraud and ensuring transparency.
President Tinubu, however, urged closer engagement with the private sector to prevent businesses from being “unduly constrained” by the implementation process.
Nigeria’s National Health Insurance Authority Act, signed into law in 2022, made health insurance compulsory for all citizens and empowered NHIA to extend coverage nationwide. But three years later, only about 10 percent of Nigerians are covered under any form of health insurance, according to World Bank estimates, leaving millions to rely on out-of-pocket payments.
Health experts note that the lack of mandatory enforcement, weak infrastructure, and poor awareness have slowed progress toward universal health coverage.
Dr. Salma Ibrahim, a former Director at the Federal Ministry of Health, described Tinubu’s directive as a “watershed moment” for health financing in Nigeria.
“Linking health insurance compliance to procurement and licensing will push both public and private actors to take it seriously. This could finally change the narrative of low enrollment,” she said.
While the directive has been praised by health advocates, some businesses worry about its implications.
Mr. Muda Yusuf, Director of the Centre for the Promotion of Private Enterprise (CPPE), told Daily Trust:
“The intention is good, but the government must ensure the rollout does not stifle small and medium enterprises. The compliance process should be digitized, simplified, and affordable.”
According to the World Health Organization (WHO), Nigerians spend nearly 77 percent of their health expenses out-of-pocket—the highest in Africa. This financial burden has been linked to rising poverty and preventable deaths.
Professor Innocent Ujah, President of the Nigerian Medical Association (NMA), welcomed the directive but stressed the need for effective monitoring.
“The NHIA must ensure that the insurance actually provides access to quality care, not just paperwork. We don’t want a situation where people have certificates but can’t get treatment.”
Tinubu’s order signals a new chapter in Nigeria’s push for universal health coverage, a target the government hopes to achieve by 2030 in line with the Sustainable Development Goals (SDGs).
Health sector analysts believe the success of the directive will depend on political will, strong enforcement, and collaboration with both state governments and private insurers.
As the NHIA prepares to roll out its digital verification platform, all eyes will be on how quickly MDAs and businesses adapt to what could become one of the most transformative reforms in Nigeria’s health sector.