Publication Details
Abstract
More than 70% of health spending in Nigeria comes from out of Pocket, causing financial difficulties and undermining health service use. The National Health Insurance Authority NHIA Act 2022 was passed to push for widening coverage towards achieving Universal Health Coverage UHC, however, limited sub-national evidence exists on implementation outcomes. The study discusses the implications of health insurance on health service delivery in Nsukka Local Government Area LGA, Enugu State, Nigeria. Between January and March 2026, a descriptive cross-sectional survey was carried out involving 415 residents aged ≥18 years and health care providers in NHIA-accredited facilities. A multistage sampling technique was employed to get the 8 communities and 28 facilities. Nsukka LGA: Access and financial protection is enhanced; however, limited awareness and operational constraints limit impact. Accredited PHCs expansion, mandatory enrollment of informal sector groups, targeted community sensitization, and timely provider reimbursement are recommended to accelerate UHC. The study identifies poor service delivery, affordability and sustainability problems. It was therefore recommended effective sensitization and provision of affordable and sustainable policy for health insurance scheme in Nigeria.