As part of efforts geared towards repositioning the NHIA and putting Nigeria on the UHC trajectory, the current NHIA leadership has outlined strategic goals focused on expanding coverage, promoting equity, improving quality of care, and enhancing market efficiency. Achieving these goals will require key enablers, including citizen-centred engagement, effective use of data and technology, and strengthened organisational capacity.

Achieving the above feat requires synergy among the wide array of actors within the health insurance ecosystem. NHIA recognises that progress will be hampered by an atmosphere of fragmentation among key actors, which results in duplication of efforts, misaligned priorities, and inefficient resource use. Hence, the desire for enhanced partnership coordination.

In view of the above, NHIA engaged Development Governance International (DGI) Consult to convene a partnership coordination framework co-creation workshop on 9^th and 10^th April 2025 in Keffi, Nasarawa State. The workshop brought together key actors in the health insurance ecosystem, including representatives of NHIA, State Social Health Insurance Agencies (SSHIAs), Development partners, Civil Society Organizations (CSOs) and the private sector. It provided a platform to assess current collaboration mechanisms, identify gaps, and co-create an effective and inclusive partnership coordination framework that aligns with NHIA’s strategic directions, central to achieving UHC in Nigeria.

In the opening remarks delivered by the Director of Planning, Research, and Statistics, Dr. Abubakar Kurfi, on behalf of the Director General of the NHIA, Dr. Kelechi Ohiri, he mentioned that GIZ is supporting efforts to strengthen the implementation of the Basic Health Care Provision fund (BHCPF), and one of the key activities envisioned was strengthening private sector engagement. He stated that in light of emerging developments in the health sector, it became paramount to broaden the scope of stakeholders engaged and develop a comprehensive and inclusive strategy for achieving the goals of NHIA. This led to the need to develop a partnership coordination framework aimed at aligning and optimizing the contributions of diverse stakeholders across the health insurance ecosystem in pursuit of NHIA’s goals of expanding coverage, improving equity, enhancing quality of care, and increasing market efficiency.

An Overview of NHIA’s Goals and Priorities

The Deputy Director of Planning, Research, and Statistics, Mr Mohammed Aliyu, explained that the Authority was established to drive Nigeria’s health insurance agenda, with the core mandate to regulate, promote, and integrate health insurance schemes across the country in a way that ensures equitable access to quality healthcare for all. He emphasized that the successful implementation of these strategic goals relies on three critical enablers, including citizen engagement, data and technology, and organizational health and structure.  According to him, these enablers are essential to ensuring alignment of stakeholder efforts, responsiveness and performance across the entire health insurance ecosystem.

Effective Partnership Coordination for Catalyzing NHIA’s Goals

The Chief Executive Officer of DGI Consult, Dr. Gafar Alawode, in his presentation on “Effective Partnership Coordination for Catalyzing NHIA’s Goal”, gave a detailed overview of the health insurance ecosystem in Nigeria and the distinct functions of various actors within the ecosystem. He emphasized the need for effective coordination among all stakeholders in the ecosystem and the importance of aligning their roles and contributions to support the achievement of NHIA’s strategic goals.

He also highlighted the significance of effective partnership coordination, emphasizing its role in aligning efforts, harmonizing resources, promoting mutual accountability, fostering peer learning, enabling result-oriented monitoring, and strengthening ownership. The presentation also explored key principles and leadership requirements for driving and sustaining effective partnership coordination.

Health Insurance Ecosystem Analysis

Participants engaged in the first group work, which focused on analyzing the health insurance ecosystem. The goal of this session was to build a shared understanding of the health insurance ecosystem, map out key actors, and examine how their unique roles and contributions align to advance NHIA’s four strategic goals. At the end of the session, each group presented the outcome of their discussions on the analysis of the ecosystem, mapping out stakeholders, their contributions to the ecosystem, key issues in terms of opportunities and challenges, as well as recommendations to strengthen the ecosystem.

Design of Partnership Coordination Tools, Structures and Principles

The second group work focused on the design of partnership coordination tools, the structures and mechanisms for effective partnership coordination, the principles of coordination and how to effectively demonstrate them to achieve the desired goals. It also featured the challenges that could make a partnership difficult and how to overcome them. Part of the group work was designing a Technical Assistance (TA) hub, outlining its proposed core functions, operational design, success factors, anticipated challenges and possible mitigation strategies.

Charting a course of action for successful partnership coordination – the role of stakeholders

The panel discussion titled “Charting a Course of Action for Successful Partnership Coordination- the Role of Stakeholders’’ moderated by Dr Gafar Alawode featured representatives of key stakeholder groups within the health insurance ecosystem, including NHIA, SSHIAs, development partners, CSOs, and the private sector, to reflect on the value of effective partnership coordination. Panelists agreed that strong coordination would promote collaboration, harmonization of resources, transparency, and knowledge sharing, enabling all actors, including the private sector, to contribute meaningfully. The session further identified the need for deliberate private sector engagement, including the development of a tangible, compelling proof of concept or product that demonstrates the health and economic impact of investing in health insurance, which could be used to communicate value to various segments of the private sector and stimulate greater investment in the health insurance space.

Panelists also emphasized the need to establish a TA hub to support the ecosystem in key areas such as technology and data systems management, accountability, capacity building and training, strategic purchasing, research, and awareness creation.

What Next?

Stakeholders reached a consensus on the outline for developing the Partnership Coordination Framework. The framework will be developed based on the inputs from the workshop, followed by a validation exercise with a broader and more diverse stakeholder group to review and finalize the document.