June 16, 2025

The Health

Your health, your choice

Financial risk protection and Nigeria’s journey towards universal health coverage

Financial risk protection and Nigeria’s journey towards universal health coverage

  • Auwal, A.-M. S., Oluwatomisin, L. A., Olatunji, T. Y., Adekunle, A. A.-R. & Oluwatobi, O. P. Achieving Universal Health Coverage in Nigeria: Current Challenges and Recommendations. Int J. Trop. Dis. Health 44, 1–5 (2023).

    Article 

    Google Scholar 

  • Awosusi, A. Nigeria’s mandatory health insurance and the march towards universal health coverage. Lancet Glob. Health 10, e1555–e1556 (2022).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • Okoroafor, S. C. et al. Conceptualizing and implementing a health workforce registry in Nigeria. Hum. Resour. Health 20, 8 (2022).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • World Health Organization. Universal health coverage. (2024).

  • World Health Organization. UHC Service coverage Index. (2024).

  • World Health Organization. SDG Target 3.8 | Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all. GlobalHealthObservatory https://www.who.int/data/gho/data/themes/topics/indicator-groups/indicator-group-details/GHO/sdg-target-3.8-achieve-universal-health-coverage-(uhc)-including-financial-risk-protection.

  • Kodali, P. B. Achieving Universal Health Coverage in Low- and Middle-Income Countries: Challenges for Policy Post-Pandemic and Beyond. Risk Manag Health. Policy 16, 607–621 (2023).

    Article 

    Google Scholar 

  • GBD 2019 Universal Health Coverage Collaborators. Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 396, 1250–1284 (2020).

  • World Health Organization. Financial Protection. (2024).

  • Boerma, T. et al. Monitoring progress towards universal health coverage at country and global levels. PLoS Med. 11, e1001731 (2014).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Wagstaff, A., Cotlear, D., Eozenou, P. H.-V. & Buisman, L. R. Measuring progress towards universal health coverage: with an application to 24 developing countries. Oxf. Rev. Econ. Policy 32, 147–189 (2016).

    Article 

    Google Scholar 

  • Adeyi, O. Health System in Nigeria: From Underperformance to Measured Optimism. Health Syst. Reform 2, 285–289 (2016).

    Article 
    PubMed 

    Google Scholar 

  • Ataguba, J. E. & Ingabire, M.-G. Universal Health Coverage: Assessing Service Coverage and Financial Protection for All. Am. J. Public Health 106, 1780–1781 (2016).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Aregbeshola, B. S. & Khan, S. M. Out-of-Pocket Payments, Catastrophic Health Expenditure and Poverty Among Households in Nigeria 2010. Int J. Health Policy Manag 7, 798–806 (2018).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Bhatia, D. et al. Identifying priorities for research on financial risk protection to achieve universal health coverage: a scoping overview of reviews. BMJ Open 12, e052041 (2022).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Sands, P. Celebrating universal health coverage in Nigeria. TheGlobalFund (2023).

  • World Health Organization. Billions left behind on the path to universal health coverage. (2023).

  • Puras, D. Universal Health Coverage: A Return to Alma-Ata and Ottawa. Health Hum. Rights 18, 7–10 (2016).

    PubMed 
    PubMed Central 

    Google Scholar 

  • Lambo, E. & Olikoye, O. Ransome-Kuti: A testimony of his achievements in health reforms and public health governance. Afr. J. Reprod. Health 27, 15–26 (2023).

    PubMed 

    Google Scholar 

  • Aregbeshola, B. S. & Khan, S. M. Primary Health Care in Nigeria: 24 Years after Olikoye Ransome-Kuti’s Leadership. Front Public Health 5, 48 (2017).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Anya, I. Developing healthy public policy in Nigeria. Lancet 363, 573–574 (2004).

    Article 
    PubMed 

    Google Scholar 

  • Federal Ministry of Health. Revised National Health Policy. (2004).

  • Anaemene, B. U. Health Diplomacy under structural adjustment programe: A view from Nigeria. Int. Aff. Glob. Strat. 15, 48–58 (2013).

    Google Scholar 

  • World Health Organization. Domestic general government health expenditure (GGHE-D) as percentage of general government expenditure (GGE) (%). GlobalHealthObservatory (2024).

  • Federal Ministry of Health. NATIONAL HEALTH FINANCING POLICY 2006. (2006).

  • Uzochukwu, B. et al. Health care financing in Nigeria: Implications for achieving universal health coverage. Niger. J. Clin. Pr. 18, 437 (2015).

    Article 
    CAS 

    Google Scholar 

  • African Union. Abuja Declaration on HIV/AIDS, Tuberculosis, and Other Related Infectious Diseases. in African summit on HIV/AIDS, Tuberculosis, and Other Related Infectious Diseases (Abuja, 2001).

  • Alawode, G. et al. The Political Economy of the Design of the Basic Health Care Provision Fund (BHCPF) in Nigeria: A Retrospective Analysis for Prospective Action. Health Syst. Reform. 8, e2124601 (2022).

    Article 

    Google Scholar 

  • Ibrahim, Z. A. et al. Influence of Basic Health Care Provision Fund in improving primary Health Care in Kano state, a descriptive cross-sectional study. BMC Health Serv. Res 23, 885 (2023).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Art, B., De Roo, L. & De Maeseneer, J. Towards unity for health utilising community-oriented primary care in education and practice. Educ. Health ((Abingdon)) 20, 74 (2007).

    Article 
    PubMed 

    Google Scholar 

  • van Weel, C. & Kidd, M. R. Why strengthening primary health care is essential to achieving universal health coverage. CMAJ 190, E463–E466 (2018).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Fabong, J. Y., Fabong, H. A. M. & Igboechesi, G. P. Review on the Reflection of National Health Financing Policy and Strategy on Nigerians towards Achieving Universal Health Coverage by 2030. Int J. Public Health Pharm. Pharmacol. 8, 10–25 (2023).

    Article 

    Google Scholar 

  • Akinwumi, A. I. et al. Strong primary care services, an important feature of primary health care: What can Nigeria learn from Israel?. Front Public Health 10, 1006095 (2022).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Ipinnimo, T. M., Durowade, K. A., Afolayan, C. A., Ajayi, P. O. & Akande, T. M. The Nigeria national health insurance authority act and its implications towards achieving universal health coverage. Niger. Postgrad. Med J. 29, 281–287 (2022).

    Article 
    PubMed 

    Google Scholar 

  • Bolongaita, S. et al. Financial hardship associated with catastrophic out-of-pocket spending tied to primary care services in low- and lower-middle-income countries: findings from a modeling study. BMC Med 21, 356 (2023).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Rahman, T., Gasbarro, D. & Alam, K. Financial risk protection from out-of-pocket health spending in low- and middle-income countries: a scoping review of the literature. Health Res Policy Syst. 20, 83 (2022).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Pinilla-Roncancio, M., Amaya-Lara, J. L., Cedeño-Ocampo, G., Rodríguez-Lesmes, P. & Sepúlveda, C. Catastrophic health-care payments and multidimensional poverty: Are they related?. Health Econ. 32, 1689–1709 (2023).

    Article 
    PubMed 

    Google Scholar 

  • Opeloyeru, O. S. & Lawanson, A. O. Determinants of catastrophic household health expenditure in Nigeria. Int J. Soc. Econ. 50, 876–892 (2023).

    Article 

    Google Scholar 

  • Edeh, H. C. Exploring dynamics in catastrophic health care expenditure in Nigeria. Health Econ. Rev. 12, 22 (2022).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Ataguba, J. E.-O. Reassessing catastrophic health-care payments with a Nigerian case study. Health Econ. Policy Law 7, 309–326 (2012).

    Article 
    PubMed 

    Google Scholar 

  • Ataguba, J. E. Assessing financial protection in health: Does the choice of poverty line matter?. Health Econ. 30, 186–193 (2021).

    Article 
    PubMed 

    Google Scholar 

  • Ataguba, J. E., Ichoku, H. E., Ingabire, M. & Akazili, J. Financial protection in health revisited: Is catastrophic health spending underestimated for service- or disease-specific analysis?. Health Econ. 33, 1229–1240 (2024).

    Article 
    PubMed 

    Google Scholar 

  • Ipinnimo, T. M. & Durowade, K. A. Catastrophic Health Expenditure and Impoverishment from Non- Communicable Diseases: A comparison of Private and Public Health Facilities in Ekiti State, Southwest Nigeria. Ethiop. J. Health Sci. 32, 993–1006 (2022).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Odunyemi, A., Rahman, T. & Alam, K. Economic burden of non-communicable diseases on households in Nigeria: evidence from the Nigeria living standard survey 2018-19. BMC Public Health 23, 1563 (2023).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Amarachukwu, C. N., Okoronkwo, I. L., Nweke, M. C. & Ukwuoma, M. K. Economic burden and catastrophic cost among people living with sickle cell disease, attending a tertiary health institution in south-east zone, Nigeria. PLoS One 17, e0272491 (2022).

    Article 
    CAS 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Knapp, G. C. et al. The out-of-pocket cost of breast cancer care at a public tertiary care hospital in Nigeria: an exploratory analysis. Pan African Med. J. 41, 272 (2022).

    Article 

    Google Scholar 

  • Okafor, C. N., Obikeze, E. N., Young, E. E. & Onwujekwe, O. E. Levels of health expenditure and payment coping mechanisms for persons living with diabetes and hypertension both singly and in comorbidity in Enugu, Southeast, Nigeria. Int J. Noncommun Dis. 9, 65–74 (2024).

    Article 

    Google Scholar 

  • Awofisayo, S. O., Akwaowoh, A. E., Arhewoh, M. I., Awofisayo, J. I. & Essien, N. L. Financial Burden of Hypertension Management on Clients Patronizing Community Pharmacies in a Nigerian Metropolis. J. Basic Soc. Pharm. Res. 2, 51–61 (2022).

    Article 

    Google Scholar 

  • Adeniji, F. I. P., Lawanson, A. O. & Osungbade, K. O. The microeconomic impact of out-of-pocket medical expenditure on the households of cardiovascular disease patients in general and specialized heart hospitals in Ibadan, Nigeria. PLoS One 17, e0271568 (2022).

    Article 
    CAS 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Olaigbe, O. Nigerians struggle to find medication after GSK pull-out. The Guardian (2023).

  • Aluh, D. O., Aigbogun, O. & Okoro, R. N. Global pharma departure from Nigeria: A threat to public health. J. Med. access 8, 27550834241256450 (2024).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Sato, R. Evaluation of catastrophic health expenditure risk due to measles in Nigeria. Hum. Vaccin. Immunother. 18, e2065836 (2022).

    Article 

    Google Scholar 

  • Adeniran, A. et al. Investigating catastrophic health expenditure among people living with HIV and AIDS in South Western Nigeria. Health Care Sci. 2, 370–380 (2023).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Etiaba, E., Onwujekwe, O., Torpey, K., Uzochukwu, B. & Chiegil, R. What Is the Economic Burden of Subsidized HIV/AIDS Treatment Services on Patients in Nigeria and Is This Burden Catastrophic to Households?. PLoS One 11, e0167117 (2016).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Ogundeji, K. D., Risenga, P. R. & Thupayagale-Tshweneagae, G. B. Direct cost of wound dressing in Nigeria: Implications for catastrophic healthcare expenditure. Int J. Afr. Nurs. Sci. 19, 100597 (2023).

    Google Scholar 

  • Oladeji, E., Ezeme, C., Baiyewu, L., Okunola, M. & Ogunlade, S. The catastrophic cost of motorcycle road traffic injuries: Experience from a major reference centre in a lower-middle income country. Injury 55, 111314 (2024).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • Bolarinwa, O. A., Akande, T. M., Janssens, W., Boahene, K. & de Wit, T. R. Effects of a temporary suspension of community-based health insurance in Kwara State, North-Central, Nigeria. Pan. African Med. J. 41, 10 (2022).

    Article 

    Google Scholar 

  • Nelissen, H. E. et al. The prominent role of informal medicine vendors despite health insurance: a weekly diaries study in rural Nigeria. Health Policy Plan 35, 354–363 (2020).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Enejoh, V. A. et al. Patent medicine vendors in Nigeria: Viable agents in bridging the health care workforce divide. Ann. Glob. Health 82, 489 (2016).

    Article 

    Google Scholar 

  • Obembe, T. A., Bankole, O. T., Abbas, G. & Ajayi, I. O. Healthcare Service Payment Methods and Coping Strategies of Nomads and Labor Migrants in Oyo State, Nigeria. Am. J. Trop. Med Hyg. 102, 1022–1029 (2020).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Etiaba, E., Onwujekwe, O., Uzochukwu, B. & Adjagba, A. Investigating payment coping mechanisms used for the treatment of uncomplicated malaria to different socio-economic groups in Nigeria. Afr. Health Sci. 15, 42 (2015).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Petrovic, D. et al. Health-related biological and non-biological consequences of forgoing healthcare for economic reasons. Prev. Med Rep. 24, 101602 (2021).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Kabembo, I. M. Forgone healthcare for medically vulnerable groups during the pandemic era: experiences of family caregivers of young adults with substance use disorders in Zambia. Front. Public Health 12, 1250608 (2024).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Chukwuma, A., Bossert, T. J. & Croke, K. Health service delivery and political trust in Nigeria. SSM Popul Health 7, 100382 (2019).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Ogu, I. J., Igwe, I., Aronu, N. I., Msughter, L. & Odo, O. K. Out-of-pocket payment on healthcare: implication on the health status of women in enugu state, south-east nigeria. WukariInternationalStudiesJournal 8, 54–67 (2024).

    Google Scholar 

  • Odunyemi, A., Sohrabi, H. & Alam, K. The evolution of household forgone essential care and its determinants during the COVID-19 pandemic in Nigeria: A longitudinal analysis. PLoS One 19, e0296301 (2024).

    Article 
    CAS 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Mafiana, J. J., Shen, X., Hu, W. & Wang, X. Insight into Nigeria’s progress towards the universal coverage of reproductive, maternal, newborn and child health services: a secondary data analysis. BMJ Open 12, e061595 (2022).

    Article 
    PubMed Central 

    Google Scholar 

  • Onwujekwe, O. et al. Was the Maternal Health Cash Transfer Programme in Nigeria Sustainable and Cost-Effective?. Front Public Health 8, 582072 (2020).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Ujah, O. I., Olaore, P., Ogbu, C. E., Okopi, J.-A. & Kirby, R. S. Prevalence and determinants of food insecurity among pregnant women in Nigeria: A multilevel mixed effects analysis. PLOS Glob. Public Health 3, e0002363 (2023).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Ujah, O. I., LeCounte, E. S., Ogbu, C. E. & Kirby, R. S. Food insecurity and delayed or forgone health care among pregnant and postpartum women in the United States, 2019–2021. Nutrition 116, 112165 (2023).

    Article 
    PubMed 

    Google Scholar 

  • Onoka, C. A., Onwujekwe, O. E., Hanson, K. & Uzochukwu, B. S. Examining catastrophic health expenditures at variable thresholds using household consumption expenditure diaries. Trop. Med Int Health 16, 1334–1341 (2011).

    Article 
    PubMed 

    Google Scholar 

  • Ichoku, E., Fonta, W. & Onwujekwe, O. Incidene and intensity of catastrophic healthcare financing and impoverishment due to out-of-pocket payments in southeast Nigeria. J. Insurance risk Manag. 4, 47–59 (2009).

    Google Scholar 

  • World Health Organization. Reducing out-of-pocket health expenditure a panacea to universal health coverage. (2022).

  • Kalu, K. Assessing the impacts of donor support on Nigeria’s health system: The global fund in perspective. Int Soc. Sci. J. 72, 243–253 (2022).

    Article 

    Google Scholar 

  • Onwujekwe, O. et al. Exploring effectiveness of different health financing mechanisms in Nigeria; what needs to change and how can it happen?. BMC Health Serv. Res 19, 661 (2019).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Aregbeshola, B. S. A Tax-based, Noncontributory, Health-Financing System Can Accelerate Progress toward Universal Health Coverage in Nigeria. MEDICC Rev. 20, 40–45 (2018).

    Article 
    PubMed 

    Google Scholar 

  • Reeves, A. et al. Financing universal health coverage-effects of alternative tax structures on public health systems: cross-national modelling in 89 low-income and middle-income countries. Lancet 386, 274–280 (2015).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Lim, M. Y., Kamaruzaman, H. F., Wu, O. & Geue, C. Health financing challenges in Southeast Asian countries for universal health coverage: a systematic review. Arch. Public Health 81, 148 (2023).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Okungu, V., Chuma, J., Mulupi, S. & McIntyre, D. Extending coverage to informal sector populations in Kenya: design preferences and implications for financing policy. BMC Health Serv. Res 18, 13 (2018).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Tangcharoensathien, V. et al. Health-financing reforms in southeast Asia: challenges in achieving universal coverage. Lancet 377, 863–873 (2011).

    Article 
    PubMed 

    Google Scholar 

  • Igbinadolor, N. Limited tax base cramps Nigeria’s revenue. Business Day Nigeria (2022).

  • Awoyemi, B. O., Makanju, A. A., Mpapalika, J. & Ekpeyo, R. S. A time series analysis of government expenditure and health outcomes in Nigeria. J. Public Health Afr. 14, 1409 (2023).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • McIntyre, D., Ranson, M. K., Aulakh, B. K. & Honda, A. Promoting universal financial protection: evidence from seven low- and middle-income countries on factors facilitating or hindering progress. Health Res Policy Syst. 11, 36 (2013).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Rudasingwa, M. et al. Universal health coverage and the poor: to what extent are health financing policies making a difference? Evidence from a benefit incidence analysis in Zambia. BMC Public Health 22, 1546 (2022).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Dutta, A. & Charles, H. Scaling Up National Health Insurance in Nigeria: Learning from Case Studies of India, Colombia, and Thailand. (2013).

  • Michael, C. Informal sector accounts for 76.7% of Nigeria’s workforce — Report. Business Day Nigeria (2024).

  • Hayatudeen, N., Umar, A. O., Abiola, T., Sulaiman, Z. T. & Jatau, J. Evaluating a health insurance scheme in a hospital setting: proposing an alternative to out-of-pocket payments in nigeria. West Afr. J. Med 41, S25–S26 (2024).

    Google Scholar 

  • Eze, O. I., Iseolorunkanmi, A. & Adeloye, D. The National Health Insurance Scheme (NHIS) in Nigeria: current issues and implementation challenges. J. Glob.Health Econ. Policy 4, e2024002 (2024).

    Google Scholar 

  • Delamothe, T. A centrally funded health service, free at the point of delivery. BMJ 336, 1410–1412 (2008).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Nwanaji-Enwerem, O. et al. Patient satisfaction with the Nigerian National Health Insurance Scheme two decades since establishment: A systematic review and recommendations for improvement. Afr. J. Prim. Health Care Fam. Med. 14, e1–e10 (2022).

    Article 
    PubMed 

    Google Scholar 

  • Odonkor, S. N. N. T., Koranteng, F., Appiah-Danquah, M. & Dini, L. Do national health insurance schemes guarantee financial risk protection in the drive towards Universal Health Coverage in West Africa? A systematic review of observational studies. PLOS Glob. Public Health 3, e0001286 (2023).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Uduu, O. Health Insurance in Nigeria – Only 3% of Nigerians are Covered. Dataphyte (2021).

  • Shobiye, H. O. et al. Determinants and perception of health insurance participation among healthcare providers in Nigeria: A mixed-methods study. PLoS One 16, e0255206 (2021).

    Article 
    CAS 
    PubMed 
    PubMed Central 

    Google Scholar 

  • A.O, A. et al. Follow-up Performance assessment of a Social Health Insurance Scheme in a southwest Nigeria state. South East Eur J Public Health 76–84 (2024).

  • Gomez, G. B. et al. Improving Maternal Care through a State-Wide Health Insurance Program: A Cost and Cost-Effectiveness Study in Rural Nigeria. PLoS One 10, e0139048 (2015).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Okoro, R., Nmeka, C. & Erah, P. Drug Use in the National Health Insurance Scheme at a Tertiary Hospital in the South East Nigeria. J. Adv. Med Pharm. Sci. 12, 1–10 (2017).

    Article 

    Google Scholar 

  • Carrin, G., Waelkens, M.-P. & Criel, B. Community-based health insurance in developing countries: a study of its contribution to the performance of health financing systems. Trop. Med Int Health 10, 799–811 (2005).

    Article 
    PubMed 

    Google Scholar 

  • UHC2030. Community-based health intervention: a step towards Universal Health Coverage in Nigeria. (2022).

  • Shittu, A. K. & Afolabi, O. S. Community Based Health Insurance Scheme and State-Local Relations in Rural and Semi-Urban Areas of Lagos State, Nigeria. Public Organ. Rev. 21, 19–31 (2021).

    Article 

    Google Scholar 

  • Odeyemi, I. A. O. Community-based health insurance programmes and the National Health Insurance Scheme of Nigeria: challenges to uptake and integration. Int J. Equity Health 13, 20 (2014).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Lawal, A. F., Araba, K. T. & Yusuf, J. The Context of Community-Based Health Insurance in Nigeria: Lessons for the African Continent. in The Palgrave Handbook of Global Social Problems 1–22 (Springer International Publishing, Cham, 2022). https://doi.org/10.1007/978-3-030-68127-2_209-1.

  • Akinwale, A. Nigeria Health Insurance Remain Low With Only 5% of 208m Population Covered”. ThisDay (2024).

  • Adetona, M. Two decades later, Nigeria’s health insurance is still flailing. Aljazeera (2022).

  • Abubakar, I. et al. The Lancet Nigeria Commission: investing in health and the future of the nation. Lancet 399, 1155–1200 (2022).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Banwat, M., et al. Community Based Health Insurance knowledge and willingness to Pay: A survey of a rural community in North Central zone of Nigeria. Jos J. Med. 6, 54–59 (2012).

    Google Scholar 

  • Olawoye-Mann, S. Alajo Shomolu. in Community Economies in the Global South 67–86 (Oxford University PressOxford, 2022) https://doi.org/10.1093/oso/9780198865629.003.0004.

  • Akwaowo, C. D. et al. Willingness to Pay for a Contributory Social Health Insurance Scheme: A Survey of Rural Residents in Akwa Ibom State, Nigeria. Front. Public Health 9, 654362 (2021).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Bolarinwa, O. A. et al. Willingness and ability to pay for healthcare insurance: A cross-sectional study of Seven Communities in East and West Africa (SevenCEWA). PLOS Glob. public health 1, e0000057 (2021).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Mariani, A. W. & Pêgo-Fernandes, P. M. Willingness to pay What? Sao Paulo Med J. 132, 131–132 (2014).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Ogundeji, Y. K., Akomolafe, B., Ohiri, K. & Butawa, N. N. Factors influencing willingness and ability to pay for social health insurance in Nigeria. PLoS One 14, e0220558 (2019).

    Article 
    CAS 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Dasgupta, R. R., Mao, W. & Ogbuoji, O. Addressing child health inequity through case management of under-five malaria in Nigeria: an extended cost-effectiveness analysis. Malar. J. 21, 81 (2022).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • David, A. M., Haddock, R. L., Bordallo, R., Dirige, J. T. & Mery, L. The use of tobacco tax revenues to fund the Guam Cancer Registry: A double win for cancer control. J. Cancer Policy 12, 34–35 (2017).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Bertolaccini, L., Viti, A. & Terzi, A. The Statistical point of view of Quality: the Lean Six Sigma methodology. J. Thorac. Dis. 7, E66–E68 (2015).

    PubMed 
    PubMed Central 

    Google Scholar 

  • Aregbeshola, B. S. Enhancing Political Will for Universal Health Coverage in Nigeria. MEDICC Rev. 19, 42–46 (2017).

    Article 
    PubMed 

    Google Scholar 

  • Ilesanmi, O. S., Afolabi, A. A. & Adeoya, C. T. Driving the implementation of the National Health Act of Nigeria to improve the health of her population. Pan African Med. J. 45, 157 (2023).

    Article 

    Google Scholar 

  • link