The Senior Health Specialist at the World Bank, Dr Olumide Okunola, has said that constitutional reforms and innovative revenue frameworks will be key to sustaining health financing in Nigeria.
Okunola, while speaking on Thursday at a policy dialogue on health financing in Abuja, pointed out that while Nigeria has made progress since 2023, the current structure of revenue allocation limits states’ ability to invest adequately in health.
He also said that additional funding sources, such as increasing allocations from the Consolidated Revenue Fund (CRF) might not be feasible without deeper fiscal reforms.
“Our calculations show that an additional one per cent from the CRF may not necessarily work because the Federal Government will not release another one per cent of its revenues. What we need is a stronger constitutional and fiscal framework that allows states to access and deploy resources more effectively,” Okunola explained.
He further highlighted the December 2023 signing of Nigeria’s Universal Health Coverage (UHC) compact as a landmark step, positioning the country as a model for global health financing reforms.
According to him, global conversations now recognise the increasing role of innovative financing for health, and Nigeria’s UHC compact has changed the narrative. This is not about a small number, it is about a compact that all governments agreed to, the opportunity for the investment we are talking about.
The health specialist urged civil society organisations (CSOs) to push for constitutional amendments that would enable states to generate and retain additional revenues for health, stressing that this would strengthen Nigeria’s journey toward UHC.
He also reaffirmed that with the right policy framework, Nigeria could move from fragmented health financing to a sustainable, inclusive system that would benefit all citizens.
Okunola further pointed out that public financial management (PFM) could translate into real-life health benefits, especially for women, noting that if things are done rightly, Nigeria can become a model that other countries come to study within five years.
Giving an instance that if NHIA should tell states to pile up receipts for safe deliveries and get reimbursed, the tragic cases being witnessed will cease.
Okunola emphasised that no woman in Nigeria should suffer or die during childbirth simply because she cannot afford good care. He also stressed that PFM is about how one builds, implements, and executes a budget.
Speaking earlier, the Permanent Secretary, Coordinating Ministry of Health, Ms. Daju Kachallom, recognised the significance of this dialogue, positioning the High-Level Policy Dialogue as a launchpad for bold, coordinated action to reform how Nigeria financed health.
“Let us move beyond dialogue into decisive action,” Kachallom said.
Aligning with the conversations at the Health Financing Policy Dialogue, organised by the NHIA with partners, health insurance coverage in Nigeria got a major boost with the directive mandating all MDAs to implement health insurance with strict compliance monitoring.
