State health insurance agencies have overtaken federal programmes as the largest drivers of Nigeria’s health insurance coverage, with Lagos, Delta and Kano emerging as the leading states in enrolment, according to the National Health Insurance Authority’s fourth quarter 2025 dashboard.
An analysis of the NHIA data showed that State Social Health Insurance Agencies accounted for 9,744,758 beneficiaries, surpassing the 7,068,457 enrollees under NHIA-managed programmes and underscoring the increasing role of states in expanding access to healthcare.
The shift comes as Nigeria continues its push towards achieving Universal Health Coverage through state-owned insurance schemes, the Basic Healthcare Provision Fund and equity programmes targeting poor and vulnerable populations.
Among the states, Lagos recorded the highest health insurance coverage with 2,757,992 beneficiaries, followed by Delta with 2,925,353 and Kano with 1,232,683.
The Federal Capital Territory accounted for 956,664 beneficiaries, while Oyo recorded 671,298, Edo had 658,337, Katsina registered 603,238, Jigawa had 583,766, and Osun recorded 561,351 beneficiaries.
