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Nigeria expands universal health coverage with GIFSHIP to reach informal workers nationwide

Nigeria has taken another step toward achieving Universal Health Coverage (UHC) with the official launch of the Group, Individual and Family Social Health Insurance Product (GIFSHIP), a new health insurance initiative aimed at providing affordable healthcare to millions of Nigerians working in the informal sector as well as small and medium-sized enterprises (SMEs).

The scheme was formally unveiled in Lagos by Ultimate Health HMO as part of efforts to extend health insurance coverage beyond employees in the formal workforce.

Speaking at the launch, the Managing Director and Chief Executive Officer of Ultimate Health HMO, Otunba Lekan Ewenla, described the introduction of U-Health GIFSHIP as a major milestone in Nigeria’s journey toward expanding access to quality healthcare.

“The formal launch of U- Health GIFSHIP today marks a bold step towards setting the right agenda for the gradual attainment of Universal Health Coverage for the country.

“Only about 15 percent of Nigeria’s population works in the formal sector, while approximately 85 percent earns a living in the informal economy, making expansion of health insurance beyond government employees critical to improving national health outcomes.”

Ewenla noted that although health insurance for federal civil servants has evolved into one of Nigeria’s most widely used employee benefit programmes across nearly 10,000 National Health Insurance Authority (NHIA)-accredited healthcare facilities, a significant proportion of the country’s population remains outside the formal employment system and requires access to structured and affordable healthcare coverage.

He explained the origin of the insurance package, saying:

“The GIFSHIP is the sole actuarially developed benefit package for the Federal Civil Servants across the country and it was made mandatory for the all the federal civil servants which makes it to be a social programme,”

According to Ewenla, the programme operates under the strict supervision of the National Health Insurance Authority (NHIA), with an annual premium fixed at ₦38,718 per enrollee, a rate that is non-negotiable under NHIA operational guidelines.

He added:

“ Ultimate Health HMO would implement the programme in full compliance with NHIA regulations, including a monthly capitation payment of ₦1,450 per enrollee and ₦700 per enrollee for fee-for-service, alongside other prescribed operational standards.

“Our objective is simple: to penetrate the informal sector and make health insurance available to millions of Nigerians who have previously remained outside the system,”

Ewenla disclosed that interest in health insurance among Nigerians outside the public sector increased shortly after the federal civil servants’ programme commenced. That growing demand from traders, artisans, transport workers, market associations and other informal sector participants, he said, led to the development and “unpacking of the federal civil servants’ benefit package into GIFSHIP, making it suitable for groups, individuals and families.”

He further explained that GIFSHIP aligns with the National Health Insurance Authority’s objective of achieving Universal Health Coverage by offering a standardised benefit package designed to make healthcare more affordable, accessible and equitable.

The initiative is expected to focus on organised groups within the informal economy, including market associations, transport unions, chambers of commerce, mechanics, furniture makers, beauticians, spare parts dealers, healthcare workers and other professional associations.

Ewenla stated:

“The adoption of GIFSHIP is intended to strengthen healthcare delivery through systematic pooling of enrollees to accredited healthcare facilities, thereby ensuring adequate patient volumes that support quality service delivery while improving relationships between HMOs and healthcare providers.

Reflecting on the development of Nigeria’s health insurance system, he recalled that the Federal Government’s health insurance programme for civil servants effectively converted the former 10 per cent medical allowance into health insurance premiums, enabling workers to access organised healthcare services instead of receiving direct cash payments.

He argued that earlier approaches, including medical allowance payments and retainership arrangements between employers and hospitals, did not produce measurable improvements in healthcare outcomes.

Ewenla expressed optimism that broader adoption of GIFSHIP would enhance public confidence in health insurance, strengthen collaboration between Health Maintenance Organisations (HMOs) and healthcare providers, and accelerate Nigeria’s progress toward equitable access to quality healthcare.

Source: Punch

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