NHIA: No woman should die over inability to pay

The National Health Insurance Authority (NHIA) says no woman should lose her life because she cannot afford treatment during pregnancy-related emergencies, assuring that financial barriers should never delay life-saving maternal healthcare.

Dr Kelechi Ohiri, Director-General of NHIA, said this in an interview with our correspondent on Friday in Abuja.

Ohiri spoke on a Federal Government intervention programme designed to provide financial protection for pregnant women facing life-threatening complications during pregnancy or childbirth.

According to him, the initiative ensures that women who arrive at hospitals with pregnancy complications receive immediate treatment without being required to make upfront payments before care begins.

“What we are essentially saying is that when a woman has a complication in pregnancy and goes to the hospital, money should not be the problem.

“Normally, when patients arrive at hospitals, they are asked to pay. If they do not have the money, care is delayed or they are referred elsewhere while they try to raise funds.

“That delay can make a woman die or suffer severe complications,” he said.

He explained that under the programme, accredited health facilities treated such patients free at the point of service, while the NHIA reimbursed hospitals for the cost of care.

He said the intervention formed part of broader reforms under the Nigeria Health Sector Renewal Investment Initiative (NHSRII), aimed at strengthening governance, financing and quality across the country’s health system.

According to him, the NHIA plays a central role in translating the reforms into measurable outcomes by expanding health insurance coverage while strengthening regulation and strategic purchasing.

Ohiri explained that the authority was shifting from passive reimbursement to strategic purchasing, where payments to healthcare providers were tied to quality standards and accreditation.

“As part of these reforms, provider participation is now linked to accreditation, compliance is being strengthened in high-volume hospitals, and accreditation and quality assessments are being digitised using the SafeCare platform.

“We have also deployed compliance officers and introduced a one-hour pre-authorisation timeline to ensure timely care for patients,” he said.

He noted that linking payments to standards encouraged hospitals to invest in better infrastructure, skilled personnel, improved data systems and stronger emergency obstetric care services.

“When payment is tied to standards, providers invest more in quality. Insurance then becomes a driver of quality, not just a payer of bills,” he said.

Ohiri added that the reforms were also helping to address maternal mortality by encouraging pregnant women with complications to seek care at properly equipped health facilities.

He said by linking accreditation to reimbursement for Comprehensive Emergency Obstetric and Newborn Care services, the authority was enforcing minimum standards and directing demand toward capable hospitals.

“Maternal mortality is often the result of fragmented services, weak infrastructure and low-volume facilities with limited capacity.

“By shaping the market to reward quality care, insurance can help discourage unsafe practices and improve outcomes for mothers and babies,” he added.

He revealed that since the emergency maternal care programme began in Oct. 2024, nearly 40,000 women across the country had benefited from the scheme.

“These are women who come with complications such as severe bleeding or cases requiring emergency caesarean section.

“When they arrive at the hospital, they are treated free of charge, and the NHIA reimburses the hospital for the services provided,” he said.

The NHIA D-G also highlighted progress in expanding health insurance coverage across the country.

He disclosed that between the fourth quarter of 2023 and the fourth quarter of 2025, enrolment under NHIA programmes increased by 34 per cent to about 21.7 million Nigerians.

According to him, five NHIA programmes targeted at vulnerable populations are also reaching millions of underserved beneficiaries, helping to ensure financial protection and quality improvement progress simultaneously.

“In spite of the progress made, the reforms remain complex and require sustained political commitment, technical coordination and time to deliver their full impact,” he said.

Ohiri emphasised that the ongoing reforms were aimed at strengthening equity, improving quality of care and expanding access to health services across Nigeria.