The Director-General of the National Health Insurance Authority (NHIA), Dr Kelechi Ohiri, says Nigeria must take charge of its health financing research agenda to sustain reforms, strengthen evidence-based policymaking and improve health outcomes nationwide.
Ohiri made the call at the inaugural Nigeria Health Financing Research and Learning Forum in Abuja, themed “Evidence and Learning for Nigeria’s Health Financing Future: Building a Locally Led Research and Learning Ecosystem.”
He said the forum was designed to leverage evidence to advance Nigeria’s health financing agenda, address the limitations of episodic research and strengthen institutional capacity for continuous learning and reform.
“For too long, our health financing initiatives in Nigeria have been shaped by well-meant studies designed, commissioned, analysed, reported, synthesised and presented to us at the finish line,” he said.
Although such studies had provided valuable insights, Ohiri noted that episodic research could not establish the enduring policy foundation needed to sustain reforms and inform long-term decision-making.
He stressed that research sovereignty did not mean isolating Nigeria from global support, but placing the country “in the driver’s seat” in defining questions, commissioning studies and embedding learning in implementation.
“International partnerships remain vital, and the work must focus on building domestic capacity and supporting domestic priorities,” Ohiri said, emphasising the need to balance collaboration with national ownership.
He said the NHIA would review five commissioned studies on embedded learning during the two-day forum and examine lessons from Ethiopia, Ghana and India to strengthen policy implementation.
Evidence must serve reforms, he added, noting that Nigeria’s health financing agenda focused on mandatory health insurance coverage, equity, quality healthcare delivery and long-term sustainability.
Nigeria’s health insurance landscape remained fragmented, comprising 37 government insurance schemes and more than 95 private schemes operating across different segments of the population. This fragmentation, he said, raised important questions about sustainability and highlighted the need for robust research to guide future reforms.
The NHIA had identified 15 studies linked to its strategic priorities and was working to build research ecosystems involving national institutions, universities and other stakeholders. It was also pursuing a national health financing observatory, 15 research action plans, a national research agenda and regional collaboration frameworks.
The World Health Organization (WHO) Representative in Nigeria, Dr Pavel Ursu, said health financing remained foundational to Universal Health Coverage and required implementation research to support reforms.
Global commitments on sustainable health financing and Universal Health Coverage, he said, must translate into concrete and transformative actions that improve healthcare access and outcomes at country level.
Establishing the Nigeria Health Financing Research and Learning Forum, Ursu added, provided an institutional opportunity to unpack research questions and increasingly drive national policy and implementation processes. WHO hoped the forum would mark the beginning of a sustained, nationally owned health financing research and learning movement.
Dr Kumanan Rasanathan, Executive Director of the Alliance for Health Policy and Systems Research, WHO, said research and learning should not be treated as luxuries in health systems.
“If you don’t have your own knowledge, if you don’t know your own problems, if that is not preserved for future generations, you cannot be sovereign,” Rasanathan said.
He noted that many institutions across Africa remained heavily dependent on external funding and warned that shrinking financial support could weaken organisations responsible for generating critical knowledge and evidence.
Countries needed domestically driven learning agendas that connected knowledge, communities and decision-makers while strengthening national ownership of research and policy development. Researchers should move beyond identifying problems and focus on developing practical solutions that could be implemented effectively within local contexts.
Countries also required domestic institutions that were sustainably financed, linked to national processes and retained the independence to provide objective advice.
Dr Yetunde Aluko, representing the Nigerian Institute of Social and Economic Research (NISER), said Nigeria needed more locally developed and relevant evidence to guide health financing reforms.
She called for an enduring national system in which policymakers, researchers, implementers, communities and practitioners jointly identified priority questions and continuously learned from implementation experiences.
“Health financing research should therefore not be viewed simply as a production of reports or academic publications,” she said. It should function as part of a national learning system capable of showing what worked, for whom, under what circumstances and at what cost, while generating evidence on implications for equity, sustainability and effectiveness.
Fatima Zannah, Cluster Manager and Head of Programme at the German Development Cooperation (GIZ), said locally generated evidence was critical for designing health financing approaches that reflected Nigerians’ realities and needs.
Health financing decisions could not be made in isolation from factors influencing healthcare-seeking behaviour, including culture, religion, geography, income, education, gender and social networks.
“This is why locally generated evidence matters. It allows us to move beyond assumptions and better understand the diversity of experiences across Nigeria,” she said.
Nigeria could also learn from countries facing similar challenges, adapt relevant lessons and build on their experiences. Zannah urged participants to view evidence as a tool for decision-making, policy development, transparency, equity and accountability. Development partners, she added, looked forward to supporting the initiative and seeing the evidence translated into better decisions and improved health outcomes.
The forum, which began on Monday, is expected to conclude on Tuesday after deliberations focused on strengthening health financing research, learning systems and evidence-informed reforms across Nigeria.
