…Advocates for inclusive health insurance coverage for women
By: Mercy Peter
Finance, cultural factors, low awareness, have been listed among the barriers to accessing quality healthcare for Nigerian women.
Consequently, the Senior Officer, Advocacy and Government and Multilateral Relations and Strategic Programmatic Partnerships at the Gates Foundation, Dr. Mojisola Odeku, has advocated for insurance benefits and packages that covers every aspect of women’s health including hormonal and reproductive services.
Dr. Odeku who spoke during a fireside chat in Abuja with the theme: “Breaking barriers to maternal health equity: the role of health insurance in promoting women’s wellness” organised by the Nigeria Solidarity Fund, said the way out is holistic health insurance for women in the country.
This, she said will help address challenges such as cultural factors, low awareness, illiteracy, and geographic inaccessibility
She identified several factors that prevent women in underserved communities from accessing quality healthcare including financial limitations, geographic inaccessibility, cultural factors, limited coverage for gender-specific needs and low awareness and illiteracy.
“Data shows that over 52% of Nigerian women report financial difficulties largely driven by out-of-pocket payments and the high rate of multidimensional poverty. Also, many insurance schemes exclude comprehensive maternal and hormonal care such as PCOS, postpartum depression and menopause-related conditions,” Odeku said.
While advocating that premium or subsidized health insurance should be given to low-income earners, Odeku stated successful projects including the State-Led Strategic Purchasing for Family Planning, Maternal, Newborn, and Child Health Project (SP4FP-MNCH), supported by the Gates Foundation, has strengthened Lagos State Health Insurance Schemes (SHIS) by integrating family planning and maternal services, the programme has led to sporadic increment and enrollment of over 950,000 workers in the informal sector within five years.
She further said: “The PHC Financing investment, implemented by R4D, revised the National Basic Minimum Package of Health Services (BMPHS) to improve access to affordable RMNCAEH services for poor and vulnerable groups.”
Explaining that health insurance can spike up resource pool of low-income communities with initiatives like Community-Based Health Insurance (CBHI) and social protection programs, Odeku mentioned that strategic private partnership and trust funds can enhance financial support to aid neglected women.
Although readiness for quality health service should be strengthen through programmes like Basic Health Care Provision Fund, more energy needs to be channeled towards sensitisation, public enlightenment and education in communities, she said.
Odeku pointed out that a guarantee of continuity of care insurance, which covers services from preconception through postpartum, could be designed to bridge access to reproductive and maternal services not excluding mental health and family planning.
She said using the human centered approach and behavior change communication health insurance for women should cover the lifecycle of productive health from puberty to menopause.
This includes essential financial and coverage support for infertility and chronic conditions like cervical and breast cancer.
She also pointed out that mobile and digital technologies can be relied on for more inclusiveness, the expert explained that more women can be reached in the remotest part of the country through mobile applications and USSD (Unstructured Supplementary Service Data) tool.
Also speaking at the panel, Dr. Binyerem Ukaire, Director and Head, Department of Family Health at the Federal Ministry of Health and Social Welfare emphasized that women’s healthcare is vital and the Ministry has prioritise healthcare insurance for women.
“Every woman has a right to health and life and the government has prioritised it, we will give premium to poor, rural women. However, there is a need for synergy and collaboration between donors and the government. It is a journey so patience is required but we must make it happen,” Ukaire said.
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Also speaking at the panel, Dr. Binyerem Ukaire, Director and Head, Department of family Health at the Federal Ministry of Health and Social Welfare emphasized that women’s healthcare is vital and the Ministry has prioritise healthcare insurance for women.
“Every woman has a right to health and life and the government has prioritise it, we will give premium to poor, rural women. However, there is need for synergy and collaboration between donors and government. It is a journey so patience is required but we must make it happen,” Ukaire said.
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including: Financial hardship with “Over 52% of Nigerian women report financial difficulties, largely driven by out-of-pocket payments and Nigeria’s high rate of multidimensional poverty.
“Geographic inaccessibility: Nearly 30% cite distance to healthcare facilities as a major challenge.
Cultural factors: In many instances, women’s healthcare decisions are determined by spouses or extended families.
Limited coverage for gender-specific needs: Many insurance schemes exclude comprehensive maternal and hormonal care such as PCOS, postpartum depression, and menopause-related conditions.
Low awareness and illiteracy: Religious, cultural, and informational barriers prevent women, especially in rural or informal sectors, from enrolling in insurance programs and accessing healthcare.
How Health Insurance Can Help:
Expand benefit packages to cover holistic women’s health, including hormonal and reproductive services. (GF) support example: The Nigeria State-Led Strategic Purchasing for Family Planning, Maternal, Newborn, and Child Health Project (SP4FP-MNCH) strengthened Lagos State Health Insurance Schemes (SHIS) and integrated FP and MNCH services. Enrolment in informal sectors rose from fewer than 1,000 to over 950,000 within five years.
Introduce tiered premium structures or subsidies for low-income earners. GF support example: The PHC Financing investment, implemented by R4D, revised the National Basic Minimum Package of Health Services (BMPHS) to improve access to affordable RMNCAEH services for poor and vulnerable groups.
Increase resource pools within low-income communities through Community-Based Health Insurance (CBHI) and social protection programs.
Leverage Trust Funds and private sector partnerships to create additional financial support mechanisms focused on underserved women.
Strengthen supply-side readiness for quality service delivery through mechanisms like the BHCPF, which provides provider payments and direct facility financing.
Enhance community outreach and education to build trust and increase health insurance uptake.
2. How can health insurance models be better designed to ensure women have continuous and affordable access to maternal and reproductive health services?
Guarantee continuity of care: Insurance should cover services from preconception through postpartum, including mental health and family planning.
Design for lifecycle coverage: Insurance should address the entire reproductive journey, from puberty to menopause, including support for infertility and chronic conditions like breast and cervical cancer.
Scale community-based health insurance (CBHI): Encourage models that allow women to contribute minimal amounts and pool risks locally.
Develop gender-responsive premiums and policies: Recognize higher healthcare utilization by women as an opportunity for improving public health outcomes.
Utilize digital and mobile platforms: Simplify enrollment and claims processing through apps and USSD tools to reach women in remote areas.
3. What role do you see the Gates Foundation playing in fostering partnerships that drive inclusive and sustainable health insurance programs for women in Nigeria?
Convening multisectoral actors (government, private insurers, civil society) to co-design inclusive insurance models.
Supporting research and data generation to strengthen gender-responsive insurance schemes.
Providing technical assistance for the adoption and scaling of innovative models through partnerships with NHIA and state governments.
Investing in digital health infrastructure to simplify and expand access.
Amplifying advocacy efforts on health financing reforms and maternal health equity.
Recent Foundation efforts to strengthen state-level PHC systems in Lagos, Kano, and Kaduna demonstrate the ongoing commitment to equitable healthcare access.
Are there innovative financing mechanisms or policy interventions that could make health insurance more accessible and beneficial to low-income women, particularly those in informal sectors?
Cross-subsidization models: Higher-income earners or formal sector employers subsidize premiums for low-income informal workers.
Voucher systems: Provide vouchers for specific health services redeemable at accredited facilities.
Conditional cash transfers (CCTs): Tie CCTs to health insurance enrollment and maternal health service attendance.
Microinsurance partnerships: Work with cooperatives and microfinance institutions to integrate health insurance into savings groups.
Tax incentives and policy reforms: Offer fiscal incentives to private insurers extending coverage to underserved women.
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She said using the human centered approach and behavior change communication health insurance for women should cover the lifecycle of productive health from puberty to menopause.
This includes essential financial and coverage support for infertility and chronic conditions like cervical and breast cancer.
She also pointed out that mobile and digital technologies can be relied on for more inclusiveness, the expert explained that more women can be reached in the remotest part of the country through mobile applications and USSD (Unstructured Supplementary Service Data) tool.
Also speaking at the panel, Dr. Binyerem Ukaire, Director and Head, Department of family Health at the Federal Ministry of Health and Social Welfare emphasized that women’s healthcare is vital and the Ministry has prioritise healthcare insurance for women.
“Every woman has a right to health and life and the government has prioritise it, we will give premium to poor, rural women. However, there is need for synergy and collaboration between donors and government. It is a journey so patience is required but we must make it happen,” Ukaire said.
