REACHING OUT TO THE VULNERABLE: THE PROSPECTS AND CHALLENGES OF COMMUNITY HEALTH INSURANCE IN NIGERIA

Abstract

Access to quality healthcare remains a major challenge in Nigeria, particularly for vulnerable populations such as informal workers, rural dwellers, and low-income families. With over 70% of Nigerians relying on out-of-pocket payments for health services, many face catastrophic health expenditures and limited access to timely care. Community Health Insurance (CHI) has
emerged as a strategy to bridge this gap by offering a community-based, prepaid health financing model designed to enhance equity and financial protection. This study explores the prospects and challenges of implementing CHI in Nigeria. It aims to assess how CHI can be effectively used to improve healthcare access for the vulnerable while identifying the operational, policy, and social barriers hindering its sustainability and scalability. This study
employed a descriptive cross-sectional design to examine the prospects and challenges of Community Health Insurance (CHI) in reaching vulnerable populations in Nigeria. Data were collected from secondary data. qualitative data were subjected to thematic analysis to explore contextual barriers and facilitators. This methodological approach provided a comprehensive
understanding of how CHI functions, its perceived value, and the systemic constraints affecting its effectiveness in serving vulnerable groups. The study recommends increased public sensitization to improve awareness and enrollment, government support through policy integration and subsidies, capacity building for scheme management, and better alignment with national health strategies. Strengthening CHI can significantly contribute to achieving Universal Health Coverage (UHC) and reducing healthcare inequities in Nigeria Community.