GIFSHIP opens health insurance access to families, SMEs, informal workers

L-R: Immediate Past President, Healthcare Providers Association of Nigeria (HCPAN), Dr. Arigbabuwo Jimmy; MD/CEO, Ultimate Health Management Services, Otunba Lekan Ewenla; Independent Non-Executive Director, Ultimate Health Management Services, Mrs. Bolajoko Odunwo; MD/CEO, Olaniba Memorial Specialist Hospital and Ebenezer Specialist Clinic & Maternity, Dr. Adenike Olaniba and CMD/Founder, Subol Hospital Limited, Dr. Olayiwola Bello, during the official launch of U-Health GIFSHIP  for the informal sector and small and medium-sized business owners, held in Lagos recently.

By Admin

Nigeria's drive towards Universal Health Coverage (UHC) received a boost with the official introduction of the Group, Individual and Family Social Health Insurance Product (GIFSHIP), a scheme designed to extend affordable healthcare to millions of Nigerians in the informal sector and small and medium-sized enterprises (SMEs).

At the launch in Lagos, the Managing Director and CEO of Ultimate Health HMO, Otunba Lekan Ewenla, described the initiative as a significant milestone in broadening access to quality healthcare beyond the formal workforce.

“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 explained that while health insurance for federal workers has grown to become one of the country's most widely utilised benefit packages across nearly 10,000 NHIA-accredited healthcare facilities, the vast majority of Nigerians remain outside the formal sector and require a structured pathway to affordable healthcare.

“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,” he said.

Ewenla said the scheme which operates under strict regulation by the National Health Insurance Authority (NHIA), has an annual premium fixed at ₦38,718 per person and is non-negotiable under NHIA operational guidelines.

“ 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 stated.

According to him, demand for health insurance coverage outside the public sector began shortly after the federal civil servants' programme took off, prompting calls for similar protection for traders, artisans, transport workers, market associations and other informal sector operators which informed the development and “unpacking of the federal civil servants' benefit package into GIFSHIP, making it suitable for groups, individuals and families.

Ewenla explained that the initiative aligns with the National Health Insurance Authority's (NHIA) drive to achieve universal health coverage by providing a standardised benefit package that makes healthcare more affordable, accessible and equitable.

He stressed that the product would particularly target 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.

"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.

Highlighting the evolution of health insurance in Nigeria, Ewenla recalled that the federal government's health insurance programme for civil servants effectively transformed the former 10 per cent medical allowance into health insurance premiums, a shift that improved access to organised healthcare instead of direct cash payments.

He argued that previous arrangements, including payment of medical allowances and retainership agreements between employers and hospitals, failed to produce measurable improvements in health outcomes.

He expressed confidence that wider adoption of GIFSHIP would improve public perception of health insurance, strengthen collaboration between HMOs and healthcare providers, and bring Nigeria closer to achieving equitable access to quality healthcare.