An advocacy effort initiated by a group of CSOs led by the Center for Social Justice (CENSOJ) for the amendment of the 2004 National Health Insurance Scheme (NHIS) came to fruition with signing into law of the new National Health Insurance Authority (NHIA) Act-2022 by President Buhari on 19th May 2022. The CSOs advocacy cluster led by CENSOJ was initially supported by the USAID Civil Society Project – Strengthening Advocacy and Civic Engagement (SACE), 2014- 2019, and the support continued under the current USAID Strengthening Civic Advocacy and Local Engagement (SCALE) project, 2020-2025. SCALE (like its predecessor SACE) strengthens the capacity of civil society organizations in Nigeria to promote policy reforms for good governance using the collective impact model (Cluster Approach)


Reform is a long-term process and the continuity of efforts under SACE and SCALE contributed to this important achievement. The CENSOJ-led group, with support from USAID SACE and SCALE projects advocated for the following specific areas which were incorporated into the amended Act:

  • Compulsory insurance for everyone,
  • Improvement of a strategy for resource mobilization for health insurance, and
  • Special provision for vulnerable groups.

The new Act paves the way for fundamental reform in financing of the health system. It binds the government to allocate more funding to the health system and implement measures to expand coverage of health insurance for the entire population, particularly to the vulnerable groups, to make progress towards achievement of Universal Health Coverage (UHC). Passing of the Act, however, is not an end but a means to guiding implementation of health reform; therefore, SCALE/CENSOJ-led CSO cluster will continue its advocacy efforts for implementation of the Act.