Impact of NHIA On Immunization Rates and Antenatal Visits in Nigeria (Published)
Preventive healthcare, especially immunization and antenatal care (ANC), remains essential for improving maternal and child health outcomes in Nigeria. Despite past public health interventions, access to these services has been inconsistent and unevenly distributed. The transition from the National Health Insurance Scheme (NHIS) to the National Health Insurance Authority (NHIA) under the 2022 Act was introduced to improve service coverage and remove financial and structural barriers to Universal Health Coverage (UHC). This study explores the impact of the NHIA on the uptake of preventive healthcare, particularly immunization and ANC services.A cross-sectional descriptive study was conducted across Nigeria’s six geopolitical zones, involving 600 women of reproductive age (15–49 years) who had delivered within the past two years. A multistage sampling technique was used to ensure representativeness. Data were collected using structured questionnaires and interviews with health workers. Quantitative data were analyzed using SPSS version 26.0, while qualitative responses were examined thematically. Ethical approval was obtained, and participation was voluntary. Following the implementation of NHIA, full childhood immunisation coverage increased from 58.4% to 72.9%, while the proportion of pregnant women who had four or more ANC visits rose from 64.1% to 80.2%. Awareness of health insurance schemes grew from 49.6% to 76.3%, and actual enrollment increased from 39.2% to 66.5%. Higher uptake was observed among women with formal education, salaried employment, and those living in urban areas. The findings suggest that NHIA has positively influenced access to preventive healthcare services in Nigeria. The removal of out-of-pocket payments and broader insurance coverage contributed to improved utilization. However, disparities remain in rural communities and among women with little or no formal education. These patterns indicate the need for targeted strategies that address geographical and socio-economic inequalities in access to care. The NHIA has shown early success in enhancing immunization and ANC service uptake. These improvements indicate that health insurance reform can be an effective mechanism for promoting preventive care and advancing UHC. Nevertheless, persistent barriers such as low awareness in rural areas, cultural influences, and infrastructure gaps must be addressed. Strengthening grassroots health education, incentivizing rural health worker retention, and implementing inclusive policies will be critical to ensuring that the NHIA achieves its full potential.
Keywords: Immunization, NHIA, Nigeria, Rates, antenatal visits