Reported by Weng Patrick Atokor l Journalist at Weng Global
Nigeria’s National Health Insurance Authority (NHIA) is pushing the institutionalisation of Health Technology Assessment (HTA) as part of efforts to improve how healthcare resources are prioritised, purchased and funded across the country.
The approach is designed to help decision-makers assess the medical, economic, social and ethical value of medicines, medical devices, treatments and healthcare interventions before scarce public and insurance resources are committed.
The NHIA has described HTA as an important tool for ensuring that healthcare spending delivers measurable value and supports progress towards universal health coverage.
What is Health Technology Assessment?
Health Technology Assessment is a systematic process used to evaluate whether a healthcare technology or intervention provides sufficient health benefits in relation to its costs and wider consequences.
The assessment can cover medicines, medical equipment, diagnostic technologies, treatment methods and models for delivering healthcare.
For Nigeria, the approach is particularly relevant as the country seeks to expand health insurance coverage while managing limited financial resources.
The NHIA has said that expanding insurance coverage can increase demand for expensive interventions, including dialysis, oncology services and long-term treatment for non-communicable diseases. Without evidence-based decisions on which interventions should receive funding and under what conditions, rising demand could place additional pressure on health-financing systems.
NHIA Pushes Evidence-Based Healthcare Spending
The NHIA’s move builds on efforts already under way to institutionalise HTA within Nigeria’s health-financing system.
At the National Health Financing Dialogue in Abuja in September 2025, the agency highlighted HTA as a mechanism for prioritising scarce resources, improving accountability and creating a more transparent basis for healthcare financing decisions.
Yakubu Agada, then Director of Standard and Quality Assurance at the NHIA, said the agency had previously faced situations where medicines and medical devices were introduced without sufficient evidence to justify their inclusion.
He argued that HTA could help ensure that healthcare spending is supported by evidence rather than decisions made without adequate data. Premium Times reported the comments during a panel discussion on advancing HTA for universal health coverage.
The Health Strategy and Delivery Foundation has also reported that the institutionalisation of HTA emerged as a key commitment from Nigeria’s National Health Financing Dialogue, with subsequent work focused on developing mechanisms for implementation.
Why the System Matters for Healthcare Financing
Healthcare systems must constantly make decisions about which services, medicines and technologies should receive funding.
Those decisions become more difficult when resources are limited and the cost of medical treatment continues to rise.
An evidence-based assessment can help policymakers examine questions such as:
- Does a treatment improve patient outcomes?
- How effective is it compared with available alternatives?
- What does it cost?
- Can the health system afford it at scale?
- Which groups are likely to benefit?
- Are there cheaper alternatives that provide comparable results?
- What are the wider social and economic consequences?
The objective is not simply to spend less. It is to make healthcare spending more closely connected to health outcomes and value.
The NHIA has repeatedly linked HTA to cost-effective and equitable healthcare decisions as Nigeria works towards universal health coverage.
Nigeria Builds Local Capacity for Health Technology Assessment
Nigeria’s HTA efforts are also being supported by the development of locally relevant health data.
A 2026 peer-reviewed study published in Quality of Life Research examined the development of Nigeria’s first EQ-5D-5L value set. The research involved the NHIA and academic and international partners and provides locally derived health utility information that can support economic evaluation and health-policy decisions.
Such data can be important because healthcare decisions cannot always rely on evidence generated in other countries.
The effectiveness, cost and social impact of a healthcare intervention can vary according to a country’s population, disease burden, healthcare infrastructure, income levels and available treatment options.
Building Nigerian evidence therefore gives policymakers a stronger basis for assessing healthcare technologies within the country’s own circumstances.
The Wider Health Insurance Reform
The HTA initiative comes as Nigeria continues efforts to expand health insurance coverage.
The NHIA was established under the National Health Insurance Authority Act of 2022, which replaced the former National Health Insurance Scheme Act of 1999. The authority’s mandate covers Nigerians and legal residents through various health-insurance programmes.
In September 2025, the NHIA announced that President Bola Tinubu had directed the implementation of mandatory health insurance across federal ministries, departments and agencies, in line with provisions of the 2022 law. The directive included requirements relating to NHIA certification for certain procurement and licensing processes.
Expanding coverage increases the importance of how health funds are allocated.
More people entering an insurance system can generate greater demand for healthcare services. If spending decisions are not carefully assessed, expensive treatments and technologies could consume significant portions of available resources.
HTA is therefore being positioned as one part of a broader effort to strengthen strategic purchasing and healthcare financing.
From Spending to Health Outcomes
The central issue is not simply the amount of money spent on healthcare but what Nigerians receive from that expenditure.
The NHIA has previously described strategic purchasing as an important part of improving healthcare quality and resource allocation. Its programmes are intended to provide financial protection while improving access to healthcare services.
The adoption and institutionalisation of HTA could give policymakers a structured way to compare competing healthcare needs.
For example, when several interventions are seeking public or insurance funding, evidence from HTA can help establish their relative clinical effectiveness, costs and broader consequences.
That could make healthcare purchasing more transparent and potentially reduce decisions based primarily on pressure, precedent or incomplete information.
However, the success of the approach will depend on the quality of available data, the independence and transparency of assessments, the capacity of institutions to apply the evidence and the willingness of decision-makers to use the findings consistently.
What Happens Next?
The development of HTA in Nigeria is expected to remain part of the country’s broader health-financing and universal-health-coverage reforms.
The NHIA has already developed initiatives and guidelines connected to health technology assessment, while researchers and health professionals are contributing to the country’s evidence base. The authority’s strategic purchasing work also includes healthcare quality and resource-allocation considerations.
For Nigerians, the practical significance will ultimately depend on how HTA findings influence decisions about which medicines, technologies and healthcare services receive funding and how those services are delivered.
If implemented effectively, the system could give policymakers more evidence when making difficult choices about limited healthcare resources. But the assessment process itself will need reliable data, transparent methodology and effective oversight to translate research into better healthcare decisions.
The broader objective remains the same: ensuring that expanding health coverage is accompanied by more efficient and evidence-based use of healthcare resources.
Why It Matters
Nigeria’s healthcare system faces the challenge of meeting growing demand while operating within financial constraints.
The institutionalisation of Health Technology Assessment represents an attempt to make those difficult spending decisions more systematic.
Rather than looking only at whether a medical intervention is available, HTA asks a broader question: what health benefits can be achieved from the resources required to provide it?
For a country working to expand health insurance and move closer to universal health coverage, that distinction can influence how limited funds are distributed across medicines, equipment, treatments and other health services.
The effectiveness of the reform will ultimately depend on how consistently evidence is translated into actual purchasing and policy decisions.
Weng Global – Stories beyond borders
Sources
- National Health Insurance Authority (NHIA) — official information on health insurance, strategic purchasing and health-financing reforms.
- National Health Insurance Authority — information on mandatory health insurance implementation across federal MDAs.
- Premium Times — report on NHIA’s push to institutionalise Health Technology Assessment in Nigeria.
- Health Strategy and Delivery Foundation — 2025/2026 annual report on the institutionalisation of HTA.
- Quality of Life Research / Springer Nature — 2026 study on Nigeria’s EQ-5D-5L valuation study.
