Kano’s health insurance: A practical lesson for other states

Kano State is emerging as a leader in Nigeria's pursuit of universal health coverage, overcoming common obstacles like low insurance penetration and weak public trust. The Kano State Contributory Healthcare Management Agency (KSCHMA), under Dr. Rahila Aliyu Muktar, has driven a 139% increase in total enrolment, bringing over one million residents under health insurance by May 2026.

The agency expanded primary healthcare-linked coverage by 434% and its state-funded Vulnerable Healthcare Programme by over 800%. These gains are particularly significant for groups often excluded from formal health financing, including pregnant women, children under five, persons with disabilities, and low-income retirees.

Kano's success stems from a decentralized registration strategy, establishing liaison offices and community centers to bring services closer to people. This approach transformed health insurance from a distant scheme into an accessible local service. The state also pioneered Nigeria's first State Social Health Insurance Agency Rapid Response Team, which provides emergency care, immediate enrolment, and welfare referrals for vulnerable individuals identified through distress calls or field visits.

This model removes critical barriers between need and access, demonstrating that health insurance must actively reach those most in need. Kano is also exploring new financing avenues, including Zakat and Waqf-linked ethical health financing, to further support universal health coverage.

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They can be overcome when policy is matched with disciplined execution, community presence, and leadership that treats health insurance not as paperwork, but as protection for real people.