ABSTRACT
Background: Nigeria’s path to Universal Health Coverage is constrained by high out-of-pocket spending and low health-insurance enrolment. Although the National Health Insurance Authority Act of 2022 strengthened the legal basis for coverage, financing and service-delivery gaps remain. With more than 220 million mobile subscriptions, the telecommunications sector offers a practical route for linking digital payments with health-insurance financing. This review examines how telecommunications can support health-insurance financing in Nigeria through a techno-economic lens, highlighting opportunities, barriers, and policy requirements.
Methods: A narrative literature review was conducted between March and August 2025 using PubMed, Scopus, and Web of Science. English-language publications from 2010 to 2025 focusing on digital health, telecommunications, health financing, and health insurance in Nigeria and comparable low- and middle-income countries were included. Additional evidence from policy documents, regulatory frameworks, institutional reports, and grey literature was integrated. Data were thematically synthesised across five domains: health financing, telecom and fintech infrastructure, techno-economic frameworks, operational models, and governance.
Results: The review found that telecom-supported initiatives, including MTNY’ello Health, Airtel–AXA Mansard, and WellaHealth, show potential to improve enrolment, affordability, premium collection, and claims processing through mobile payment systems. These models may strengthen financial nclusion and administrative efficiency, particularly for informal-sector and underserved populations. However, persistent challenges include poor broadband access, high data costs, regulatory overlap, low public awareness, limited benefit coverage, and uncertain long-term sustainability. Technoeconomic evaluation highlights the need for interoperability, scalability, equity, and sustainable financing.
Conclusions: Telecom-driven health insurance can contribute to more equitable coverage in Nigeria if embedded within the national health financing architecture and supported by interoperable data systems, strong consumer protection, affordable benefit design, and inclusive implementation.Adaptive techno-economic evaluation should guide pricing, subsidies, regulation, and scale-up.
Keywords: Nigeria, Digital health insurance, health financing; Mobile money, universal health coverage.