The World Bank has set aside $40 million to bolster financial protection for poor and vulnerable Nigerians as part of a broader healthcare initiative aimed at improving essential health services across the country. This targeted support is embedded within a newly approved programme, known as the Human Capital Opportunities for Prosperity and Equality – Health Programme-for-Results (HOPE-Health-PforR).
The five-year programme, which officially commenced in late 2024 and will run through June 2029, is designed to address long-standing challenges in Nigeria’s healthcare sector, including inequity in service delivery, insufficient digital health infrastructure, and catastrophic out-of-pocket spending by the country’s poorest populations.
Linking Funds to Measurable Health Outcomes
The $40 million allocation is tied to Disbursement Linked Indicator 3 (DLI 3)—a performance-based metric aimed at expanding access to health insurance for the country’s most vulnerable citizens. Under this results-driven model, the funds will only be released once specific enrolment and service delivery milestones are achieved and independently verified.
This disbursement mechanism falls within Result Area 2 of the HOPE-Health programme, which has been allocated a total of $272.5 million, combining both International Development Association (IDA) funding and a $70.01 million grant from the Global Financing Facility (GFF).
The DLI framework is scalable and time-bound, encouraging states and federal authorities to meet tangible goals in return for financial backing. These goals include increasing the number of poor Nigerians enrolled in health insurance schemes and demonstrating reduced exposure to catastrophic healthcare costs.
A Holistic Approach to Healthcare Reform
Beyond financial protection, the HOPE-Health programme focuses on enhancing maternal and child health, modernising digital health platforms, and deploying trained public health fellows across all 774 Local Government Areas in the country. Institutional reforms at both the federal and state levels are also prioritized, with specific attention to capacity-building for key agencies like the National Primary Health Care Development Agency and the National Health Insurance Authority.
The programme is anchored on a Sector-Wide Approach (SWAp), encouraging collaboration between international development partners, federal institutions, and local governments under a unified implementation strategy. This coordinated model is expected to yield more sustainable outcomes compared to past fragmented initiatives.
Mounting Challenges Amid Rising Poverty
The urgency of these interventions is underscored by a troubling rise in poverty rates. The World Bank’s Africa’s Pulse report for April 2025 projected a 3.6 percentage point increase in Nigeria’s poverty levels by 2027, citing volatile oil revenues and weak governance structures as key contributors.
The report also highlighted that Sub-Saharan Africa remains home to 80 per cent of the world’s extremely poor population, with Nigeria among the four countries hosting half of the region’s 560 million impoverished people.
In light of these findings, reducing health-related financial burdens is seen as a strategic step toward reversing poverty trends. Currently, out-of-pocket payments still account for a large share of healthcare spending in Nigeria, leaving millions at risk of being pushed deeper into poverty due to medical expenses.
Federal Government’s Efforts to Broaden Social Protection
The Nigerian government is complementing the World Bank initiative with its Conditional Cash Transfer (CCT) programme. According to the Minister of Humanitarian Affairs and Poverty Reduction, Professor Nentawe Yilwatda, six million Nigerians have already benefitted from the scheme in the past six months—an exponential increase from the two million reached over the previous nine years.
The ministry has embarked on a comprehensive digital overhaul of the social register, assigning digital identities and e-wallets to eligible households to ensure transparency and prevent duplication. Plans are in place to reach 15 million beneficiaries by October 2025.
To further boost credibility, the World Bank was invited to verify beneficiaries independently. The verification process confirmed the legitimacy of 96 per cent of the recipients, while the remaining 4 per cent were either in inaccessible regions or had been displaced due to security issues.
A Defining Moment for Health and Poverty Alleviation
The HOPE-Health programme reflects a growing recognition of the link between health access and poverty reduction. If successfully implemented, it could mark a turning point in Nigeria’s human capital development—building a more inclusive health system that protects the most vulnerable while laying the groundwork for long-term social and economic resilience.