Industry overview
The health insurance sector in Africa is marked by varied stages of development, yet unified by a common pursuit of Universal Health Coverage (UHC). A key trend across the continent is the transition from voluntary to mandatory insurance frameworks, as governments seek to expand coverage and reduce reliance on out-of-pocket payments, which remain alarmingly high in countries such as Nigeria (69% of total healthcare expenditure) and Egypt (61%).
These reforms aim to create a more predictable and sustainable financing base, setting the stage for broader participation in health insurance systems. Currently, insurance penetration varies widely. Ghana reported a relatively high 68.8% population coverage by public or private schemes in 2021, while Kenya’s was around 20%. Nigeria's former National Health Insurance Scheme (NHIS) historically covered less than 10% of the population; however, recent reforms aim to increase this coverage.
This variation, combined with the policy momentum toward mandatory enrollment, underscores the
