A University Don and Professor of Public Health and Health Systems Economics, Professor Chima Onoka of the University of Nigeria Enugu Campus (UNEC), has outlined measures to achieving Universal Health Coverage (UHC), in Nigeria.
He argued that research alone cannot transform Nigeria’s healthcare delivery system without effective policy implementation and political engagement.
Onoka made this submission while delivering the 241st Inaugural Lecture of the University of Nigeria, Nsukka (UNN).
In the lecture titled “Bridging the Divide: The Pracademic’s Mandate in the Quest for Universal Health Coverage, ” Onoka said that healthcare reforms in Nigeria required experts who understand politics, negotiation, advocacy, and policy implementation in addition to academic research.
The Professor introduced the concept of the “pracademic,” describing it as a professional who combines academic expertise with practical policy and implementation skills to bridge the gap between research findings and government action.
Onoka urged universities to embrace what he termed “advanced pracademic agency” by producing scholars capable of translating research into practical policy outcomes while building partnerships across academia, government institutions, non-governmental organisations, and the private sector.
He also called for stronger collaboration among academics, policymakers, and healthcare practitioners to advance Universal Health Coverage (UHC) in the country.
Onoka noted that although Nigeria already possesses sufficient research evidence for healthcare reform, progress toward universal health coverage had remained slow due to political interests, bureaucratic bottlenecks, and poor policy execution.
He described universal health coverage as “a power problem” rather than merely a technical or medical challenge, stressing that many reforms threaten existing structures controlling public resources and healthcare financing.
The public health expert lamented Nigeria’s dependence on out-of-pocket healthcare spending, revealing that about 72 per cent of healthcare costs were paid directly by citizens, compared to between 30 and 40 per cent in countries such as Rwanda, Kenya, and Ghana.
He further disclosed that government health expenditure per person in Nigeria was 21 times lower than the global average.
Onoka estimated Nigeria’s universal health coverage financing gap at between ₦157 trillion and ₦236 trillion over the next decade, but expressed optimism that improved efficiency and better resource allocation could significantly reduce the burden.
He commended recent reforms introduced by the National Health Insurance Authority (NHIA), including expanded insurance coverage, establishment of strategic purchasing and actuarial units, and strengthened regulatory systems.
The don also praised the Basic Healthcare Provision Fund, describing it as one of Nigeria’s most important healthcare social protection initiatives capable of expanding access to healthcare services for millions of Nigerians.
He warned that without adequate financial protection mechanisms, the nation’s healthcare system would continue to push citizens deeper into poverty.
He also stressed the need for long-term healthcare workforce planning, stronger institutional funding, and reforms aimed at reducing waste and improving efficiency in the health sector.
In his remarks, the Vice-Chancellor of the University of Nigeria, Nsukka, Simon Ortuanya, represented by the Deputy Vice-Chancellor, Josaphat Onwumere, praised the lecture for its depth and intellectual value.
Onwumere described the inaugural lecture as rich in intellectualism, humility, mentorship, and practical wisdom, noting that the audience learned valuable lessons from the presentation.
