Short-term expert in Health financing - Cost accounting - Nigeria (M / W)

This mission will focus on the second priority lever of the project. The development of a social health protection system is crucial for Nigeria, a country where health coverage remains below 5%. The current system suffers from fragmentation among the actors, the lack of stable funding mechanisms, and a government-exploded power, which undermines the effectiveness of existing mechanisms.

The federal authorities have expressed their desire to structure a more coherent and sustainable policy of social protection, inspired by international models, particularly Asian ones such as those of Indonesia, Thailand, and the Philippines. This ambition is part of the implementation of the law on the National Health Insurance Authority (NHIA) of 2022, which aims to establish mandatory universal health coverage for all citizens.

As a result, the short-term expert will provide technical support to lay the foundations for a sustainable financing model. The scope of this support should be specified with the Nigerian authorities during the first mission to identify priority needs and relevant actions to be implemented to strengthen the capacities of stakeholders, by initiating, for example, a pilot approach to cost accounting in one or several States, and studying different financing scenarios for health insurance.

This work will allow to :

• Identify the prerequisites necessary for the functioning of universal health coverage in Nigeria
• Define the foundations of a future funding model
• Prepare the operational programming of a national implementation plan that could be supported by technical assistance

As a final deliverable, the short-term expert is expected to provide a financing model by May 2027, including a progressive financing scenarios based on participatory dialogue with different national stakeholders, taking into account local context, national priorities and international lessons.

This list is not exhaustive, and the tasks and activities mentioned are not restrictive and will be further defined during a preparatory mission in January.

EF in Nigeria

Expertise France (EF) operates in Nigeria within a broader regional framework, notably through its collaboration with ECOWAS. Its activities primarily involve regional or multi-country initiatives funded by the European Union and the AFD Group.

Currently, Expertise France is engaged in the implementation and development of several regional projects, including :

In addition, the Health Department of Expertise France is launching the implementation of two national projects in Nigeria at the end of this year :

Additional national or regional projects may be launched in the coming years.

FEXTE (Fund for technical expertise and exchange of experiences)

In response to the significant public health challenges, the Nigerian government launched an ambitious health sector reform in late 2023, centred around a Sector-Wide Approach (SWAp). This reform aims to strengthen primary healthcare—particularly maternal and child health—expand universal health coverage, and redesign the financing of primary care through mechanisms such as the Basic Healthcare Provision Fund (BHCPF). Major international partners, including the World Bank and the Gates Foundation, are supporting this effort.

As part of this dynamic, Nigeria has expressed interest in diversifying its technical partnerships. France has been identified as a complementary partner, especially in under-addressed strategic areas such as health workforce development, pharmaceutical systems, universal health coverage, and maternal and child health.

The overall objective of FEXTE is to contribute to improving equitable access to quality, affordable, and population-responsive healthcare by supporting the reform of the Nigerian health system. The project will be implemented in close coordination with the Federal Ministry of Health and Social Welfare, the NHIA, and NAFDAC, under the guidance of the French Embassy and AFD Nigeria.

More specifically, the project aims to strengthen the capacities of Nigerian institutions to effectively lead, finance, and regulate their health system through four priority levers :

Its ultimate objective is to contribute to equitable access to quality, affordable and context-appropriate healthcare, particularly for the most vulnerable populations by accompanying the reflection and dialogue between national authorities to strengthen the structuring of their health insurance system, the sharing of international best practices and operational recommendations adapted to the Nigerian context.

Desired profile

The following experience and skills will be considered as an asset

Working method

Terms of application