Kano State in Nigeria has emerged as a beacon of hope for the country's Universal Health Coverage (UHC) journey, demonstrating that breaking down barriers to healthcare is possible through innovative policy and disciplined execution. The Kano State Contributory Healthcare Management Agency (KSCHMA), led by Dr. Rahila Aliyu Muktar, has achieved remarkable progress in just three years, transforming health insurance from a distant government scheme into a lifeline for its residents.
One of the key challenges in achieving UHC is low insurance penetration, which Kano has addressed by decentralizing registration and bringing health insurance closer to communities. By establishing local government liaison offices, café registration centers, and a self-service portal, the agency has reduced distance, waiting time, and confusion, making health insurance more accessible and understandable to the people.
The scale of enrollment in Kano is impressive, with a 139% increase in total enrollment from 497,262 in June 2023 to 1,187,119 by May 2026, bringing more than one million Kano residents into health insurance coverage. This growth is particularly significant because it directly benefits the most vulnerable groups, including pregnant women, children under five, persons with disabilities, sickle cell patients, low-income retirees, orphans, widows, inmates, and other vulnerable groups.
Kano's success is not just about the scale of enrollment, but also the method behind it. The state has opened new financing pathways for UHC through its Zakat and Waqf-linked ethical health financing model, which allows faith-based institutions to pay premiums for indigent beneficiaries. This approach has shown that domestic philanthropy can be organized into a credible health insurance financing channel.
Another bold example of Kano's commitment to UHC is its custodial health insurance model, which enrolls inmates in correctional facilities and trains facility health workers on referral pathways. This approach affirms the principle that loss of liberty should not mean loss of the right to healthcare.
Quality assurance has also received significant attention in Kano. The agency has conducted supportive supervisory visits across accredited facilities, resolved thousands of enrollee complaints, and tracked service utilization through surveys and digital systems. In 2025 alone, 605,582 enrollees accessed healthcare services, representing a 56% utilization rate.
Digital transformation has played a crucial role in strengthening Kano's progress. The agency has deployed a primary healthcare service utilization portal, trained more than 1,000 providers across hundreds of facilities, introduced electronic medical records in high-volume hospitals, upgraded its website and contact center, and adopted digital financial management. These reforms have improved data quality, decision-making, accountability, and the overall efficiency of the health insurance system.
Kano's recognition as one of Nigeria's top-performing state social health insurance agencies is not accidental. It reflects institutional sweat, political support from the Kano State Government, and the hard work, community engagement, provider management, and patience required to make public systems function in difficult environments.
The next task for Kano is consolidation. Enrolment must continue to translate into timely, respectful, and quality care. Facilities must be ready, data must remain clean, and communities must keep receiving clear information. However, Kano has already sent a powerful message to the federation: with commitment, hard work, and accountable leadership, health insurance can become more than a policy promise. It can become a lifeline.
In conclusion, Kano's success in achieving UHC is a testament to the power of innovative policy, disciplined execution, and community engagement. It is a shining example for other states in Nigeria and beyond, demonstrating that breaking down barriers to healthcare is possible when policy is matched with action. As Kano continues to consolidate its gains, it will undoubtedly inspire others to follow suit, bringing the promise of UHC closer to reality for all.
