National Health Insurance Policy and Access to Healthcare in Rural Areas of Bauchi State, North East Nigeria

This study examines the implementation of the National Health Insurance Authority Act and its implications for healthcare access in rural communities in Bauchi State, North East Nigeria. Despite the passage of the National Health Insurance Authority Act in 2022, expanding health coverage to rural and low-income populations in states like Bauchi remains a formidable policy challenge. Drawing on health systems financing theory and current health policy literature from 2020 to 2024, the study adopts a descriptive survey design. Data are collected from 230 rural households, health facility managers, local government health officers, and national health insurance enrolment agents in four local government areas of Bauchi State using structured questionnaires and in-depth interviews. Descriptive statistics and chi-square analysis are applied. The study anticipates that very low enrolment rates in rural Bauchi reflect a combination of contributory affordability barriers, limited awareness, inadequate accreditation of rural health facilities, and structural capacity deficits in the state health management information system. It also assesses state government fiscal commitments to matching contributions for vulnerable populations. Recommendations will address community-based health insurance modalities, state government premium subsidy schemes, digital enrolment platforms, and provider accreditation reforms to expand health coverage equity in rural North East Nigeria. Keywords: national health insurance, healthcare access, rural communities, Bauchi State, universal health coverage