Mary Nnah
Alexandria Hall, The Colossus, Lagos, turned into Nigeria’s most uncomfortable confessional on Thursday as Hallmark Health Services Limited convened the 5th edition of its Stakeholders Engagement Forum. The theme read like a policy paper: “Collaborating for Sustainable Healthcare Systems.”
The reality inside was stark with 93 percent of Nigerians still outside any form of health insurance, executives, doctors, regulators, and employers spent the day admitting what millions already know: the system is failing the very people it is meant to protect.
Chairman of Hallmark HMO, Eddie Efekoha, opened the forum by stripping healthcare back to human terms. Every Nigerian, he said, walks in with a story, the relief of timely treatment, the anxiety of finding a doctor, or the shame of choosing between drugs and food.
He reminded the room that the engagement began five years ago with one mandate: force the people who shape health in Nigeria to sit at the same table and speak plainly.
From strengthening systems in 2022, to financing and technology in 2023, to customer-first solutions in 2024, and last year’s focus on how inflation was eroding SME cover, each edition has pushed the conversation deeper.
The conclusion now is inescapable. Healthcare only works when stakeholders stop working in silos, technology serves people and not paperwork, financial sustainability is treated as survival, and the patient experience becomes the measure of success.
Efekoha said the sector is at a defining moment, squeezed by inflation, the exodus of doctors, rising demand for quality care, new regulations, and the speed of digital change.
The choices made today, he warned, will decide whether the next generation inherits a system that collapses under pressure or one that is resilient, inclusive, and innovative.
The keynote from Olumide Ajomale, Board Advisor and CEO of Facilitation and Training Services Limited, did not soften the blow.
Speaking to journalists after his session, Ajomale said 71 percent of Nigerians pay out of pocket for care, and that number is a death sentence.
He traced it to one root cause: trust. People avoid insurance because they do not believe it will work when they need it. Hospitals show up without equipment. Doctors show up late or not at all.
HMOs show up with processes that feel punitive. And when a bill arrives, every item is contested until the patient feels like the accused.
“The absence of trust makes everything collapse. It is a domino effect,” Ajomale said. He argued that trust must be rebuilt from the reception desk outward, with empathy replacing bureaucracy, with HMOs responding like humans, and with regulators creating environments where partners can rely on each other.
He also called for a hard pivot from data collection to data intelligence.
“Data is the new gold,” he said. “If you are still just storing it and not mining it to predict the future, you are already out of business.”
Hallmark executives then explained why the middle of Nigeria’s health equation is breaking. A client pays ₦50,000 and expects access to ₦500,000 worth of care.
Hospitals, facing rising costs, return within months to say they cannot honor the tariff agreed in January. But HMOs cannot adjust premiums until the next cycle.
Unlike car insurance, where a vehicle can go five years without a claim, health is constant. People will visit the hospital four or five times a year for malaria, cold, or other ailments.
If every enrollee used their plan fully, the business would be bankrupt. Yet providers must be paid, and patients must be treated.
The only way out, they said, is the kind of collaboration the forum is designed to force. Providers must embrace technology and human-centric service.
Enrollees must see HMOs as partners, not enemies. And the culture of waiting for medical emergencies must end.
With only about 7 percent of Nigerians on insurance, most families are still relying on out-of-pocket spending that pushes them into debt or forces them to delay care until it is too late.
Hallmark’s own pitch is availability. The company told reporters it runs a 24/7 system that lets enrollees reach someone at any time, and that responsiveness has become its edge in a crowded market.
The 2026 theme, they said, was deliberate, to bring finance, intelligent systems, regulatory excellence, and stakeholder experience into one room because sustainable healthcare cannot be delivered by one player.
The message to Nigerians was direct and personal: Own your health first. Choose healthy lifestyles. Insure yourself before a crisis.
“Whatever we are doing is only support. You are the first doctor of yourself.”
By the time the forum closed, the consensus in Alexandria Hall was stark. The government cannot regulate its way out of the crisis. HMOs cannot price their way out.
Hospitals cannot treat their way out. And patients cannot wait their way out. “No one party has all the solutions, Ajomale said.
