Health Access Covenant Foundation has been established to advance Universal Health Coverage through a Community financed and Community-governed Primary Healthcare delivery system.

Healthcare Access Covenant Foundation (HAC) is a Nigerian Non-Governmental Organisation established to translate Universal Health Coverage (UHC) from policy aspiration into structured, community-level implementation, neighbourhood by neighborhood.

Building on over two decades of national advocacy and published work on health financing reform, HAC, focuses on developing a scalable, self-sustaining, cooperative-based primary healthcare model in Ekiti State that integrates contributory health insurance, community medical services, and structured accountability systems.

🏥 Who We Are

Healthcare Access Covenant Foundation is a non-partisan, community-centered, non-governmental organisation committed to sustainable reform of Nigeria’s primary healthcare system.

We advance Universal Health Coverage by integrating:

        Community-embedded primary healthcare services

        Structured financial protection mechanisms

        Cooperative governance

We believe UHC must function not only at federal policy level, but at neighbourhood level.

💡 Our Core Philosophy

Sustainable Universal Health Coverage can only be achieved when communities are structurally integrated into health financing, service delivery, and accountability systems — not treated as passive beneficiaries. People involvement is primary to a sustainable health system.

We promote:

Health of the people. By the people. For the people.

Encourage communities to be co-financiers, co-governors, and co-accountability partners in their own health system.

🎯 Our Vision

To develop an accessible, affordable, evidence-based, culturally appropriate, self-sustaining, and technology-enabled primary healthcare model that contributes measurably to the attainment of Universal Health Coverage in Nigeria.

🚀 Our Mission

To establish a Mutual Health Association-based primary healthcare network, neighbourhood by neighbourhood, in Ekiti State that integrates contributory health insurance, open access community medical services, including telemedicine that achieves universal health coverage, — serving as a scalable model for Southwestern Nigeria.

🤝 Community Mutual Health Association Clinics

HAC will establish Community Mutual Health Associations (MHAs), designed as neighbourhood-based primary healthcare clinics owned and governed cooperatively by their members.

These clinics will operate as structured, walk-in community health centres integrated that utilises membership fees as contributory health insurance premium.

What do people get as Members Mutual Health Association:

    Annual preventive health checks

    Primary care consultations

    Essential medicines within approved treatment protocols

    Coordinated referral to specialist care

    Community-based follow-up after hospital discharge

Services are delivered by trained Key Workers responsible to registered nurses and supervised by and Task Sharing  and Task Shifting with qualified medical doctors.

💳 Membership Structure

HAC operates two membership pathways:

1. Open Membership

Entry-level community registration available to all residents in participating neighbourhoods.  Residents are encouraged to walk in and be engaged.

Benefits of Open Membership include:

          Free in-take health assessment

          One free medical consultation

          Short-term care coordination support with secondary health institutions

This Open Membership enables structured onboarding into the cooperative system that ultimately lead into insured membership.

2. Insured Membership

Prepaid annual contribution transforms Open Membership into Insured     Membership in which the member enjoys defined ambulatory primary healthcare access for one year. 

Subscription fees

In 2026 the Annual Contribution is NGN 22,500 (approximately USD 15) per member.

Benefits include:

    Ongoing primary care access for one year.

   Essential medicines within established protocol

  Referral coordination with secondary health institutions

  Post-discharge follow-up upon discharge from secondary health institutions

    Opportunity to participate in management and governance of the MHA

Insured Membership operates within cooperative and NHIA-aligned financing structures.

🛡 Subsidy Framework

HAC is committed to ensuring that inability to pay membership fees does not exclude vulnerable individuals from structured healthcare access and care. One enrollment drive is to recruit a critical mass of members.

We will implement a community-validated, means-tested vulnerability assessment tool to identify individuals eligible for fee subsidy and contribution support.

The assessment protocol will ensure:

    Accurate identification of vulnerability

     Inter-rater reliability 

    Transparency and community oversight

Subsidy allocation will be supervised by elected community governance structures.

💼 Sustainability Model

HAC operates a blended financing structure combining:

    Cooperative membership contributions

    Capitation payments through NHIA-aligned insurance mechanisms

     Institutional grants

    Support from philanthropic support

    Diasporan sporsorship of vulnerable people.

The Investment Opportunity

HAC seeks institutional partnerships to:

Support initial establishment of cooperative clinics 

Subsidise membership fees for vulnerable individuals

Strengthen monitoring and evaluation systems

Scale the model across Ekiti State and Southwestern Nigeria

Install necessary technology in our clinics

Partnerships

We seek partnership with government, philanthropists, and institutional donors to support vulnerable households through structured contribution sponsorship. 

Strategic partnerships:

    An individual can be targeted for support

    Subsidies can be offered to vulnerable households

    Grants can be offered to support enrollment a the critical mass required for     coopeative insurance

This model promotes long-term stability, reduces dependence on episodic outreach funding, and reduces the risk of catastrophic out-of-pocket health expenditures.

📊 Measuring Impact & Accountability

HAC is committed to measurable, transparent performance reporting.

We will track:

    Enrollment and retention growth

    Primary care service utilization rates

    Financial protection outcomes

    Key health indicators

    Comparative trends with similar non-participating communities where     feasible.

Financial Transparency

Each Mutual Health Association will elect a local management committee responsible for monitoring revenues and expenditures.

Financial statements will be independently reviewed and made publicly accessible at the association office.

Monitoring & Evaluation

Community Mutual Health Committees will publish periodic performance reports covering:

    Enrollment and retention

    Service access indicators

    Financial performance

    Member satisfaction

Reports will be available to members and institutional partners.

🌱 Our Contribution to Sustainable Development Goals

A key measure of progress will be the percentage of residents in participating Ekiti communities enrolled in structured primary healthcare and contributory insurance within three years.

Our medium term objective is to enrol all residents in the neigbourhood of our Clinics.

Our long-term objective is measurable advancement toward Universal Health Coverage in alignment with Sustainable Development Goal 3.8 of the United Nations.

🏛 Governance & Institutional Integrity

Healthcare Access Covenant Foundation operates under:

   A Board of Trustees

   Medical Advisory Support overseeing clinical and ethical audits

   Community-elected cooperative committees, The Mutual Health Committee

    Independent financial oversight

Conflict-of-interest and financial disclosure policies are in place for all governance bodies.

We are committed to professionalism, transparency, and constructive engagement with public institutions while advocating for expanded, inclusive health coverage.

Position Statement

Healthcare Access Covenant Foundation is not an outreach programme.

We are building a structured, cooperative, community-owned primary healthcare system designed to advance Universal Health Coverage sustainably and at scale.

The Problem

Despite national commitment to Universal Health Coverage, many Nigerians remain outside structured health financing systems. There is:

    Low insurance enrollment

    Fragmented primary healthcare delivery

    High out-of-pocket expenditure

    Limited integration of communities into governance and financing     mechanisms

    Without structured enrollment and community ownership, UHC remains     unevenly implemented.

Our Solution

HAC is establishing Community Mutual Health Associations (MHAs) — cooperative, neighborhood-based primary healthcare clinics owned and governed by their members to be financed with membership fees.

Our model integrates:

    Prepaid annual membership contributions

    NHIA-aligned insurance mechanisms

    Preventive and ambulatory primary healthcare services

    Essential medicines within approved protocols

    Coordinated referral pathways from primary to secondary instituions

    Community-based follow-up after discharge 

Our approach replaces episodic medical outreach with structured, sustainable access to health care.

Financing Model

HAC operates a unique, sustainable financing framework by embedding fund raising in Cooperative membership contributions and service delivery that focuses on preventive care and prompt refferral to secondary care when indicated.

This will be supplementad with:

    Capitation payments through NHIA mechanisms

    Institutional and philanthropic grants

    Targeted subsidies for vulnerable households

Impact Objectives (First 3 Years)

HAC aims to achieve:

Significant enrollment growth in participating Ekiti communities

Measurable improvement in primary care utilisation

Measurable improvement in population health indices n participating communities.

Increased financial protection among members with measurable reduction in out-of-pocket health expenditures

Importantly, a demonstrable progress toward Sustainable Development Goal 3 of the United Nations.

Where feasible, outcomes will be compared with similar non-participating communities to assess measurable impact.

Sustainable Universal Health Coverage can only be achieved when  communities are structurally integrated into health financing, service delivery, and accountability systems — not treated as passive beneficiaries

Healthcare Access Covenant Foundation (HAC) ​Conflict of Interest Policy ​. Purpose

​The purpose of this policy is to protect the Foundation’s interest when it is contemplating entering into a transaction or arrangement that might benefit the private interest of an officer, director, or "Key Person" of the Foundation. This policy is intended to supplement, but not replace, any applicable Nigerian laws governing conflicts of interest.

​II. Definitions

​Interested Person: Any director, principal officer, or member of a committee with governing board-delegated powers who has a direct or indirect financial interest.

​Financial Interest: A person has a financial interest if they have, directly or indirectly:

​An ownership or investment interest in any entity with which the Foundation has a transaction or arrangement. ​A compensation arrangement with the Foundation or with any entity or individual with which the Foundation has a transaction or arrangement.

​III. Procedures

​Duty to Disclose: In connection with any actual or possible conflict of interest, an interested person must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of committees. ​Determining Whether a Conflict Exists: After disclosure of the financial interest and all material facts, and after any discussion with the interested person, he/she shall leave the governing board or committee meeting while the determination of a conflict of interest is discussed and voted upon.

​Procedures for Addressing the Conflict:

​The chairperson shall, if appropriate, appoint a disinterested person or committee to investigate alternatives to the proposed transaction. ​The board shall determine whether the Foundation can obtain with reasonable efforts a more advantageous transaction or arrangement from a person or entity that would not give rise to a conflict of interest.

​IV. Annual Statements

​Each director, principal officer, and member of a committee with board-delegated powers shall annually sign a statement which affirms such person:

​Has received a copy of the conflicts of interest policy; ​Has read and understands the policy; ​Has agreed to comply with the policy.

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