Cooperative and Mutual Principles
We remove the barriers to health access
The Cooperative Clinic
Problem statement (health inequity in Nigeria)
The disparity in health access in Nigeria generally and in Ekiti State in particular is legendary. The burden of care falls largely on families, friends, and well-wishers.
Health insurance remains unpopular and most Nigerians are uncovered. We organise neighbourhoods into mutual cooperative organisations that provide health insurance for members in which the members take active leadership roles in achieving the goal of the organisation.
HACF intervention logic
Our unique approach is to combine health delivery with health insurance under one roof. Our Mutual Health Associations all over the state requires membership fees to join and uses this membership fees to provide health services for the people.
Sustainability pathway
Our operations are sustained by the contribution of members. We do not believe that healthcare can be completely free of all fees but prepayments in form of membership fees will be required to sustain our organisation.
Monitoring & Evaluation framework
We cover distinct geographical areas and our impact will be measured by the improvement in population health in areas we cover.
Our members and community leaders are integral part of our management system with representatives participating in service delivery as volunteers, in decisions regarding what services to provide and how to provide them and in evaluating the operations of the NGO.
Ekiti Mutual Health Association is an open membership organisation based on cooperative values, working to improve the health and well-being of our members. Our purpose is to make health accessible to everyone, everywhere, everytime without exhorbitant medical bills.
We have medical offices, The Cooperative Clinics, in neighbourhoods throughout Ekiti State. Our members join our Cooperative with annual membership fees and receive medical care and support for a whole year
Public Private Partnership
We work in a Public, Private Partnership, PPP, with the government and our members:
1. The Government
The government provides a subsidy for health insurance premimium of our members
2. Our Members
Our members pay an Agreed Membership fees and attend for annual health checks and any appointment offered them.
3. Mutual Health Association
Will provide Walk-In services for all health needs of members and refer them to specialists for further treatment. In addition, we will liaise with the treating specialists so that we can monitor the health of our members when they are discharged for the specialists.
All your primary health care needs
OPERATIONAL PLAN
FUNDING PARTNERSHIP PROPOSAL
Healthcare Access Covenant Foundation (HACF)
Building a Community-Governed Primary Healthcare Model in Ekiti State, Nigeria
The Opportunity
Healthcare Access Covenant Foundation (HACF) seeks strategic institutional partnership to establish and scale a cooperative-based primary healthcare financing and delivery model in Ekiti State.
Our objective is to operationalise Universal Health Coverage (UHC) through structured community enrollment, prepaid financing, and accountable service delivery aligned with the National Health Insurance Authority and global UHC principles promoted by the World Health Organization.
This initiative will serve as a scalable model for Southwestern Nigeria.
Funding Request
Total Initial Investment Sought (36 Months): USD 0.2 – 1.8 million
Flexible partnership structures are available, including co-funding arrangements.
Use of Funds
1️⃣ Establishment of 3–5 Community Mutual Health Association Clinics
Facility setup and basic equipment
Digital enrollment and health records systems
Clinical staffing support (early phase)
Telemedicine integration
AI in Medicine Platform
2️⃣ Vulnerable Household Subsidy Pool
Means-tested sponsorship of annual membership contributions
Target: Over the first three years, our target is 35,000 population, being 1% of the total population of Ekiti State, with a large number of vulnerable individuals in rural areas, over three years.
3️⃣ Systems Strengthening & M&E
Enrollment tracking infrastructure
Financial performance monitoring
Independent evaluation and impact assessment
Comparative community analysis
4️⃣ Community Governance & Capacity Building
Cooperative governance training
Financial oversight training
Clinical audit systems
Projected 3-Year Outcomes
20,000–35,000 individuals enrolled in structured primary healthcare
Significant reduction in out-of-pocket primary care expenditure among members
Measurable improvement in service utilization rates
Increased insurance participation within target communities
Demonstrable progress toward Sustainable Development Goal 3 of the United Nations.
Sustainability Strategy
By Year 3, the model is projected to transition toward operational sustainability through:
Cooperative membership contributions
Capitation payments via NHIA-aligned insurance mechanisms
Gradual reduction in external subsidy dependence
External funding will catalyse system establishment — not perpetuate service dependency.
Why Invest in HACF?
Policy-aligned with national insurance reform
Community-owned governance structure
Blended financing model reducing long-term donor reliance
Clear measurable outcomes
Replicable across Southwestern Nigeria
HACF is not an outreach program. It is a structured health financing and delivery reform initiative.
Partnership Modalities
We welcome:
Multilateral and bilateral grants
Foundation partnerships
Matching-fund arrangements
Technical assistance collaborations
Results-based financing pilots
Detailed budgets, governance documentation, and implementation timelines are available upon request.
In Summary:
An investment in HACF is an investment in a replicable, community-governed pathway to Universal Health Coverage in Nigeria.
We seek partners ready to move from policy commitment to practical, measurable implementation.
Mutual Health Association (MHA) will work in partnership with the Nigeria Health Insurance Authority (NHIA) to facilitate attainment of Universal Health Coverage (UHC) in Nigeria.
