Trends In Enrolment and Utilization of Basic Health Care Provision Fund Services under the Rivers State Contributory Health Protection Programme, Nigeria (2024-2025)

Abstract

Background: The law establishing the Rivers State Contributory Health Protection Program (RIVCHPP) represents Nigeria’s principal fiscal instrument for achieving Universal Health Coverage. Yet, its sub-national implementation within the complex geopolitical landscape of the Niger Delta remains under-scrutinised. In Rivers State, a region characterised by dichotomies between urban and remote riverine communities, the translation of federal funding into equitable access and effective service utilisation faces unique systemic barriers until the launch of the Rivers State Contributory Health Protection Program (RIVCHPP). This study aims to examine the operational effectiveness of the RIVCHPP in Rivers State by critically analysing longitudinal trends in beneficiary enrolment and service utilisation in Rivers State. Methodology: The study adopted a retrospective descriptive trend analysis over time; the data were extracted and analysed from the administrative records of RIVCHPP over 18 months spanning six complete quarters from April 2024 to September 2025. The dataset comprised 114,111 enrolment records and comprehensive service utilisation. Results: RIVCHPP demonstrated a strong capacity for rapid enrolment, with a 961.5% surge following campaign-based registration in Q3 2024 (36,483 beneficiaries), followed by a decline to 11,690 by Q3 2025 (67.9%), indicating dependence on targeted campaigns rather than continuous enrolment. Enrolment was highly concentrated in Rivers East Senatorial District (83.16%), though participation in Rivers West and South-East suggests potential for equitable expansion. Despite enrolment volatility, service utilization was substantial, with 195,246 encounters recorded, driven mainly by malaria treatment (36.8%) and immunization (30.8%). Antenatal care accounted for 10.3% of services, while facility-based deliveries remained low (1.8%), highlighting opportunities to strengthen continuity of maternal care within the scheme. Conclusion: RIVCHPP has become a central pillar of the State’s health system, expanding access to comprehensive preventive, promotive, and curative services across urban and rural areas. The programme has strengthened service delivery through broad facility coverage, increased utilisation, and financial risk protection for vulnerable groups, particularly women, children, and low-income households. As an inclusive social protection and near-universal health coverage platform, RIVCHPP has reduced out-of-pocket spending, improved continuity of care, and enhanced health-seeking behaviour, contributing significantly to improved health outcomes and progress toward universal health coverage in the State.