“Platforms have treated gig workers as independent contractors, which means no pension, no sick leave, no workers’ compensation, and no health insurance. The worker bears every risk. The platform bears almost none.”
Femi Oladipo, a Lagos-based Bolt driver, started getting constant headaches and chest pain in mid-August last year. He struggled to understand what was happening to him until he realised that he was over-worked.
At the start of that month, Bolt had announced that its “top performing” drivers would receive health insurance, malaria treatment, accident and emergency care, and cover for surgeries.
Femi wanted that perk. For almost two weeks, he worked nearly 18 hours a day. He slept in his car on several nights to save the time it would take to drive home.
“It was one of the darkest seasons of my life,” he told Rest of World. “I was burned out because I thought if I could just meet the target, I could use the health insurance to access medical treatment without worrying about high medical costs, especially in these hard times.”
Gig Workers And Dignity In Labour
Femi’s story is not about labour law. It is about something far more fundamental: the dignity of a human being who falls ill and discovers that his right to healthcare depends on an algorithm’s approval.
The Mandate
On 15 May, 2026, the National Health Insurance Authority (NHIA) issued a directive to all app-based transport, food delivery, and logistics platforms operating in Nigeria. All “independent contractors and self-employed persons” working on these platforms must have access to health insurance coverage.
Compliance would become a condition for obtaining licences, permits, and other regulatory approvals. Failure to comply, the NHIA warned, would constitute a violation of the National Health Insurance Authority Act, 2022.
This is not a minor administrative tweak. It is a radical redefinition of who counts as a person deserving of health protection in Nigeria.
For decades, gig workers have occupied a legal grey zone. They are not “employees” in the traditional sense — they own their vehicles, set their own hours, and are paid per trip or delivery.
Platforms have treated gig workers as independent contractors, which means no pension, no sick leave, no workers’ compensation, and no health insurance. The worker bears every risk. The platform bears almost none.
The directive, issued in line with a September 2025 presidential mandate on compulsory health insurance, says that arrangement is no longer acceptable. Consultations with state governments and regulatory agencies are ongoing, and the Federal Ministry of Labour and Employment is coordinating stakeholders to begin implementation.
But the directive does something even more important than expanding coverage. It asks a question that Nigeria can no longer afford to ignore: Can Nigeria achieve Universal Health Coverage while millions of workers remain outside traditional employment?
The Dignity Question
Consider the life of a typical app-based driver in Lagos. He wakes before dawn, spends hours in traffic, faces the risk of accidents, armed robbery, and police harassment, and returns home long after dark. He has no sick leave. If he falls ill, he cannot work. If he cannot work, he cannot eat. He is one medical emergency away from destitution.
A dispatch rider weaving through Lagos traffic on a motorcycle faces the same risks — plus the added danger of road accidents, which are among the leading causes of death and disability for young Nigerian men.
A 2022 study in the International Journal of Environmental Research and Public Health found that gig workers have significantly higher rates of occupational injury than traditional employees — with odds ratios of 3.40 for any minor injury and 8.37 for activity-limiting injury.
The risk is partly due to lack of experience, irregular hours, and the pressure to maximise earnings. In a system where the algorithm rewards speed, safety becomes secondary.
When such a worker falls ill or is injured, the current system offers him two choices: borrow money he cannot repay, or self-medicate and hope.
Neither is compatible with human dignity. Health insurance is not a luxury benefit. It is a fundamental safeguard of dignity — the assurance that when your body fails you, you will not be abandoned to suffer alone.
The Legal Fiction
That fiction allows platforms to avoid many obligations traditionally associated with employers — health insurance, workers’ compensation, sick leave — while still exercising substantial control over workers through algorithms, ratings, pricing, and access to jobs.
A platform does not merely connect driver and passenger. It sets the fare, deducts the commission, monitors the route, punishes the cancellation, and rewards the speed. It controls the terms of work with a precision no factory foreman ever achieved. Yet when the worker falls ill, the platform says: “We are just an app.”
The National Health Insurance Authority Act, 2022 makes health insurance mandatory for every person resident in Nigeria. Section 14(1) states: “Subject to the provisions of this Act, every person resident in Nigeria shall be required to obtain health insurance.” Section 14(2) explicitly includes “informal sector employees” among those residents.
This was a radical departure from the old National Health Insurance Scheme (NHIS) Act of 1999, which was voluntary and covered less than five per cent of the population — mostly federal civil servants and employees of large private firms.
The NHIA Act recognised what the old scheme ignored: that the vast majority of Nigerians work outside formal employment — in markets, on farms, in workshops, and now, increasingly, on digital platforms.
The Act also established the Vulnerable Group Fund, financed through the Basic Health Care Provision Fund, health insurance levies, special government allocations, and other sources, to subsidise coverage for the indigent.
The Act alone does not enforce itself. For three years, gig workers remained outside the net — until the May 2026 directive brought them in.
The Constitutional Dimension
The NHIA directive rests on a constitutional foundation. Section 17 of the 1999 Constitution establishes, as a directive principle of state policy, that “the State shall direct its policy towards ensuring that there are adequate medical and health facilities for all persons.” This is not an optional aspiration. It is a constitutional command that informs every law, every policy, and every directive issued in the health sector.
Section 34 guarantees the right to the dignity of the human person — a right that is meaningless if a sick worker must choose between treatment and starvation. And Nigeria’s obligations extend beyond its own Constitution. The African Union’s Agenda 2063 and the International Labour Organisation’s principles on social protection both affirm that every worker, regardless of employment classification, is entitled to social security including health protection. When Nigeria signed these frameworks, it made a promise to its people. The May 2026 directive is an attempt to keep that promise.
What Must Be Done
So where do we go from here?
First, the NHIA must publish clear, sector-specific guidelines on how platforms should enrol workers, how premiums should be structured, and how compliance will be verified. Vague directives create confusion; clear rules create accountability.
Second, the funding model must be fair. Platforms should bear a significant portion of the cost — they profit from these workers’ labour, and they externalise the risks. A shared-contribution model, with platforms paying the larger share, would recognise both the worker’s limited means and the platform’s moral responsibility.
Third, coverage must be portable. A worker’s health insurance should follow the worker, not the platform. This requires integration with the National Identification Number (NIN) system and a centralised enrolment database that transcends individual employers.
Fourth, the quality of care must match the promise of coverage. There is no dignity in an insurance card that opens the door to a clinic with no doctor, no drugs, and no electricity. The NHIA must link enrolment to facility accreditation standards that are actually enforced.
Fifth, and most importantly, we must resist the temptation to treat this as a compliance box to be ticked. The measure of success is not the number of drivers enrolled. It is whether Femi Oladipo, the next time he feels chest pain, can walk into a hospital without fear — without having to sleep in his car for two weeks to earn the right to be treated.
A Final Thought
The future of work has already arrived in Nigeria. A driver accepts a ride because an algorithm tells him to. A courier races through traffic because an app rewards speed. A delivery rider postpones treatment because illness means no income.
Technology has transformed the way Nigerians work. The law must now transform the way it protects them. Because a person’s right to healthcare should never depend on whether their employer is a company or an application on a smartphone.
The driver who delivered your lunch deserves to know that if he falls ill, someone will catch him. That is what dignity means.
•Sanu is a Nigerian lawyer and health law scholar. This column breaks down complex health laws for everyday Nigerians.
