Universal Coverage and financial protection are the goals of health systems the world over. Using data from the
Harmonized Nigerian Living Standard Survey HNLSS 2009/2010 to calculate the catastrophic and
impoverishing impacts of out-of-pocket health payment in Nigeria, we discovered that 19.5% of Nigerians
suffered financial catastrophe, while 3.5% are pushed below the poverty line. Factors associated with
catastrophic health expenditure include; household size, number of spouse in the household, geopolitical zones,
place of residence, household sex. We also utilized the tool of financing incidence analysis to show the
progressivity of out-of-pocket expenditure across socioeconomic groups in Nigeria. A health system dominated
by excessive reliance on out-of-pocket expenditure cannot achieve the goal of financial protection and UC.
Vulnerable households with high risks of catastrophic and impoverishing effects of OOP should be targeted.