JOHN RAWLS’ THEORY OF DISTRIBUTIVE JUSTICE AND THE NIGERIAN HEALTH INSURANCE SCHEME: A CRITICAL ANALYSIS

Abstract

This paper focused on the application of John Rawls' Theory of Distributive Justice in Nigeria especially in the Health system policy, “National Health Insurance Scheme”, emphasizing how Rawls’ principles of justice can promote inclusiveness, fairness and equality in the provision of health services, especially for disadvantaged populations. The paper examines how Rawls' abstract philosophical principles can be integrated into a structured evaluation framework (Rawlsian grid) and its application to the Nigerian socio-political and cultural context through the National Health Insurance Scheme. This allows for a systematic assessment of inequalities in the health system and proposals for equitable policy solutions. The findings show that programs such as the National Health Insurance Scheme (NHIS) have contributed to broader access to health care, but disparities remain in remote and underdeveloped areas. Using the Rawlsian grid, the study highlights challenges in budget allocation, health worker distribution, and infrastructure access. Recommended strategies include reallocating health budgets, fair distribution of health workers, expansion of telemedicine, and participatory planning. This study concludes that integrating Rawlsian principles of justice through a structured evaluation framework can support a more inclusive and sustainable health system in Nigeria, ensuring fair and equal access to quality health services for all citizens.