By Ayomide Otitoju
The Lagos State Government has stepped up efforts to implement its Executive Order on Mandatory Social Health Insurance, convening a high-level meeting with Permanent Secretaries of the six Health Districts, Directors of Medical Services, and Medical Officers of Health across Local Government Areas and Local Council Development Areas to accelerate adoption at primary healthcare centres (PHCs).
Speaking at the Ikeja meeting, the Permanent Secretary of the Lagos State Health Management Agency (LASHMA), Dr. Emmanuella Zamba, described the session as a “deliberate and coordinated effort to deepen compliance, strengthen operational alignment, and accelerate full implementation of the Executive Order,” with particular focus on PHCs, where residents experience the most direct impact.
Zamba reminded attendees that Governor Babajide Olusola Sanwo-Olu signed the Executive Order on July 16, 2024, mandating social health insurance for all Lagos residents, a directive later reinforced by the Presidential Executive Order of September 12, 2025, as a pathway toward Universal Health Coverage (UHC). She noted that LASHMA had already engaged senior officials before extending discussions to district and PHC leadership.
“As leaders within the Primary Healthcare system, the responsibility for translating this policy into tangible outcomes rests significantly with you,” Zamba said. She added that residents visiting PHCs without proof of enrolment on the ILERA EKO Scheme must not be turned away, stressing that facilities should provide immediate on-the-spot enrolment and guide patients through activation in line with LASHMA guidelines.
She further clarified that life-threatening emergencies must be stabilised before any enrolment requirement is applied. The LASHMA-AID programme, launched in December 2025, supports emergency care, verification systems, and provider-led enrolment processes. “Compliance must be embedded into daily workflows, patient management, and supervisory structures across all PHCs,” Zamba emphasised.
Speaking on behalf of other district Permanent Secretaries, Dr. Monsurat Adeleke of Lagos Health District III urged healthcare leaders to become ambassadors of the scheme, noting that even senior officials had yet to activate their coverage. She recounted a case where her driver, enrolled as a dependent, still paid out-of-pocket for services despite having valid insurance. “For us, for our dependents, and for patients at our primary centres, let us be ambassadors,” she said.
Adeleke also called on district heads to ensure broad dissemination of the policy and to engage both public and private stakeholders in driving enrolment. “The more people get on board, the better and healthier the Lagos we are all craving for,” she added.
Mr. Tosin Awosika, Coordinator of Regulations at LASHMA, highlighted the legal framework underpinning the scheme. He noted that the Lagos State Health Scheme (LSHS) Law No. 4 of 2015 mandates health insurance for all residents and established the Lagos State Health Fund as a ring-fenced risk pool. The law also created an Equity Fund, representing one per cent of the state’s Consolidated Revenue Fund, to support vulnerable populations, while empowering LASHMA to register, regulate, and sanction HMOs and healthcare providers.
Dr. Olugbenga Fadipe, Head of Medical Operations at LASHMA, explained that PHCs must stabilise emergency cases without demanding deposits upfront. He added that facilities seeking inclusion in the ILERA EKO network must pass quality assessments, warning against infractions such as charging for covered services, poor infection prevention, inadequate data reporting, and inconsistent pricing. “Numbers don’t lie. Data is important, and compliance is non-negotiable,” he said.
Participants agreed that effective implementation of the Executive Order at the grassroots is critical to reducing out-of-pocket expenditure, expanding enrolment, improving quality of care, and accelerating Lagos State’s progress toward Universal Health Coverage.
