Lagos Steps up Mandatory Health Insurance Drive

By Modupe Gbadeyanka

Efforts to entrench mandatory health insurance through the Ilera Eko Social Health Insurance Scheme in Lagos State have been stepped by the state government.

This was done with the formal investiture of the Commissioner for Health, Professor Akin Abayomi, and the Special Adviser to the Governor on Health, Mrs Kemi Ogunyemi, as Enforcement Leads of the Lagos State Health Scheme Executive Order and ILERA EKO Champions.

The Commissioner described the recognition as both symbolic and strategic, noting that Lagos is deliberately shifting residents away from out-of-pocket healthcare spending to insurance-based financing.

“We have been battling with how to increase enrolment in ILERA EKO and change the culture of cash payment for healthcare. Insurance is a social safety net, and this mindset shift is non-negotiable,” he said.

He recalled that Lagos became the first state to domesticate the 2022 National Health Insurance Authority (NHIA) Act through an Executive Order issued in July 2024, making health insurance mandatory. He stressed that the decision reflected the Governor’s strong commitment to healthcare financing reform, adding, “When Mr. Governor personally edits and re-edits a document, it shows how critical that issue is to the future of Lagosians.”

Mr Abayomi also warned against stigmatisation of insured patients, describing negative attitudes towards Ilera Eko enrolees as a major barrier to uptake. “If someone presents an Ilera Eko card and is treated as inferior, uptake will suffer. That must stop,” he said, pledging to prioritise insurance compliance during facility inspections. “The key question I will keep asking is: ‘Where is the Ilera Eko?’”

In her remarks, Mrs Ogunyemi, said the enforcement role goes beyond a title, stressing that the health insurance scheme is now law.

“This is about Universal Health Coverage and equitable access to quality healthcare for everyone in Lagos State,” she said, noting that ILERA EKO aligns with the state’s THEMES Plus Agenda.

She commended the Lagos State Health Management Agency (LASHMA) for aggressive sensitisation efforts across the state, saying constant visibility was necessary to address persistent gaps in public knowledge. “People are still asking, ‘What is Ilera Eko?’ ‘Where do I enrol?’ Those questions tell us the work must continue,” she said.

She urged all directors and health officials to mainstream Ilera Eko promotion in every programme and engagement, emphasising that responsibility for health insurance advocacy does not rest with LASHMA alone. “When people come with medical bills, the first question should be: are you insured?” she said, adding that early enrolment remains critical as premiums rise over time.

Earlier, the Permanent Secretary of LASHMA, Ms Emmanuella Zamba, said the investiture marked a critical step in positioning leadership to drive enforcement of the Executive Order across the public service.

“What we are undertaking is pioneering in Nigeria. All eyes are on Lagos as we demonstrate how mandatory health insurance can work,” she said.

Ms Zamba disclosed that enforcement nominees across Ministries, Departments and Agencies have been trained, with a structure in place to ensure compliance beyond the health sector.

According to her, “This initiative cuts across the entire public service, particularly public-facing MDAs, in line with the provisions of the Executive Order.”

She explained that the formal designation of the Commissioner and the Special Adviser as Enforcement Leaders was meant to strengthen compliance, alongside the Head of Service, while also recognising their consistent advocacy for universal health coverage. “This decoration is to amplify their roles and appreciate the leadership they have shown,” she said.