The Lagos State Government has intensified enforcement of its Executive Order on Mandatory Social Health Insurance, convening a high-level strategic meeting with Permanent Secretaries of the six Health Districts, Directors of Medical Services (DMS), and Medical Officers of Health (MOHs) across Local Government Areas (LGAs) and Local Council Development Areas (LCDAs). The engagement aims to accelerate implementation of the policy at the primary healthcare level.
At the meeting held in Ikeja, the Permanent Secretary of the Lagos State Health Management Agency (LASHMA), Dr. Emmanuella Zamba, described the session as a deliberate move to deepen compliance, strengthen operational alignment and fast-track full implementation of the Executive Order, particularly at Primary Healthcare Centres (PHCs) where residents first access care.
Zamba recalled that Governor Babajide Olusola Sanwo-Olu signed the Executive Order on July 16, 2024, making social health insurance mandatory for all residents. She added that the directive was further reinforced by a Presidential Executive Order of September 12, 2025, affirming health insurance as a pathway to Universal Health Coverage (UHC). According to her, LASHMA began structured engagements with top government officials before cascading discussions to district and PHC leadership.
She emphasised that PHCs, as the first point of contact for most residents, bear significant responsibility for translating the policy into measurable outcomes. As frontline managers of primary healthcare services, she said, district and facility leaders must ensure that the Executive Order is reflected in everyday service delivery.
Clarifying implementation guidelines, Zamba stated that individuals presenting at PHCs without proof of enrolment on the ILERA EKO Scheme must not be denied care. Instead, facilities are expected to facilitate immediate provider-led enrolment, properly capture enrolment details and guide patients through activation in line with LASHMA’s procedures. She added that in life-threatening emergencies, patients must be stabilised before enrolment requirements are applied.
Zamba noted that LASHMA has introduced verification systems, streamlined enrolment processes and an emergency care framework under the LASHMA-AID programme launched in December 2025, stressing that compliance must be embedded in routine workflows and supervisory structures.
Speaking on behalf of other district Permanent Secretaries, Dr. Monsurat Adeleke of Lagos Health District III urged health leaders to become ambassadors of the scheme. She lamented persistent out-of-pocket payments, revealing that even individuals with valid coverage sometimes pay at facilities due to poor enforcement, and called for stronger internal compliance and wider circulation of the policy across districts.
Earlier, the Coordinator, Regulations, Mr. Tosin Awosika, said the Lagos State Health Scheme Law No. 4 of 2015 mandates health insurance for all residents and established the Lagos State Health Fund as a dedicated risk pool, including an Equity Fund for vulnerable groups.
Head of Medical Operations, Dr. Olugbenga Fadipe, added that PHCs must treat and stabilise emergency cases without demanding deposits, warning that infractions such as charging for covered services and poor data reporting would attract sanctions as the state pushes toward Universal Health Coverage.
