… . As LAGOS MOVES TO ENFORCE MANDATORY HEALTH INSURANCE AT GRASSROOTS
…Enforcement Commences Across MDAs, Informal Sector Next
Faces of dignitaries at the event.
The Lagos State Government has intensified enforcement of its Executive Order on Mandatory Social Health Insurance, charging Local Government and Local Council Development Area Chairmen to lead grassroots implementation in a decisive push toward Universal Health Coverage.
The charge was the central message at the Strategic One-Day Retreat with LGA/LCDA Chairmen under the aegis of Conference 57, on the implementation of the Executive Order, held at the Lagos Continental Hotel, where top government officials rallied the third tier of government to deepen enrolment into the Lagos State Social Health Insurance Scheme, popularly known as ILERA EKO.
This was stated in a release signed by Tunbosun Ogunbanwo, Director, Public Affairs, Ministry of Health.
Speaking at the retreat, Chairman of the House Committee on Health, Hon. Lawal Aina Musibau, said the Lagos State House of Assembly had long laid the legal foundation for sustainable healthcare financing through the Lagos State Health Scheme Law of 2015, which established Lagos State Health Management Agency and the Lagos State Health Fund.
He reminded the chairmen that enforcement of mandatory health insurance had commenced, stressing that “awareness alone is insufficient; deliberate action and sustained commitment are required to guarantee compliance and affordable healthcare for our people.”
Musibau urged Conference 57 to take full ownership of the scheme, sponsor vulnerable residents where possible, and work closely with the Agency to resolve operational challenges, declaring the retreat open “to the glory of God” and reiterating legislative backing for the reform.
In his remarks, Head of Service, Mr. Bode Agoro, described the Executive Order signed on July 16, 2024, as “a bold reform aimed at guaranteeing Universal Health Coverage for all residents of Lagos State.”
Agoro disclosed that his office had issued compliance circulars, convened strategic sessions with Permanent Secretaries and Agency Heads, and recently inaugurated a 26-member Enforcement Team to drive institutional adherence, adding that proof of enrolment is now required to access certain government services.
“Compliance is not optional, it is a statutory obligation,” he said, noting that enforcement had begun in some MDAs and full compliance was expected by the second quarter, while urging council chairmen to mobilise political office holders, staff and residents under their jurisdictions.
Delivering the keynote policy direction, State Commissioner for Health, Prof. Akin Abayomi, framed the reform within health economics, explaining the interplay between the supply and demand sides of healthcare delivery.
On the supply side, he cited ongoing investments in infrastructure, equipment and human resources, including the establishment of a standalone University of Medicine and Health Sciences to boost the production of doctors, nurses and allied professionals.
Turning to financing, Abayomi said, “In Nigeria today, a significant proportion of healthcare expenses are paid out-of-pocket. This is neither sustainable nor equitable,” stressing that mandatory insurance would replace informal, connection-based assistance with a structured, fair and sustainable system.
He maintained that laws without enforcement mechanisms often remain ineffective, adding that the Executive Order strengthens the legal mandate and signals government’s resolve to ensure that every resident carries a health insurance plan, either self-funded or subsidised for the vulnerable.
Earlier in his welcome address, Board Chairman of Lagos State Health Management Agency, Dr. Adebayo Adedewe, described the retreat as a renewed phase of grassroots-driven implementation of ILERA EKO.
Adedewe commended Governor Babajide Sanwo-Olu’s leadership and reminded chairmen that LGAs and LCDAs are the closest tier of government to the people, making their mobilisation capacity critical to universal enrolment.
“Experience has shown that when Local Governments take ownership, enrolment increases; and when leadership speaks clearly, communities listen,” he said, urging integration of ILERA EKO advocacy into town halls, ward meetings and community engagements.
Also speaking, the Permanent Secretary, LASHMA, Dr. Emmanuella Zamba, outlined specific areas of collaboration, including designation of two enforcement officers per council to work with the state team.
Zamba emphasised that enforcement was not punitive but compliance-driven, noting that weekly review meetings, local permit structures and market associations would serve as strategic touchpoints for expanding coverage.
She also sought provision of office space within council premises, support for stakeholder mobilisation, advocacy videos by chairmen, onboarding of more Primary Health Centres for 24-hour service, and backing for door-to-door campaigns supported by Clinton Health Access Initiative and the National Health Insurance Authority.
In her goodwill message, Permanent Secretary, Ministry of Local Government, Chieftaincy and Rural Development, Mrs. Kikelomo Bolarinwa, said full implementation of the scheme would significantly reduce the financial burden on councils frequently approached by indigent residents for hospital bill support.
She urged maximum cooperation with LASHMA officials and encouraged chairmen to internalise lessons from the retreat, describing the programme as essential to inclusive and sustainable healthcare financing.
Similarly, Permanent Secretary, Office of the Auditor General for Local Government, Mr. Obafemi Ogunlana, said access to quality healthcare was a core dividend of democracy and must transcend political affiliations.
He encouraged council leaders to integrate ILERA EKO advocacy into routine engagements with constituents, stressing that promoting enrolment would not only improve health outcomes but also strengthen community trust and inclusive governance.
The highpoint of the retreat was the decoration of all 57 chairmen as ILERA EKO Champions, symbolising their commitment to intensifying enrolment drives and enforcement efforts across their jurisdictions.
Ten of the chairmen were further honoured as EKOSHA Icons for committing resources, office space and strategic support toward enrolling vulnerable and indigent residents under the equity fund framework.
With enforcement already underway in MDAs and expansion to the informal sector imminent, stakeholders expressed confidence that coordinated state–local collaboration would accelerate Lagos State’s march toward universal health coverage and shield residents from catastrophic health expenditures.