.. What Those Who Are Yet To Enrol Are Missing
THE LAGOS STATE MANDATORY SOCIAL HEALTH INSURANCE Scheme, popularly known as ILERA EKO, is indeed the way to go in this age and time.
In her speech, the Permanent Secretary, Lagos State Health Management Agency, LASHMA, Dr. Emmanuella Zamba, at the capacity building workshop for media professionals in collaboration with the Institute of Social and Public Health Management, ISMPH, Gate Foundation and EngenderHealth.
The Permanent Secretary, Lagos State Health Management Agency, LASHMA, Dr. Emmanuella Zamba with other partners’ representatives at the media engagement training.
According to her, the Lagos State Government remains resolutely committed to ensuring that all residents, regardless of socio-economic status, have access to quality, affordable, and equitable healthcare services. This commitment informed the Executive Order signed by His Excellency, Mr. Babajide Olusola Sanwo-Olu, on 16th July, 2024, which makes health insurance under ILERA EKO mandatory for all residents of Lagos State.
Following this directive, enforcement has commenced across Ministries, Departments, and Agencies. However, beyond enforcement, our priority remains education, engagement, and building public confidence in the Scheme.
To demonstrate leadership by example, all public servants in Lagos State have been enrolled on ILERA EKO, with the State Government paying 75 per cent of the annual premium, while public servants contribute the remaining 25 per cent. In addition, one per cent of the Consolidated Revenue Fund has been dedicated as an Equity Fund to provide health insurance coverage for vulnerable residents. This Equity Fund was increased from ₦1 billion to ₦3 billion and approved as a one-line charge, reinforcing the State’s resolve to leave no one behind.
Despite these efforts and the introduction of innovations to simplify enrolment and reduce out-of-pocket health expenditure, many residents are still yet to be covered. This highlights the need for sustained awareness and accurate information.
In a megacity like Lagos, health insurance is no longer optional, it is essential. The Mandatory Social Health Insurance Programme is designed to protect residents from catastrophic health expenses, strengthen the health system, and ensure sustainable healthcare financing.
Policies alone do not guarantee success. Their effectiveness depends on the understanding and cooperation of all stakeholders.
As media professionals, part of our roles is to explain the policies, dispell myths, amplify impacts, and hold institutions accountable. That’s exactly what is being done here and we will continue to play our roles.
The government, through Lagos State House of Assembly enacted the Lagos State Health Scheme Law No. 4 of 2015 for residents to have access to quality healthcare services at affordable rates.
The Law established the Lagos State Health Scheme (LSHS) and made it mandatory for all residents of Lagos State to be enrolled on the Scheme.
The Law further established LASHMA charged with the responsibility to promote, regulate, supervise and ensure the effective administration and viability of the LSHS.
The law also set up Lagos State Health Fund (LASHEF), an independent fund and a risk pool, ring fenced by law.
It is now mandatory for all residents of Lagos State to have Health Insurance. And this will eventually be for the benefit of all.
HMOs operating in Lagos must be NHIA accredited while Healthcare Providers must be HEFAMAA accredited.
The Agency is to register HMOs, MHAs, HCPs, and Allied Associations and MUST ensure that all health plans sold in the state are operated for the economic benefit of residents of the state.
There is also establishment of the Equity Fund (1% of CRF) for the enrolment of vulnerable persons in the state as well as appointment of Focal Persons by LGA/LCDA Chairmen to collaborate with the Agency in coordinating participation at the grassroot level.
Residents should feel free to report any infractions and LASHMA has been receiving and investigating complaints including financial impropriety leveled against any stakeholder and ensure that these are resolved judiciously.
The National Health Insurance Authority, NHIA Act 2022 provides for the establishment & implementation of State Social Health Insurance Scheme [SSHIS]. In Lagos, this is the ILERA EKO Health Plan.
The NHIA Act makes it mandatory for every resident of Nigeria to subscribe to a State Health Insurance Scheme before purchasing private health insurance plans from HMOs.
To achieve this, Lagos State domesticated the NHIA Act through the issuance and signing of an Executive Order (NO. EO/BOS/01 OF 2024) by Governor Babajide Sanwo-Olu, on 16th July 2024.
Meaning that all residents and workers in Lagos State are required to have a valid Social Health Insurance Plan.
To support this, all public health facilities have been designated as enrollment centers, and healthcare providers have been sensitized accordingly.
Other benefits include access to Emergency Services LASHMA-AID (Assistance In Distress) is expanded access to Emergency Services to ILERA EKO enrollees and Vulnerable/indigent residents providing immediate, life-saving medical attention during critical health events.
There is coverage for Vulnerable Populations as well. For residents who are unable to afford the State’s Social Health Insurance Plan, public healthcare officers are to profile such individuals and refer them to LASHMA for enrollment under the Equity Fund, which provides coverage for vulnerable groups.
If we are not yet clear on this, the ILERA EKO Social Health Insurance Programme represents a foundational shift in how healthcare is financed and accessed in Lagos State.
Its core mission is dual-fold: to provide qualitative, affordable healthcare to all residents and to offer robust financial protection against the catastrophic burden of out-of-pocket medical expenses.
It is not a one-size-fits-all programme. It offers different plans designed to meet the diverse needs and economic realities of Lagos residents.
There is the Standard Plan of just ten thousand naira only per annum. There’s the Standard Jaara & Jaara Plus) offering enhanced benefits at fifteen thousand naira only among others.
There are the Specialized Plans: These include the Seniors Plan for the elderly, a School Plan for Secondary school students, and the Tertiary Plan for University students.
The programme also features innovative plans like Diaspora Konnect (for residents abroad to cover relatives back home) and Waka Well (designed for visitors and holiday makers).
This structure ensures that every segment of Lagos’ populace from formal employees to market traders, students to seniors can find a suitable entry point into the health insurance system.
The value of any health insurance lies in its benefits package. ILERA EKO’S coverage is notably extensive, moving beyond basic care to include critical, high-cost services that are often out of reach. Let’s visit www.lashma.com for more information.
Enrollees have access to the following; Registration, General/Specialist Consultations, treatment of Common Ailments, Immunizations, and Annual Wellness Screenings to promote early detection.
Comprehensive Antenatal Care, Safe Delivery (including both Vaginal And Caesarean Sections), immunizations and treatment of childhood illnesses.
In-patient Admission, a range of Surgeries, and Emergency Services. Essential Laboratory Investigations, Radiology (X-rays, Ultrasound, ECG), Physiotherapy, and Dental Care.
Utilize the Referral Network: For specialized services beyond the doctor’s scope, a structured referral process guides the patient seamlessly to a network of higher-level public or private hospitals. This ensures continuity of care and prevents patients from getting lost in the system. In an emergency, the PCP refers to a higher level or specialised hospital after stabilization or an enrollee is referred directly to a higher-level hospital through an ambulance service.
•Another critical pillar of the ILERA-EKO programme is its commitment to equity. The Programme through the Eko Social Health Alliance (EKOSHA) arm of LASHMA, explicitly covers the indigent and vulnerable populations of Lagos State through a government-supported equity fund.
We have interviewed some beneficiaries of this scheme and it’s going to be a continuous conversation here as we keep on monitoring our hospitals. Watch out and let’s have your feedbacks too through our mail: sakinah207@yahoo.com