The Lagos State government has threatened to enforce its Executive Order on Mandatory Social Health Insurance at primary healthcare level in the state.
As the first push, the state government, on Thursday, convened a high-level strategic engagement with Permanent Secretaries of the six Health Districts, Directors of Medical Services (DMS), and Medical Officers of Health (MOHs) across all Local Government Areas (LGAs) and Local Council Development Areas (LCDAs) to accelerate implementation 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 engagement as a “deliberate and coordinated effort to deepen compliance, strengthen operational alignment, and accelerate the full implementation of the Executive Order on Mandatory Social Health Insurance,” particularly at the Primary Healthcare Centres (PHCs) where impact is most directly felt.
Zamba reminded participants that Governor Babajide Sanwo-Olu signed the Executive Order on July 16, 2024, mandating social health insurance for all residents of the State, a directive further reinforced by the Presidential Executive Order of September 12, 2025, affirming health insurance as a pathway to Universal Health Coverage (UHC).
She noted that LASHMA had since embarked on structured engagements beginning with the Body of Permanent Secretaries and Heads of Agencies before cascading 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, stressing that PHCs remained the first point of contact for most Lagos residents and the backbone of the state’s healthcare system.
She clarified that under the Executive Order, individuals presenting at PHCs without proof of enrolment on the ILERA EKO Scheme must not be turned away.
“Facilities are expected to facilitate immediate on-the-spot enrolment through the provider-led enrolment process, ensure that enrolment details are properly captured, and guide the patient through activation in line with LASHMA guidelines,” she stated.
According to her, in life-threatening emergencies, patients must be promptly stabilised before any enrolment requirements are applied, assuring that LASHMA has introduced verification systems, provider-led enrolment processes and a policy framework for emergency care through the LASHMA-AID programme launched in December, 2025.
“Compliance must be embedded into daily workflows, patient management processes and supervisory structures across all PHCs,” she emphasised.
In her address on behalf of other district Permanent Secretaries, the Permanent Secretary of Lagos Health District III, Dr. Monsurat Adeleke, urged health leaders to become ambassadors of the scheme, revealing that even some senior officials had yet to fully activate their coverage.
“Out-of-pocket expenditure is the craziest thing that anybody can go through. This is the best opportunity we’ve gotten, especially as the government has made it compulsory for us,” she stated.
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