The Lagos State Health Management Agency (LASHMA) on Thursday convened a high-level strategic meeting with Heads of Agencies to fast-track the implementation of Governor Babajide Sanwo-Olu’s Executive Order mandating Social Health Insurance for all residents of the state. The engagement, held at Providence Hotel, Ikeja, brought together senior government officials as the state intensified efforts to eliminate out-of-pocket health expenditure.

Special Adviser, Parastatal Monitoring Office, Hon. Ibrahim Obanikoro, who delivered the keynote address, said the gathering marked a critical step in ensuring full compliance with the Executive Order signed on July 16, 2024, which compels all Lagos residents to enroll under the ILERA EKO Health Insurance Scheme. He described Heads of Agencies as “custodians of the Executive Order” whose cooperation would determine the pace and success of its enforcement.

Obanikoro noted that Governor Sanwo-Olu’s commitment to healthcare, as reflected in the THEMES+ Agenda, was evident in massive investments in hospitals, personnel, and social protection systems. He said mandatory health insurance was necessary to shield residents from catastrophic medical costs, stressing that many have resorted to self-medication, traditional herbs, or asset sales to fund treatment.

He warned that Lagos State was under national and international scrutiny as the first state to adopt such a model, urging MDAs to lead the compliance process without delay. Obanikoro added that accurate health insurance data from agencies would be crucial for sustainability, calling on participants to “join forces to make history” and prove Lagos truly remains the Centre of Excellence.

Permanent Secretary of LASHMA, Dr. Emmanuella Zamba, in her remarks, said the Executive Order represented a decisive shift toward Universal Health Coverage (UHC) at a time when global advocacy against unaffordable healthcare costs was gaining momentum. She acknowledged the support of top government officials and commended Heads of Agencies for demonstrating readiness to institutionalize health insurance in their operations.

Zamba reminded participants that the Executive Order had been further reinforced by a Presidential directive issued in September 2025, underscoring the seriousness of the mandate. She said MDAs were central to translating the policy into measurable outcomes because they serve as both implementers and influencers of public behaviour in Lagos.

The Permanent Secretary emphasised that LASHMA had already strengthened its enrolment platforms, expanded ILERA EKO benefit packages, and created compliance tools for MDAs, but stressed that institutional will was required at agency level. She said enforcement would soon begin, and any MDA whose workforce was not fully enrolled would be deemed non-compliant with the law.

Zamba reiterated that mandatory health insurance was a social protection tool capable of reducing poverty, boosting productivity, and protecting families from health-induced financial crises. She urged agencies to integrate ILERA EKO verification into all public-facing processes, from permits to certifications, so as to push the state closer to achieving UHC.

Permanent Secretary, Parastatal Monitoring Office, Dr. Olugbemiga Aina, in his remarks, praised the depth of conversations held during the four-hour session, describing it as more robust than earlier engagements with Permanent Secretaries. He said the meeting exposed gaps that LASHMA, agencies, and service providers must jointly close to achieve effective implementation.

Aina outlined a one-month target for achieving 100% enrolment of all Oracle and non-Oracle government staff, noting that January offers a window for accelerated implementation. He insisted the target was achievable, citing successful pension enrolment as precedent, and directed LASHMA to develop a pragmatic timetable.

The Permanent Secretary also called for re-energizing and retraining focal persons responsible for compliance at MDAs. He said these officers must be empowered to simplify health coverage verification, improve client experience, and ensure agency-wide understanding of entitlements under the Patient’s Bill of Rights.

He stressed that out-of-pocket health payments were “no longer sustainable for any Lagosian,” urging Agencies to begin immediate action on low-hanging issues such as enrolling drivers and frontline staff who often remain uninformed about their health benefits. He added that mixed-structure parastatals with private and government staff must also be prioritised.

Aina announced that from January 2026, LASHMA compliance would be incorporated into the monthly reporting framework monitored by the Parastatal Monitoring Office, alongside revenue and pension indicators. This, he said, would ensure accountability and drive consistent progress across agencies.

Coordinator of Regulations at LASHMA, Mr. Tosin Awosika, in his presentation, explained that the Executive Order was issued to align the Lagos State Health Scheme Law with the National Health Insurance Authority Act, which makes Social Health Insurance mandatory nationwide. He said Lagos domesticated the requirement through the July 2024 Executive Order.

Awosika highlighted key provisions, including compulsory proof of health insurance before residents can access services in any MDA, and mandatory registration for anyone seeking care in public or private hospitals in the state. He clarified that only life-threatening emergencies may be treated before proof of insurance, after which the patient must immediately enroll.

He further outlined steps approved by Mr. Governor for MDAs, beginning with full enrolment of all staff; Oracle, non-Oracle and ad-hoc, and extending to updating internal SOPs to include ILERA EKO as a mandatory document for processing permits, licenses, approvals and certifications. He urged MDAs to invite LASHMA for on-site enrolment drives for staff yet to be captured.

The engagement ended with a renewed commitment from all participating Heads of Agencies to drive compliance ahead of enforcement. Officials agreed that mandatory health insurance represents a transformative policy that will safeguard residents, reduce poverty, and strengthen the state’s health system.

With implementation frameworks now in place, Lagos is poised to become the first state in Nigeria to operationalize a statewide mandatory social health insurance system, setting a model that others are expected to replicate.

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