The Lagos State Government on Wednesday formally inaugurated the Lagos State Health Scheme (LSHS) Enforcement Team, marking the commencement of full implementation of Governor Babajide Olusola Sanwo-Olu’s Executive Order on mandatory social health insurance, aimed at ensuring that no resident is denied access to healthcare due to financial constraints.

The inauguration ceremony, held at the Conference Room of the Public Service Office (PSO), Alausa-Ikeja, brought together key stakeholders from the state and federal levels, reinforcing Lagos State’s leadership position in driving universal health coverage through the Ilera-Eko Social Health Insurance Scheme.

Delivering the keynote address, the Head of Service (HoS), Lagos State, Mr. Olabode Agoro, described the event as a critical milestone in the state’s health reform journey, stressing that the Executive Order underscores government’s commitment to affordable, accessible, and sustainable healthcare for all residents.

Agoro explained that since the issuance of the Executive Order, strategic engagements had been undertaken to ensure smooth implementation, including a retreat with Permanent Secretaries in September 2025 and a subsequent engagement with Heads of Agencies in December 2025, aimed at securing institutional ownership and aligning MDAs with the enforcement framework.

He noted that enforcement would commence in phases, beginning with Ministries, Departments and Agencies (MDAs) in the first quarter of the year, before extending to local governments, local council development areas, the formal sector and corporate organizations across the state.

Clarifying public concerns, the HoS emphasized that enforcement was not punitive. “This is not about arrests or sanctions; it is about advocacy, persuasion and moral suasion,” he said, adding that enforcement would also involve restricting access to certain government services for those who fail to enroll, similar to tax compliance requirements.

Agoro directed MDAs to lead by example by ensuring that all staff are enrolled on Ilera-Eko, integrating the LASHMA registration link on their websites, and demanding proof of enrollment before rendering services. He further disclosed that enforcement compliance would be monitored through monthly reports submitted to his office.

In a far-reaching directive, the Head of Service announced that evidence of Ilera-Eko enrollment would henceforth be mandatory during monthly staff audits, warning that salaries of officers who fail to comply would be withheld. “Government already pays 75 per cent of the premium. We cannot afford to waste resources,” he stated.

Earlier, the Director-General of the National Health Insurance Authority (NHIA), Dr. Kelechi Ohiri, commended Lagos State for pioneering mandatory health insurance implementation, noting that the initiative aligns with President Bola Ahmed Tinubu’s health sector renewal agenda and the National Health Insurance Act of 2022.

Ohiri described health insurance as a critical tool against “health poverty,” explaining that both the poor and middle-income earners remain vulnerable to catastrophic health costs without insurance. “No Nigerian should have to sell property or borrow money in the middle of the night to save a life,” he said.

He pledged continued federal support for Lagos State, expressing optimism that the state would record millions of enrollees. “We will be here to celebrate one million, two million, and even ten million enrollees,” he assured.

The Permanent Secretary, Lagos State Health Management Agency (LASHMA), Dr. Emmanuella Zamba, stated that the Enforcement Team was constituted pursuant to the Governor’s Executive Order of July 16, 2024, which mandates social health insurance enrollment for all residents.

Zamba explained that Ilera-Eko offers actuarially designed plans to meet diverse needs, including the Standard, Standard Jaara, Standard Jaara Plus, Seniors Plan, and diaspora-focused packages, stressing that mandatory enrollment is essential for equity, sustainability and financial protection.

She disclosed that members of the Enforcement Team had undergone specialized training at the Lagos State Law Enforcement Training Institute (LETI) and would be expected to operate with professionalism, fairness and integrity, given the public interest nature of their assignment.

The LASHMA boss also acknowledged the leadership of the Head of Service, describing his support as pivotal to the progress recorded so far, while appealing for additional logistics, including buses and a pick-up vehicle, to enhance field operations and monitoring.

In his remarks, the Special Adviser to the Governor on the Parastatal Monitoring Office, Hon. Ibrahim Obanikoro, described health as wealth and urged Lagos residents to embrace the scheme, noting that health insurance provides critical financial relief during emergencies.

Obanikoro encouraged civil servants and residents alike to take advantage of the scheme, stressing that out-of-pocket healthcare spending could be financially devastating, particularly in emergency situations.

Also speaking, the Permanent Secretary, Public Service Office, Mrs. Sunkanmi Oyegbola, announced an operational compliance measure, stating that officers must now present evidence of Ilera-Eko enrollment during monthly staff audits and “pay-at-site” exercises.

Oyegbola declared, “No enrollment, no pay,” explaining that the directive would ensure full compliance across MDAs and reinforce the principle that a healthy workforce is a productive workforce.

The inauguration of the LSHS Enforcement Team signals a decisive shift from voluntary participation to structured compliance, as Lagos State intensifies efforts to secure universal health coverage and safeguard residents against the financial risks of ill health.

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