Lagos to enforce health insurance for civil servants, expands maternal care under Ilera Eko —LASHMA

THE Lagos State Health Management Agency (LASHMA) has confirmed that enrollment in the state’s social health insurance scheme, Ilera Eko, will be enforced for public servants starting with the April salary payments, following a directive from the Office of the Head of Service.

The Permanent Secretary of LASHMA, Dr Emanuela Zanga, disclosed this at the close of a two-day capacity-building workshop for journalists on the Lagos State Health Scheme (LSHS) and the mandatory social health insurance plan, Ilera Eko.

The workshop was organised by the agency in collaboration with EngenderHealth and the International Society of Media in Public Health (ISMPH).

Dr Zanga said the circular mandating the policy was issued about two weeks ago and aims to ensure that government workers lead by example in complying with compulsory health insurance.

“If the government says health insurance is mandatory, public servants must also comply. Registration is ongoing, and cooperation has been very good so far,” she said.

She explained that the enforcement is part of broader efforts to achieve universal health coverage and reduce out-of-pocket medical expenses, which often push families into poverty.

Dr Zanga noted that the Ilera Eko package places a strong emphasis on maternal and child health, including heavily subsidised or free caesarean sections for enrolled mothers—procedures that can otherwise cost ₦500,000 to ₦1 million in some facilities.

Beyond maternal care, she added that the insurance programme is designed to improve access to quality healthcare across Lagos through a wide network of accredited facilities. She urged residents to enrol, noting that unexpected medical bills can devastate household finances.

She emphasised that the scheme is subsidised by the state government, offers flexible payment options, and is available at multiple locations across Lagos.

While urging residents to take control of their health by joining the scheme instead of waiting for emergencies, Dr Zanga emphasised that wider enrollment would also help reduce preventable deaths from conditions such as hypertension and pregnancy-related complications.

The Coordinator of Regulations at LASHMA, Dr Tosin Awosika, stated that the enforcement drive has begun with public servants, many of whom are already covered under employer-funded plans but have not yet activated their enrollment.

He said that expanding enrollment is critical to building a large financial pool that can improve healthcare infrastructure, fund equipment purchases, train personnel, and enhance service delivery.

“Insurance works based on numbers. The larger the pool, the more resources are available to treat everyone and reduce out-of-pocket expenses,” he said.

According to him, broader participation will also enable the state to provide coverage for vulnerable populations, expand benefits over time, and strengthen the overall healthcare system.

He acknowledged that not all medical procedures are covered under the basic plan but stated that the benefits package includes surgeries, medications, diagnostic tests, and treatment for chronic conditions, with additional services expected as enrollment grows.

Awosika added that the state is collaborating with federal authorities to harmonise social and private health insurance frameworks, ensuring seamless coverage across Nigeria.

Presenting the programme’s scorecard, Mr Kehinde Daodu, a monitoring and evaluation officer at the agency, stated that the scheme has reached 1.3 million beneficiaries, with annual growth expected to accelerate following the introduction of mandatory coverage.

Daodu stated that the scheme has recorded an average annual growth rate of 27 per cent since its inception, a figure expected to increase to between 50 and 100 per cent as the enforcement of compulsory enrollment takes effect.

“We started in 2021 with far fewer numbers, but as of June 4, 2025, we have reached 1.3 million and are still expanding,” he said.

The data presented show that women constitute a slight majority of enrollees, while men account for 47 per cent.

By age distribution, the working-age population constitutes the largest share at 61 per cent, followed by children aged 5 to 18 at 25 per cent. Children under five make up four per cent, while persons over 60 account for 10 per cent.