Lagos: In line with the global commitment toward Universal Health Coverage (UHC), Nigeria is striving to ensure equitable access to high-quality and affordable health care for all citizens. However, progress has been slow, highlighted by high out-of-pocket healthcare expenses, poor health insurance penetration, and low national and subnational health budgets.
According to News Agency of Nigeria, Nigeria faces one of the highest rates of out-of-pocket healthcare spending globally, with an estimated 77 per cent of healthcare expenses being paid directly by individuals, as reported by the World Health Organisation (WHO). The WHO further indicates that the world is off track to make significant progress towards universal health coverage, a critical target of the Sustainable Development Goals of good health and well-being. This trend is consistent across all regions and most countries, revealing the financial strain on individuals who pay for health services out of their own pockets, which can push them into poverty.
For Nigerians, particularly those in rural and underserved communities facing financial constraints and rising healthcare costs, the situation is dire. The delay in seeking medical treatment exacerbates morbidity and mortality rates. To them, UHC is not merely a goal but a lifeline. Prof. Muhammad Ali Pate, the Coordinating Minister of Health and Social Welfare, highlighted that only 16 million Nigerians were enrolled in health insurance at the start of President Bola Tinubu’s administration in 2023. However, in two years, four million additional Nigerians have enrolled in the National Health Insurance Scheme.
In Lagos State, the Lagos State Health Management Agency (LASHMA), established in 2015, manages the Ilera Eko Scheme, designed to enhance access to quality healthcare services while providing financial protection. The state’s growing population of 30 million poses significant demands on its health system. Currently, only five per cent of Lagos residents are enrolled in the state’s social health insurance, but there is a 30-year plan to increase this to 90 per cent, according to Lagos State Commissioner for Health, Prof. Akin Abayomi.
The Ilera Eko health insurance scheme offers various plans for individuals and families, covering a wide range of hospital services. Gov. Babajide Sanwo-Olu signed an Executive Order in July 2024 for compulsory subscription to the state’s health insurance, with plans for full enforcement by the third quarter of 2025. Currently, about 1.3 million residents are enrolled in the scheme. Dr Emmanuella Zamba, Permanent Secretary of LASHMA, emphasizes the importance of public awareness and the necessity of health insurance.
Despite the progress, challenges remain, including long waiting times, low enrollment, and service accessibility. Nevertheless, Lagos State demonstrates strong political will and progress in providing equitable, affordable, and accessible healthcare services.