The Lagos State Governor Mr. Babajide Sanwo-Olu, represented by the first lady, Dr Claudiana Ibijoke Sanwo-Olu, launched the new, expanded benefit packages of the Lagos State Health Scheme (Ilera Eko), on Wednesday, 16th February 2022. The old benefit package was reviewed by the Lagos State Health Management Agency (LASHMA) based on the findings of the actuarial study conducted with support from the Bill and Melinda Gates Foundation funded Strategic Purchasing for Family Planning, Maternal, New-Born and Child Health (SP4FP/MNCH) Project. The SP4FP/MNCH Project implementation is led by Health Systems Consult Limited (HSCL) and have been providing technical assistance to LASHMA, the Lagos State Health Facility Monitoring Agency and Accreditation Agency (HEFAMAA) and the State Ministry of Health (SMOH) since 2019.
In commissioning the actuarial study HSCL took an integrated MNCH approach that went beyond family planning to also include the implication of including other critical services such HIV/AIDS, TB, some additional secondary services, as well as cancer care. The findings showed that integrating the full complement of family planning and some HIV and TB services into the base benefit package did not change the premium. This is because the number of enrollees that will be receiving these services and cost of the services are small relative to the entire pool of insured people and given the risk sharing across all enrollees. As a result, LASHMA expanded its base package to include additional family planning, HIV and TB services at the same premium of N8,500 ($20.7) per enrollee per year. With this new package, all enrollees who desire these services will be able to receive them in empaneled public and private health facilities without paying at the point of care. Some of the services are covered under Capitation while for others, providers will be reimbursed under a Fee-for Service (FFS) arrangement, by LASHMA. In addition to expansion of the base benefit package, LASHMA also created additional benefit packages with higher premium, to provide options for those who want even more services such as advanced diagnostic screening and some cancer care.
In addition to the wife of the governor, the launch was also attended by the leadership of the State Ministry of Health led by the Honourable Commissioner for Health, Prof Akin Abayomi, the leadership of the Primary Health Care Development Board, Health Services Commission, royal fathers, health care providers, beneficiary groups, development partners, implementing partners and the media, amongst others.
The launch was hosted and anchored by LASHMA led by its General Manager, Dr Emmanuella Zamba. Goodwill messages were presented by a representative of beneficiaries, Health Service Commission (Dr Atinuke Onayiga), WHO (Dr Samuel Ogiri), UNFPA (Dr Omolaso Omosehin) and the Bill and Melinda Gates Foundation (Dr Caroline Jehu-Appia). Dr Jehu-Appia who is the Deputy Director Health, Nutrition and Eradication represented Dr Jeremie Zougrana, the Director, Nigeria Country Office, Bill and Melinda Gates Foundation. As part of the goodwill message from the Gates Foundation, she congratulated the state as a “trail blazer” and encouraged other states and the NHIS to toe same line and include full family planning and other missing MNCH services in their benefit packages as the actuarial had demonstrated that these would not have the feared effect of increasing the premium. The Commissioner for Health, Prof Abayomi, welcomed everybody to the event and reiterated the commitment of the state to fast tracking progress towards Universal Health Coverage (UHC). The LASHMA GM Dr Zamba provided an overview of progress in increasing enrolment under the Ilera Eko scheme. She reported that enrolment has gone up from over 200,000 by end of 2020 to over 500,000 by end of January 2022, with expectations that the numbers will go up even faster with the rebranding under Ilera Eko and extensive demand generation and marketing. The Founding Partner of HSCL, Dr Nkata Chuku presented an overview of the SP4FP/MNCH Project and the outputs of the actuarial studies while the Head of Business Development LASHMA, Mr Rotimi Olatunji presented the new packages and marketing strategies.
During the formal launch by the First Lady on behalf of Mr Governor, she expressed the governor’s resolve to make health insurance accessible to all residents of Lagos as well as improve the quality of health care enrolees receive. She encouraged all Lagosians to subscribe to the health insurance scheme so that they can receive health care services when they need them, without paying at the point of service delivery.
Besides the formal presentations, the launch featured many fun events including an exhilarating dance performance by the Xplicit Dancers (a LASHMA partner) and the entire LASHMA team including the GM and their Board Chairman. All participants eventually joined in the dance, and it was fun all round. LASHMA also utilised the event to provide free medical checks and enrol more people.
Lagos is the first state in Nigeria to integrate the full complement of family services and comprehensive HIV/AIDS services (besides counseling) into its health insurance benefit package. This is a huge step towards financial sustainability for disease programmes that have been mostly donor funded, especially with the uncertainties around donor aid and need to increase local financing for health.
Nigeria’s President, Muhammadu Buhari launched the Revised National Policy on Population for Sustainable Development, earlier in the month. During the launch he stressed the need for urgent measures to address Nigeria’s high fertility rate, through expanding access to modern contraceptive methods nationwide. The integration of family planning into the Ilera Eko benefit packages is a critical step towards increasing access to contraceptives method and will contribute to achieving the goals of the revised national policy.
The old and new health benefit package showing differences for family planning, TB and HIV is presented below:
PPM – Provider Payment Mechanism, CAP – Capitation, FFS – Fee for Service