Lagos Expands Oversight On Basic Healthcare Fund Implementation

 

 

 

The Lagos State has reaffirmed its commitment to improving healthcare delivery through the effective implementation of the Basic Healthcare Provision Fund (BHCPF). This was the highlight of the State Oversight Committee (SOC) meeting held yesterday at the Folarin Coker Staff Clinic Conference Room, State Secretariat, Alausa-Ikeja.

At the heart of the discussions was a presentation by the Head of Planning, Research, Monitoring & Evaluation at the Lagos State Health Management Agency (LASHMA), Mrs. Adetoro Tayo-Adetoro. She provided updates on the NHIA Gateway, focusing on financial management, quality improvement, and fund utilization.

According to the presentation, enrollment under the NHIA Gateway has expanded significantly since its inception. From just 58 Primary Healthcare Centres (PHCs) in 2022, the number has now grown to 194 PHCs, covering a broader population across the state. Financial disbursements have also increased, with over marked improvement in funds released between Q2 2024 and Q1 2025 to support service delivery.

She noted that despite this expansion, utilization of healthcare services remains low. While more Lagosians are enrolled in the health insurance scheme, many are not actively using the services. According to her, the current utilization rate ranges from 0.68% to 3%, averaging just 1.67%, a statistic that raised concerns among policymakers.

To address this, she noted that the Lagos State Government has adopted new strategies, including enrolling beneficiaries directly through PHCs rather than relying solely on LASHMA. She disclosed that PHCs that fail to report utilization data now face funding cuts, a measure introduced in May 2024 to enforce compliance.

Adetoro stated that Malaria remains the most frequently treated condition at PHCs, followed by hypertension, upper respiratory tract infections, and gastroenteritis. However, the rising number of malaria cases puzzled stakeholders at the meeting, leading to calls for a data review to ensure accurate reporting.

During the discussions, the Lagos State Commissioner for Health, Prof. Akin Abayomi emphasised the need for a cost-benefit analysis of the scheme, noting that low utilization may be financially beneficial for providers but is detrimental to the health system.

The Special Adviser to the Governor on Health, Dr. (Mrs.) Kemi Ogunyemi, raised concerns about the quality of care at PHCs, questioning why some cases of hypertension were being referred to secondary facilities instead of being managed at the primary level. She stressed the need for clear service packages under the BHCPF to avoid discrepancies between different health insurance schemes.

Similarly, the Permanent Secretary of the Ministry of Health, Dr. Olusegun Ogboye questioned the sustainability of enrollment cycles. He asked whether existing enrollees remained on the scheme each year or if they were replaced with new beneficiaries. He also proposed a review of the capitation payment model, given the persistently low utilization rates.

One of the major challenges identified at the meeting was the gap in knowledge among health workers. Many frontline health personnel struggle to differentiate between the BHCPF and the Lagos State Social Health Insurance Scheme (Ilera-Eko), leading to confusion in implementation.

Other concerns included poor infrastructure in some PHCs, staff shortages, and underreporting of services rendered. To combat these issues, it was proposed that the State government increase training for PHC staff, establish health insurance desks at each facility, and strengthen community engagement programmes.

A significant outcome of the meeting was the inauguration of the expanded BHCPF State Oversight Committee by Prof. Abayomi. This Committee will now oversee multiple health programmes under the Sector-Wide Approach (SWAp) framework. According to the Commissioner, Lagos State is already meeting its performance indicators under BHCPF and is poised to receive more funding rewards.

The meeting also featured a presentation on the National Primary Health Care Development Agency (NPHCDA) Gateway, highlighting the role of financial management, quality improvement, and fund retirement in optimizing service delivery.

Another key session was the introduction of the newly appointed Lagos State Health Fellows, who will work across various LGAs to support healthcare programmes. Addressing the fellows, Dr. Jumoke Oyenuga, Director of Planning, Research, and Statistics, commended their selection and emphasised their role in driving innovation and service delivery.

In his closing remarks, Prof. Abayomi urged all stakeholders to intensify efforts to ensure that Lagosians fully benefit from the BHCPF initiative. He reiterated that efficient healthcare financing and service delivery remain top priorities for the administration.

As the state continues to fine-tune its health insurance and primary healthcare framework, the success of the BHCPF will largely depend on improving utilization, ensuring data accuracy, and strengthening accountability across all health facilities.

The meeting, chaired by the Honourable Commissioner for Health, Prof. Akin Abayomi, brought together key stakeholders in the health sector. Among those in attendance were the Special Adviser to the Governor on Health, Dr. (Mrs.) Kemi Ogunyemi; Permanent Secretary of the Ministry of Health, Dr. Olusegun Ogboye; Permanent Secretary, Lagos State Primary Health Care Board, Dr. Ibrahim Mustafa, mni; Permanent Secretary, Lagos Health District II, Dr. Dayo Lajide; Permanent Secretary, Lagos Health District IV, Dr. Abimbola Bowale; Permanent Secretary, Lagos Health District VI, Dr. Abimbola Mabogunje; Permanent Secretary, Lagos Health Management Agency (LASHMA), Dr. Emmanuella Zamba and heads of relevant health agencies and facilities.