By Oluwafunke Ishola
In a landmark move to overhaul its emergency medical response, the Lagos State Government has launched the Ilera Eko Emergency Services (LASHMA-AID). This initiative represents a systemic solution to one of healthcare’s most critical failures: the tragic rejection of patients in life-threatening situations due to financial uncertainty.
Dr. Adebayo Adedewe, Board Chairman of the Lagos State Health Management Agency (LASHMA), unveiled the program, emphasizing its core mission: to ensure no emergency case is turned away without stabilization in any health facility across the state. This policy directly tackles the “wallet biopsy”—where treatment is delayed or denied while a patient’s ability to pay is assessed—a practice that has cost countless lives.
How LASHMA-AID Works: A Coordinated Lifeline
The program is not merely an ambulance service; it’s an integrated, financially-backed emergency pathway. Its scope is specifically designed for the critical window of survival:
- Coverage: Up to 48 hours of in-facility treatment to stabilize a patient.
- Beneficiaries: Active enrollees of the ILERA EKO social health insurance scheme and identified vulnerable residents.
- Process: It creates a single, coordinated system for pre-hospital care, inter-facility transfers, and crucially, guarantees payment to providers for emergency stabilization services.
As Dr. Adedewe stated, “LASHMA-AID is about saving critical minutes and preserving lives… ensuring that in moments of crisis, our enrollees are not left unattended due to financial barriers, confusion, or fear.”
The Critical Gap This Initiative Fills
Dr. Kemi Ogunyemi, Special Adviser to Governor Babajide Sanwo-Olu on Health, highlighted the historical context that makes this launch so pivotal. “For too long, emergency responses remained one of the weakest points in the healthcare delivery chain,” she noted. The fragmentation was twofold: patients faced catastrophic bills, while healthcare providers had no assurance of reimbursement for emergency care rendered. This financial standoff often resulted in life-threatening delays or outright denial of care. LASHMA-AID acts as the trusted intermediary that removes this barrier, allowing medical professionals to focus solely on their oath to save lives.
Financial Backing and Governance: The Engine of Sustainability
The program’s potential for success is rooted in substantial political and financial commitment:
- Executive Order: It is empowered by Sections 6 and 7 of the Executive Order on mandatory social health insurance, signed by Governor Sanwo-Olu in July 2024.
- Equity Fund: A cornerstone of the initiative is the dedication of 1% of the state’s Consolidated Revenue Fund (CRF) as an equity fund for vulnerable populations. Governor Sanwo-Olu has increased this fund and made it a statutory charge—a first-of-its-kind policy in Nigeria.
- Integrity Safeguards: While built on trust and a shared sense of duty among providers, LASHMA has made clear that the system includes checks and sanctions to prevent exploitation, protecting the program’s integrity for long-term sustainability.
A Call for Co-Ownership and Data-Driven Improvement
The launch emphasized that LASHMA-AID’s success hinges on its frontline operators. “While LASHMA will coordinate, it is the daily decisions made by doctors, nurses, paramedics, call handlers… that will determine the true success,” Dr. Adedewe explained. Providers are urged to see themselves as co-owners of the system.
Furthermore, the program is designed for evolution. LASHMA commits to monitoring usage patterns, reviewing feedback, and refining processes. “Our goal is not just to have an emergency programme, but one that becomes smarter, more responsive over time and a foundation for others to emulate,” Adedewe affirmed.
In essence, LASHMA-AID is more than a new service; it is a fundamental re-engineering of the social contract in emergency healthcare for Lagos residents. By guaranteeing payment and coordinating response, it aims to transform panic and uncertainty into a reliable chain of survival, making the state’s ambitious journey toward Universal Health Coverage a tangible reality in its most critical moments.
Edited by Vivian Ihechu
