Ondo State’s drive towards Universal Health Coverage

Since launch of Abiyamo Scheme, beneficiaries have been singing praises of the government for a “lifeline intervention” for mothers and children under five years. Across antenatal clinics, labour rooms and maternity wards, women speak of the relief that comes with receiving essential care at no cost. For mothers in communities, the scheme has eased the financial pressure of childbirth and has restored confidence in the public health system with the choice of safer facility-based deliveries.

The Abiyamo Scheme has continued to reshape maternal health outcomes in the state in ways that are measurable and deeply felt in communities. The aim is to reduce maternal and newborn mortality rate to zero, however, the available data shows a significant reduction in maternal and neonatal mortality rate under the scheme, the initiative is quietly proving its worth.

Over 20,157 deliveries have been recorded under the scheme, reflecting trust in facility-based care. Of the births, 489 were twins, 11 triplets, two were quadruplets, and the rest single deliveries. More than 14,733 women delivered through spontaneous vertex delivery (normal delivery), showing increasing confidence for normal delivery in equipped health facilities. Meanwhile, 5,501 Caesarean sections were successfully carried out, ensuring that women facing complications received timely surgical intervention. Together, these figures illustrate a system that is not only expanding access to care but steadily lifting standards of maternal and newborn care in the state, one safe delivery at a time.

By February 2021, the state deepened its commitment to accessible healthcare with inauguration of the Basic Healthcare Provision Fund Programme (BHCPFP), Ilera Loro Scheme, jointly financed by federal and state governments to strengthen primary healthcare delivery and accelerate Ondo State’s journey toward Universal Health Coverage. Unlike contributory insurance models, BHCPFP stands out for one crucial reason: it is non-contributory for beneficiaries, just like Abiyamo Scheme. The programme is funded through one per cent of Federal Government’s Consolidated Revenue Fund (CRF), as mandated by National Health Act of 2014, and further supported by donor agencies and development partners. To keep the system sustainable, states are to provide a 25 per cent counterpart contribution, a mechanism ensuring shared responsibility and increased coverage. Access to care started in October and since then, Ilera-Loro Scheme has positioned the state among those ensuring that the poor and vulnerable access essential health services without financial or social obstacles. Medical care under BHCPFP is available in all 203 wards of the 18 councils, delivered through accredited and well equipped Primary Healthcare Centres to handle the needs of beneficiaries.

The scheme targets residents who are most vulnerable: indigent pregnant women, children under five years old. Persons Living with Disabilities, orphans and vulnerable children, persons living with sickle cell disease, women of reproductive age, elderly citizens and widows or widowers lacking family or financial support. By identifying these groups, BHCPFP directly confronts equity gaps in access to healthcare.

Beyond primary-level services, the programme also runs on an active referral system. All accredited secondary and tertiary health facilities in the 18 councils are to receive BHCPFP beneficiaries when higher-level care is needed and ensure continuity, timeliness, and dignity in treatment.

By June 2025, enrolment under BHCPFP in Ondo State had reached 82,669 beneficiaries, offering a snapshot of the scheme’s reach and impact. Children under five form the largest group with 22,265 enrollees, followed by 17,373 women of reproductive age and 7,220 pregnant women, including 8,827 elderly persons, 7,600 widows and widowers were captured, with 2,885 poor and vulnerable individuals, 203 orphans, and 290 inmates who often face structural barriers to care. Till date, 2,536 persons with disabilities and 456 persons living with sickle cell disease have received care under the programme.

Beyond enrolment figures, Ilera-Loro Scheme has recorded measurable clinical and life-saving outcomes through its referral and secondary-care support. Beneficiaries have accessed a wide range of healthcare services, including 57 Caesarean sections that ensured safe deliveries for high-risk pregnancies. In addition, 45 cases of chronic kidney disease have been managed, supported by 344 dialysis sessions.

Surgical interventions under the scheme include 17 herniorrhaphies, nine myomectomies, five urological surgeries, one hysterectomy, and one procedure for symptomatic uterine fibroid. These interventions, with others not listed, underscore the programme’s capacity to go beyond basic care by providing critical and specialised services for vulnerable populations, without exposing beneficiaries to catastrophic health expenditure.

 Altogether, the enrolment pattern shows a scheme that is expanding coverage strategically while prioritising the poor and the vulnerable.

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Complementing these two foundational schemes is the Orange Health Insurance Scheme (ORANGHIS), introduced in September 2022. ORANGHIS was created to ease access to quality care for public servants who, for years, bore the burden of medical expenses out-of-pocket. This scheme covers the principal, spouse and at most four biological or legally adopted children under 18 years. Unlike the non-contributory BHCPFP and Abiyamo Scheme, ORANGHIS operates on an employer-employee contributory model with a value proposition: a small, predictable contribution today prevents catastrophic health spending tomorrow. As of November, there are 106,499 enrollees, with 40,165 principal applicants and 65,334 dependents.

Overall service delivery figures further underscore the programme’s expanding impact. Thirty three deliveries have been recorded with 2,794 surgical procedures, including 34 Caesarean sections. Beyond routine coverage, the commission has spent over N45 million to support enrollees who sought financial assistance for critical services outside the standard benefit package, including kidney transplants, open reduction and internal fixation procedures, and intensive care, among other specialised treatments. This is a clear reflection of rising public confidence in the state’s health insurance programme.

The scheme also has an informal sector arm accommodating non-public servants like artisans, traders, pensioners, farmers and others outside the public workforce. This category is likewise contributory: individuals below 59 years pay N18,000 annually, those 60 years and above pay N36,000, while the family plan is N90,000 per annum; it covers the principal, spouse, and up to four biological or legally adopted children under 18 years. Through this, ORANGHIS broadens financial risk protection to salaried workers and residents, ensuring that income level or employment type no longer determine access to essential health services.

ODCHC targets  one million enrollees under ORANGHIS by 2027. This confidence rises from aggressive and visible enrolment drive and medical outreaches in communities with positive feedback from beneficiaries. Not to mention sustained backing from government and investments in facility revitalisation and public messaging.

For Ondo residents, the promise is straightforward and profound: fewer families pushed into poverty by illness, more predictable spending on health and better primary care in long neglected neighborhoods.

ODCHC is repositioning healthcare not as a privilege but as a shared right and responsibility, protecting residents, reshaping service delivery, and moving Ondo State closer to Universal Health Coverage.