Akwa Ibom, Bayelsa, Imo top states with most miserable health budgets

Akwa Ibom and Imo have the lowest budget allocations for health in Nigeria, according to an analysis of 2025 state budgets by SBM intelligence.

While Lagos leads in nominal terms, spending over ₦221 billion, rich states like Akwa Ibom (4.3%), Bayelsa (4.1%), and Imo (3.5%) dedicate a fraction of their budgets to healthcare, putting millions at risk.

Northern states, by contrast, prioritise health more in their budgets. Kaduna allocates 16.1% of its total budget to healthcare, followed by Kano (15.2%) and Bauchi (15.1%).

On a per capita basis, the disparities are even clearer: Abia (₦22,926) and Ogun (₦21,051) spend the most per citizen, while Imo (₦3,950) and Adamawa (₦4,271) lag far behind, potentially limiting access to quality healthcare.

The 2025 Health Preparedness Index (HPI) by SBM Intelligence paints a worrying picture of Nigeria’s readiness for health crises. Not a single state reached 30% preparedness for the second year in a row.

“This finding is a stark metric of Nigeria’s overall vulnerability,” the report said. “The country’s healthcare system faces an extreme deficit in basic capacity, reflecting years of neglect and underinvestment.” Abia scored highest at 26.85, while Katsina (12.54), Kebbi (13.31), and Ebonyi (12.85) were the worst performers.

The human impact of these gaps is severe. Nigeria now has an average of 15,361 patients per doctor, far below the World Health Organization’s standard.

Some states, including Bauchi and Zamfara, have more than 43,000 people per doctor. Hospitals are overburdened, and the “Japa Syndrome”—the migration of doctors and nurses abroad—has worsened the shortage of skilled health workers.

Budget trends show that political will matters more than wealth. While Lagos leads in absolute spending, states in the north allocate a higher share of their budgets to health than southern states like Akwa Ibom and Imo.

The SBM Intelligence report warns, “Without sustained and equitable investment in health, Nigeria’s preparedness for future crises will remain critically low.”

The HPI measures readiness using six indicators: doctor-to-population ratio, infant and child mortality, Human Development Index, per capita health budget, share of health in total state budget, and average household size.

Analysts say the report highlights the urgent need for investment, infrastructure reform, and better allocation of medical resources across the country.