Nationwide health emergency may be imminent as all 36 Nigerian states scored below 30 per cent in the 2025 SBM Health Preparedness Index (HPI), according to a new report by SBM Intelligence.
The report revealed that no state in the country achieved up to 30 per cent preparedness to respond to health emergencies or deliver effective healthcare services, raising concerns over Nigeria’s ability to withstand future health crises.
Released today, the report assessed the performance of states across key indicators, including doctor-to-population ratio, health budget, human development index, and infant mortality rate.
The highest score recorded was 26.85 by Abia State, while all other states also failed to reach the 30 per cent threshold, reflecting what the analysts described as years of neglect, underfunding, and weak institutional capacity within Nigeria’s health system.
According to SBM researchers, the findings come at a time when the country is still struggling with the lingering effects of the COVID-19 pandemic, five years after its outbreak.
They noted that structural deficiencies, poor fiscal prioritisation, and the ongoing exodus of medical professionals had compounded the sector’s inability to deliver quality healthcare or prepare for future outbreaks.
The report identified the migration of Nigerian-trained doctors as a major threat to the country’s health capacity. It stated that poor working conditions, insecurity, and inadequate pay had driven thousands of health workers abroad, with estimates showing that more than 67 per cent of Nigerian-trained doctors now practise overseas.
The report warned that the direct consequence of this migration was the collapse of the doctor-to-patient ratio, which, according to them, now averages one doctor to 15,361 patients nationwide, which is far below the World Health Organisation (WHO) standard. In Bauchi State, the situation is most severe, with a ratio of one doctor to 54,249 people.
The report further showed that while states like Lagos, Edo, and Enugu have fewer than 3,200 patients per doctor, northern states such as Zamfara, Kebbi, and Bauchi face extreme shortages.
They noted that the uneven distribution highlights the urgent need for policies that will retain and redistribute the country’s medical workforce. The 2025 HPI also examined state health budgets and found wide disparities in government commitment to healthcare. Lagos maintained the highest nominal allocation of over N221 billion, while Kaduna devoted the largest proportion of its total budget to health at 16.1 per cent, followed by Kano (15.2 per cent) and Bauchi (15.1 per cent).
In contrast, Akwa Ibom (4.3 per cent), Bayelsa (4.1 per cent), and Imo (3.5per cent) were identified as the least committed states in terms of health funding. On a per capita basis, Abia (N22,926) and Ogun (N21,051) led the country, while Imo (N3,950) and Adamawa (N4,271) ranked at the bottom.
The report’s authors cautioned that such uneven fiscal patterns could perpetuate health inequalities, particularly in states that continue to allocate minimal resources despite high disease burdens and recent environmental disasters.
Abia State topped the 2025 Health Preparedness Index for the first time, driven by strong per capita health spending and a relatively high Human Development Index (HDI) of 0.674. Ogun and Lagos followed in second and third positions, while Osun and Edo rounded out the top five.
In contrast, the northern region remained heavily represented among the lowest-performing states. Kebbi (13.31) and Katsina (12.54) occupied the bottom positions, alongside Sokoto, Gombe, and Zamfara. The report also noted that Ebonyi, a southern state, joined the bottom five for the first time due to poor health spending and an alarming doctor-to-patient ratio of one doctor per 21,202 residents.
