Healthcare has emerged as one of the weakest links in governance across Nigeria, according to the 2025 State Performance Index (pSPI). The report shows that while some states are making progress in public health delivery, most citizens remain dissatisfied with the quality, access and affordability of healthcare services.
The national assessment released in Abuja by Phillips Consulting (PCL) and made available to newsmen on Thursday showed the performance index.
The firm evaluated 36 states and the Federal Capital Territory (FCT) using both objective data (70 per cent) and citizen perception (30 per cent) across critical governance indicators.
The report said that healthcare stood out as a recurring concern, with respondents consistently ranking it low compared to other public services.
The findings showed that less than 30 per cent of Nigerians expressed satisfaction with healthcare in public hospitals, highlighting persistent gaps in infrastructure, personnel and affordability.
While states such as Nasarawa ranked among the highest for hospital access, the FCT was placed 37th for health infrastructure, reflecting public frustration with poor facilities and weak investment in the sector.
Similarly, Benue, in spite of being rated highly for the affordability of hospitals, still recorded only 20 per cent citizen satisfaction on the quality of care, showing that affordability has not translated into better outcomes.
In Kogi, healthcare indicators were among the lowest nationwide, with just 16 per cent of respondents satisfied with hospital affordability.
The report noted sharp disparities in healthcare delivery between high-performing and low-performing states.
States that invested in recruiting health professionals, upgrading hospitals and improving affordability recorded higher rankings.
In contrast, states grappling with security crises, poor infrastructure and low capital expenditure fell behind.
The North-Central zone showed mixed results: while Nasarawa excelled in health access, neighbouring states like Benue and Kogi struggled with weak hospital infrastructure and underfunded health systems.
Public perception surveys revealed that healthcare ranked among the top three areas of dissatisfaction, alongside roads and access to clean water.
Respondents cited lack of drugs in hospitals, shortage of health workers, high out-of-pocket payments, and dilapidated facilities as recurring challenges.
“Healthcare remains a pressing concern for Nigerians. Even where hospitals exist, citizens are not convinced that they are receiving quality service.
“The pSPI findings are clear, citizens want affordable, reliable and accessible healthcare. States that ignore this risk fall further behind in both perception and performance,” the report said.
Analysts said that the findings underline the urgent need for state governments to prioritise health as a governance benchmark.
They said the report warned that poor health outcomes not only weaken public trust but also slow economic growth, increase poverty and widen inequality across the federation.
The pSPI recommended increased investment in healthcare infrastructure, recruitment of qualified health workers and equitable distribution of services between urban and rural communities.
It also urged greater transparency in state health spending, stronger partnerships with development actors, and targeted interventions to address local health challenges.
The 2025 pSPI findings send a clear message: health is a governance litmus test.
As Nigerians continue to demand accountability, states that prioritise hospitals, healthcare workers and affordability are likely to win citizen trust, while those that do not risk being left behind.
By Abujah Racheal
