BudgIT, a leading civic-tech organization, has released its 2024 State of States Report, titled “Moving Healthcare Delivery from Suboptimal to Optimal.
The report assesses and ranks Nigeria’s 36 states’ fiscal performance from most to least sustainable.
Rivers State maintained its top position, while Ebonyi and Kaduna dropped out of the top five, replaced by Cross River and Kwara.
Lagos and Anambra retained their positions in the top five. Jigawa State replaced Zamfara at the bottom of the ranking.
The report evaluated states’ fiscal performance using five key metrics. First, it examined states’ ability to meet operating expenses with Internally Generated Revenue (IGR). Second, it assessed year-on-year IGR growth.
Third, it reviewed states’ ability to cover operating expenses and loan repayment with total revenue. Fourth, it estimated debt sustainability.
Finally, it evaluated the degree to which each state prioritizes capital expenditure over operating expenses.
According to the report, Rivers and Lagos were the only two states that generated enough IGR to cover operating expenses.
However, 32 states relied on FAAC receipts for at least 55% of their total revenue, while 14 states relied on FAAC receipts for at least 70% of their total revenue.
The combined revenue of all 36 states increased significantly by 31.2% to N8.66tn in 2023. Lagos State contributed N1.24tn, representing 14.32% of the cumulative revenue.
Total expenditure across all 36 states reached N9.78tn, marking a 21.19% increase from 2022.
The report highlighted concerns about states’ over-reliance on federally distributable revenue, vulnerability to crude oil-induced shocks, and significant debt burdens. The total debt stock of the 36 states surged by 38.1% to N10.01tn.
Iniobong Usen, Head of Research and Policy Advisory at BudgIT, emphasized the need for states to mobilize internal revenues, curb foreign loan reliance, and establish robust debt transparency frameworks.
“The fiscal viability and long-term sustainability of states heavily depend on their capacity to mobilize revenues internally,” Usen said.
In the health sector, cumulative allocations reached N2.3tn, but spending was N1.39tn, representing 58.16% budget performance. Investments in healthcare infrastructure, personnel, and supplies remain inadequate.
The report underscores the need for improved fiscal management, debt sustainability, and healthcare investments to ensure long-term economic growth and development in Nigeria’s states.
The National Health Facility Registry records an aggregate of 38,182 hospitals across the 36 states, with 25.92% privately owned and 74.08% government-owned. However, Nigeria faces a severe shortage of healthcare professionals, with a doctor-to-patient ratio of four doctors to 10,000 patients.
The report calls for urgent attention to address the challenges in the healthcare sector, including inadequate infrastructure, limited availability of drugs and medical supplies, and shortage of medical professionals. States must prioritize healthcare investments to improve the overall well-being of their citizens.
The full report is available on the BudgIT website.
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