Lagos Spends ₦119.51bn on Health, but What Does It Mean for Patients?
Korede Abdullah 
LAGOS, Nigeria – Lagos State recorded ₦119.51 billion in actual health expenditure between January and June 2026, the highest amount among the 34 states assessed in a report by BudgIT, yet healthcare accounted for just 7.8 per cent of the state’s total spending during the period. In this report, Korede Abdullah examines what the figures reveal about Lagos’s healthcare financing priorities, the state’s drive to expand health insurance and the questions that remain about translating public spending into affordable, accessible medical services.
Lagos Leads in Actual Health Spending
Lagos spent ₦119.51 billion on healthcare in the first half of 2026, the highest amount among the 34 states assessed in a report published by BudgIT on Wednesday, October 21.
However, health accounted for just 7.8 per cent of the state’s total actual expenditure of approximately ₦1.54 trillion between January and June. The contrast raises a critical question: does spending more money on healthcare necessarily mean better access to medical services?
The figures show that Lagos committed the largest absolute amount among the states assessed, but Kano allocated 19.7 per cent of its actual expenditure to health. Kebbi and Jigawa followed, with 12.5 per cent and 11.6 per cent, respectively.
These differences highlight the distinction between the amount a state spends, and the proportion of its resources devoted to healthcare. Neither measure alone establishes whether residents receive better services.
Assessing performance also requires data on population needs, budget implementation, hospital capacity, staffing, affordability and health outcomes.
Sanwo-Olu Administration Faces Healthcare Financing Challenge
Governor Babajide Sanwo-Olu’s administration has identified healthcare financing and access as priorities, while state health officials have advocated wider insurance coverage to reduce the financial burden on patients.
For Lagos, with its large population and extensive demand for public and private healthcare, the challenge extends beyond allocating funds. Hospitals and primary healthcare centres need functioning equipment, trained personnel, essential medicines and services residents can afford.
The ₦119.51 billion expenditure figure shows how much the state spent during the six-month period. It does not reveal how the money was distributed across primary healthcare, specialised treatment, hospital infrastructure or other services.
More importantly, the available figures do not establish whether patients experienced lower medical bills, improved access or better-quality care.
Those outcomes are essential to determining whether public spending is making a meaningful difference to residents.
Health Commissioner Warns About Medical Costs
At the Business of Health Conference in Lagos on Saturday, October 17, Commissioner for Health Professor Akin Abayomi highlighted the need for sustainable healthcare financing and wider insurance coverage.
He said Nigeria spent about ₦3 trillion annually on outbound medical tourism, warning that treatment costs were pushing Nigerians to seek care abroad. “Three trillion naira leaves Nigeria every year in terms of outbound medical tourism,” Abayomi said.
He also highlighted the financial pressure on patients who pay directly for treatment. According to him, about 76 per cent of healthcare spending in Nigeria came out of pocket, while less than five per cent was covered by insurance. “Once the demand and ability to pay for health are established, then the supply side will take over,” he said, arguing that reliable financing could encourage investment in hospitals and specialised medical services.
His remarks point to a wider problem: healthcare facilities may exist, but patients can still struggle to afford treatment. Meanwhile, providers need predictable funding to sustain services and expand capacity.
The figures cited by Abayomi should, however, be interpreted in the context of their sources, definitions and reference periods, as estimates of out-of-pocket expenditure and insurance coverage can vary by methodology.
Can Health Insurance Reduce Patients’ Bills?
Lagos has pursued mandatory health insurance through an executive order issued in July 2024 to support implementation of the National Health Insurance Authority Act. Its Ilera Eko scheme also provides coverage for residents, including subsidised options for eligible groups.
The policy aims to reduce reliance on direct payments by pooling funds to cover eligible healthcare costs.
Under an insurance model, members can access covered services without bearing the full cost of treatment at the point of care. However, the level of financial protection depends on enrolment, the benefits included, the availability of participating facilities and the quality of services provided.
For Lagos residents, the key questions are practical: how many people are enrolled, which treatments are covered, where can members receive care, and what additional costs must they pay?
Expanding enrolment is only part of the solution. Residents must also understand how to register, access participating facilities and use their benefits.
The state must therefore demonstrate that its insurance policies are translating into accessible services and meaningful protection against medical expenses.
The Difference Between Spending More and Spending Better
Lagos recorded the highest absolute health expenditure among the 34 states assessed by BudgIT, but its 7.8 per cent spending share was below the proportions reported for Kano, Kebbi and Jigawa.
The comparison shows why healthcare financing must be assessed from multiple angles.
Absolute expenditure measures the amount spent, while the budget share indicates the proportion of total government spending allocated to health. Neither measure independently establishes whether funding meets the population’s needs or delivers the intended results.
A more complete assessment would examine spending on primary healthcare, hospital infrastructure, essential medicines, health workers, preventive services and specialised treatment.
It would also consider whether planned projects were completed, facilities remained operational and patients experienced shorter waiting times or lower medical costs.
For Lagos, the distinction matters because high public expenditure does not automatically make healthcare affordable for every resident. Similarly, allocating a larger share of the budget to health does not guarantee adequate staffing, reliable infrastructure or quality services. The ultimate test is whether public resources are used effectively and equitably.
Accountability Must Extend Beyond Spending Figures
BudgIT’s figures provide a snapshot of actual health expenditure between January and June 2026. But the amount spent is only one part of the accountability process.
The Lagos State Government would need to show how the funds were distributed, which services they supported and whether they improved healthcare delivery. Greater transparency in budget implementation would enable residents, journalists and civil society organisations to assess whether spending priorities reflect community needs.
Key indicators include the functionality of primary healthcare centres, the availability of essential medicines, the distribution of health workers, access to maternal and child healthcare, insurance enrolment and the proportion of patients facing catastrophic medical expenses.
The state’s insurance expansion also requires scrutiny to establish whether vulnerable households can enrol, access treatment and receive adequate financial protection. A detailed breakdown of the ₦119.51 billion, including implementation progress and measurable service-delivery outcomes, would help clarify what the expenditure achieved.
From Financial Commitment to Better Healthcare
Lagos’s position as the highest-spending state among those assessed by BudgIT reflects the scale of its healthcare expenditure. Yet the fact that health accounted for just 7.8 per cent of total actual spending underscores the need to examine both the amount committed and the share allocated to the sector.
Expanding health insurance could help reduce patients’ financial burden, while sustainable financing could support hospitals and specialised services. However, the impact will depend on how effectively these policies are implemented.
Ultimately, healthcare investment should be measured not only by the money spent but also by whether residents can access treatment, afford medical services and receive care from adequately equipped facilities staffed by qualified professionals.
For Lagos residents, the central question remains whether the billions spent will translate into tangible improvements in access, affordability and quality. Public spending matters. What matters even more is what that spending delivers to the people it is meant to serve.
About the Author
Mirian Gom 
