Available indices currently show a stronger, better‑documented primary healthcare performance and a clearer budgetary commitment than Imo, especially when you look at NGF PHC rankings, per‑capita spending and the share of the state budget going to health.
Imo has notable PHC initiatives and expansion of facilities, but the available data does not show it matching Abia’s combination of outcomes and sustained budget priority.
Abia’s primary healthcare system has received repeated national recognition, including emerging as the best‑performing state in the South‑East at the 2025 Nigeria Governors’ Forum (NGF) Primary Healthcare Leadership Challenge, where it clinched a zonal cash prize and was explicitly praised for PHC delivery.
The same period saw Abia ranked number one nationally on the 2025 SBM Health
Preparedness Index, with a score of 26.85 points, reflecting strong emergency readiness and PHC‑linked indicators such as child mortality and doctor‑patient ratios.
Imo’s government has also been showcased for progress in PHC, particularly around improved access to essential medicines based on performance data from 2023 and collaborative work with partners like UNICEF and the Imo State Primary Health Care Development Agency.
The state has launched workforce training and system‑strengthening initiatives aimed specifically at boosting primary healthcare delivery at the grassroots, including annual operational plan development for PHC services.
Abia’s PHC network sits within a broader health system that includes 687 public primary health care centres across its wards, supported by a state health insurance scheme (ABSHIA) that finances a basic minimum package of services at primary and secondary facilities.
This combination of widespread facilities, insurance‑backed benefit packages and NGF‑verified
PHC indicators underpins the awards the state has received for primary healthcare leadership.
Imo has focused visibly on PHC infrastructure expansion under Governor Hope Uzodimma, including the construction of 55 new primary health centres across the state and specific revitalisation projects such as the Mgbirichi Health Centre in Ohaji, which the governor personally inspected.
These projects aim to move closer to rural communities and are framed within the administration’s stated goal of achieving universal health coverage.
Abia’s documented strengths lean more towards financing, preparedness and system performance than standalone workforce headlines, but the SBM Health Preparedness Index that ranked Abia top includes metrics linked to staffing, emergency response and continuity of primary care.
The NGF PHC Leadership Challenge also evaluates governance, service readiness, data use and community engagement around PHC, areas where Abia’s consistency was cited as a reason for its zonal win.
Imo, by contrast, has highlighted workforce and systems‑strengthening more explicitly in its public communications, for instance through capacity‑building workshops in Owerri to train PHC workers on annual operational planning, modern clinical techniques, disease prevention and digital tools for monitoring PHC implementation.
The “train‑the‑trainer” model used in these sessions is designed to cascade skills across PHC facilities, making it an important qualitative investment even if headline quantitative indices still favour Abia.
Abia’s 2024 health budget is both relatively large and strongly prioritised within the total state budget: one independent analysis of Nigeria’s state health budgets notes that Abia is among a small group of states (including Bayelsa and Kano) meeting the 15 per cent health‑budget target, with Abia’s health vote around 85 billion naira and per‑capita health spending of about 22,000 naira, the highest in the country.
State‑level commentary on Abia’s 2025 performance similarly describes a 14.8 per cent health‑budget share and a per‑capita spend of 22,925 naira as key drivers of its top rank on the SBM Health Preparedness Index.
Within that envelope, the 2024 approved estimates show a dedicated line for the Abia State Primary Health Care Development Agency, with a total allocation of 732,015,600 naira, and separate substantial funding for the Abia State Health Insurance Agency, which had over 1.0 billion naira approved with 57.6 per cent performance by Q2 2024.
These figures indicate that primary healthcare is not only embedded in the overall health budget but also has its own institutional funding line and a financing mechanism (ABSHIA) that supports PHC service utilisation.
For Imo, available public documents and infographics on the state’s finances show overall revenue and expenditure patterns but do not clearly indicate a health‑budget share that matches Abia’s 15 per cent benchmark.
Civil‑society‑compiled overviews of state health spending suggest that most states, including those in the South‑East, still allocate well below 15 per cent of their budgets to health, and Imo is not listed among the few that have hit the 15 per cent mark.
While Imo’s government communicates “enormous concern” for citizens’ health and references sector investments to strengthen healthcare delivery, these statements are generally qualitative and do not come with precise, independently‑verified figures showing a large or rising share of the overall budget going to health or to PHC‑specific institutions.
Without evidence of a comparable per‑capita health spend or a dedicated PHC budget line on the scale seen in Abia, Imo’s budgetary commitment, though real, appears more modest.
Abia’s primary healthcare performance is triangulated by several independent indicators: the
NGF PHC Leadership Challenge zonal award in 2025, the state’s earlier runner‑up position in 2024, and top position on the SBM Health Preparedness Index in 2025, where it outperformed all other states in emergency readiness and key health outcomes. Commentary on these recognitions repeatedly links them to consistent health budgeting at or above 14.8–15 per cent of the state budget and the highest per‑capita health spending in the country.
Imo’s PHC system has also attracted some positive attention, including through performance on access to essential medicines rankings based on 2023 data and through partnership‑driven PHC initiatives with UNICEF and others.
However, there is no evidence that Imo has recently topped regional or national PHC performance indices in the way Abia has, which suggests that, at least for now, its PHC outcomes lag behind Abia’s despite expansion of facilities and workforce training.] Considering both budget structure and outcomes, Abia’s budget reflects more concrete commitment to primary healthcare than Imo’s.
Abia meets or slightly surpasses the 15 per cent health‑budget benchmark, leads the country in per‑capita health spending, and ring‑fences resources for a Primary Health Care Development Agency and a state health insurance scheme that directly supports PHC, with this financial stance validated by NGF and index‑based performance awards
Imo has stepped up PHC investments via new health centres, revitalisation of existing facilities and workforce capacity building, and it has documented progress in specific indicators like access to essential medicines, but the available fiscal data does not show it matching Abia’s level of health‑sector prioritisation in terms of budget share or per‑capita spending.
On balance, therefore, Abia’s combination of higher health allocations, clear PHC institutional funding and stronger measured outcomes supports the conclusion that Abia currently demonstrates greater commitment to primary healthcare than Imo.