Diagnostic accuracy among clinical health workers in Nigeria’s public health facilities has declined, falling from 56.2% in 2023 to 46.1% in 2025.
This is according to findings from the National Health Facility Survey (NHFS) released by the National Bureau of Statistics (NBS) in Abuja on Tuesday.
The report assessed diagnostic accuracy using vignettes across five priority diseases—diarrhoea, pneumonia, malaria, postpartum haemorrhage, and asphyxia—and highlighted gaps in healthcare delivery nationwide.
It showed that the North-East recorded the highest diagnostic accuracy at 54.3%, while the South-West had the lowest at 36.7%. At the state level, Zamfara had the highest accuracy at 79.0%, and Osun the lowest at 13.4%.
Secondary health facilities performed better, with 68.1% diagnostic accuracy compared to 44.6% in primary facilities. By cadre, doctors recorded the highest accuracy at 74.3%, followed by nurses and midwives at 56.3%, Community Health Extension Workers (CHEWs) at 43.7%, and other health workers at 32.3%.
The survey also revealed moderate adherence to clinical guidelines, with 53.9% of health workers following history-taking protocols nationwide. The North-East ranked highest at 62.9%, while the South-West recorded 46.9%. At the state level, Borno led with 70.2%, and Osun was lowest at 41.3%.
Disease-specific adherence to history-taking guidelines was 56.0% for diarrhoea, 46.7% for pneumonia, and only 26.1% for postpartum haemorrhage, highlighting gaps in obstetric emergency care. Adherence to physical examination guidelines was low nationwide at 31.0%, with the North-East at 46.1% and the South-West at 24.4%.
Availability of essential drugs slightly improved to 37.4% in 2025 from 35.0% in 2023. Primary health facilities recorded 36.2% availability, while secondary facilities had 60.6%. Edo had the highest state-level availability at 57.3%, and Katsina the lowest at 15.7%. Regionally, the South-West had the highest availability at 42.3%, and the North-West the lowest at 31.0%.
Availability of basic medical equipment stood at 36.9% nationally, with 34.8% in primary facilities and 76.8% in secondary facilities. Several states, including Bauchi, Borno, Ebonyi, Gombe, Jigawa, Ondo, Sokoto, Katsina, and the FCT, reported 100% availability, while Osun had the lowest at 9.1%.
Infection prevention and control indicators showed that 82.0% of facilities had safety boxes, 51.0% had medical waste containers, 74.1% had hand-washing units, and 79.9% had disposable gloves. However, only 26.5% had long-lasting insecticidal nets (LLINs) or vouchers, indicating weak malaria prevention readiness.
The 2025 NHFS was conducted by the NBS in collaboration with the Federal Ministry of Health and Social Welfare, with technical support from the World Bank. It builds on earlier surveys conducted in 2016, 2019, and 2023.
A total of 3,330 health facilities were visited across Nigeria’s 36 states and the FCT, covering public primary and secondary facilities as well as selected private facilities.
