Diagnostic accuracy among clinical health workers in Nigeria’s public health facilities has declined significantly, falling from 56.2 per cent in 2023 to 46.1 per cent in 2025, according to a new report released by the National Bureau of Statistics.
The findings were contained in the National Health Facility Survey unveiled in Abuja on Wednesday. The report provides updated insights into service quality, healthcare delivery and clinical decision-making across the country.
The survey assessed diagnostic accuracy using clinical vignettes across five priority diseases—diarrhoea, pneumonia, malaria, postpartum haemorrhage and asphyxia. It highlighted persistent gaps in healthcare delivery and the ability of health workers to correctly diagnose illnesses.
Regionally, the North-East recorded the highest diagnostic accuracy at 54.3 per cent, while the South-West had the lowest at 36.7 per cent, revealing sharp disparities in clinical performance across the country.
At the state level, Zamfara State posted the highest diagnostic accuracy at 79.0 per cent, while Osun State recorded the lowest at 13.4 per cent, underscoring major differences in health worker capacity nationwide.
The report also found that secondary health facilities performed better than primary health centres, with diagnostic accuracy of 68.1 per cent compared to 44.6 per cent in primary facilities.
By professional cadre, doctors recorded the highest diagnostic accuracy at 74.3 per cent, followed by nurses and midwives at 56.3 per cent. Other health worker categories recorded lower performance levels, including Community Health Extension Workers at 43.7 per cent and other health workers at 32.3 per cent.
The survey further revealed moderate adherence to clinical guidelines across the country, though compliance levels varied significantly by region.
Again, the North-East ranked highest with 62.9 per cent adherence, while the South-West recorded the lowest at 46.9 per cent. At the state level, Borno State recorded the highest compliance rate at 70.2 per cent, while Osun State had the lowest at 41.3 per cent.
According to the report, adherence to physical examination guidelines remained low nationwide at 31.0 per cent. The North-East recorded the highest regional performance at 46.1 per cent, while the South-West recorded 24.4 per cent, highlighting weaknesses in routine clinical assessments.
On the availability of essential drugs, the report showed a slight improvement to 37.4 per cent in 2025, up from 35.0 per cent in 2023. Primary health facilities recorded 36.2 per cent availability, while secondary facilities had 60.6 per cent.
State-level analysis showed Edo State recorded the highest availability at 57.3 per cent, while Katsina State recorded the lowest level.
Regionally, the South-West had the highest availability of essential medicines at 42.3 per cent, while the North-West recorded the lowest at 31.0 per cent.
The report also highlighted disparities in access to basic medical equipment. National availability stood at 36.9 per cent, with 34.8 per cent in primary facilities and 76.8 per cent in secondary facilities, indicating significant infrastructure gaps.
Several states—including Bauchi State, Borno State, Ebonyi State, Gombe State, Jigawa State, Ondo State, Sokoto State, Katsina State and the Federal Capital Territory—recorded 100 per cent availability of key equipment, while Osun State had the lowest at 9.1 per cent.
In terms of infection prevention and control, the survey showed that 82.0 per cent of facilities had safety boxes, 51.0 per cent had waste containers, 74.1 per cent had hand-washing units and 79.9 per cent had gloves.
However, only 26.5 per cent of facilities had long-lasting insecticidal nets or LLIN vouchers, indicating weak malaria prevention readiness.
The News Agency of Nigeria reported that the 2025 National Health Facility Survey was conducted by the National Bureau of Statistics in collaboration with the Federal Ministry of Health and Social Welfare, with support from the World Bank.
The survey builds on previous rounds conducted in 2016, 2019 and 2023, offering trend data to track progress and identify persistent challenges in Nigeria’s healthcare system.
According to the report, 3,330 health facilities were selected and visited across Nigeria’s 36 states and the Federal Capital Territory, with a nominal sample of 90 facilities per state and territory. The assessment covered public primary and secondary facilities as well as private health institutions to provide a comprehensive overview of service delivery nationwide.
