Nigeria’s public health system is facing renewed scrutiny after a new report revealed a sharp decline in diagnostic accuracy among clinical health workers nationwide.
Diagnostic accuracy dropped from 56.2 per cent in 2023 to 46.1 per cent in 2025, according to the latest National Health Facility Survey released by the National Bureau of Statistics.
The report, which assessed health workers using clinical case scenarios across five priority diseases—diarrhoea, pneumonia, malaria, postpartum haemorrhage and asphyxia—highlights persistent weaknesses in diagnosis and clinical decision-making.
Findings show wide regional disparities, with the North-East recording the highest diagnostic accuracy at 54.3 per cent, while the South-West had the lowest at 36.7 per cent. At the state level, Zamfara led with 79.0 per cent, while Osun recorded the lowest performance at just 13.4 per cent.
The survey also revealed gaps between levels of care. Secondary health facilities performed significantly better, recording 68.1 per cent diagnostic accuracy, compared to 44.6 per cent in primary healthcare centres.
By professional cadre, doctors had the highest diagnostic accuracy at 74.3 per cent, followed by nurses and midwives at 56.3 per cent. Community health extension workers recorded 43.7 per cent, while other health workers posted the lowest at 32.3 per cent.
Adherence to clinical guidelines remained inconsistent nationwide. The North-East again ranked highest at 62.9 per cent, while the South-West recorded the lowest at 46.9 per cent. At the state level, Borno posted the highest compliance at 70.2 per cent, while Osun ranked lowest at 41.3 per cent.
The report also found that adherence to physical examination standards remains low at just 31.0 per cent nationwide, pointing to ongoing clinical practice gaps.
On essential medicines, availability improved slightly to 37.4 per cent in 2025 from 35.0 per cent in 2023. Secondary facilities recorded higher availability at 60.6 per cent, compared to 36.2 per cent in primary facilities. Edo ranked highest in availability, while Katsina recorded the lowest.
Basic medical equipment availability stood at 36.9 per cent nationally, with a significant gap between primary facilities at 34.8 per cent and secondary facilities at 76.8 per cent.
In terms of infection prevention, most facilities had safety boxes, gloves and hand-washing units. However, only 26.5 per cent had long-lasting insecticidal nets, indicating weak malaria prevention readiness.
The 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.
A total of 3,330 health facilities were assessed across all 36 states and the Federal Capital Territory, covering both public and private providers, as part of ongoing efforts to track progress and identify gaps in Nigeria’s healthcare system.
