Diagnostic accuracy among clinical health workers in Nigeria’s public health facilities has declined, dropping from 56.2 per cent in 2023 to 46.1 per cent in 2025, a new report shows.

The findings are from the National Health Facility Survey released by the National Bureau of Statistics on Wednesday, providing updated data on service quality and healthcare delivery nationwide.

The report assessed diagnostic accuracy using vignettes across five priority diseases (diarrhoea, pneumonia, malaria, postpartum haemorrhage and asphyxia). It highlighted persistent gaps in healthcare delivery and clinical decision-making across the country.

It showed 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, reflecting significant regional disparities in clinical performance levels.

At the state level, Zamfara recorded the highest diagnostic accuracy at 79.0 per cent, while Osun recorded the lowest at 13.4 per cent, indicating stark differences in health worker capacity nationwide.

Further breakdown showed secondary health facilities performed better with 68.1 per cent diagnostic accuracy, compared to 44.6 per cent in primary facilities, underscoring gaps between different levels of care provision.

By cadre, doctors recorded the highest diagnostic accuracy at 74.3 per cent, followed by nurses and midwives at 56.3 per cent. Other categories performed significantly lower: community health extension workers at 43.7 per cent, and other health workers at 32.3 per cent.

The survey also revealed moderate adherence to clinical guidelines nationwide with compliance levels uneven.

It showed the North-East again ranked highest at 62.9 per cent, while the South-West recorded the lowest at 46.9 per cent, with notable state variations in adherence levels. Borno recorded the highest state-level compliance at 70.2 per cent, while Osun recorded the lowest at 41.3 per cent.

The report detailed disease-specific adherence across priority conditions assessed in the survey.

Adherence to physical examination guidelines was low nationwide at 31.0 per cent, with the North-East at 46.1 per cent and South-West at 24.4 per cent, indicating persistent clinical weaknesses.

On essential drugs, availability improved to 37.4 per cent in 2025 from 35.0 per cent in 2023. Primary facilities recorded 36.2 per cent availability, while secondary facilities had 60.6 per cent.

Edo had the highest availability at 57.3 per cent, while Katsina recorded the lowest level. Regionally, the South-West recorded the highest availability at 42.3 per cent, while the North-West had the least at 31.0 per cent.

The report also reviewed disparities in access to medicines nationwide.

Availability of basic medical equipment stood at 36.9 per cent nationally, with 34.8 per cent in primary facilities and 76.8 per cent in secondary facilities, highlighting major infrastructure gaps.

Bauchi, Borno, Ebonyi, Gombe, Jigawa, Ondo, Sokoto, Katsina and the FCT recorded 100 per cent availability, while Osun had the lowest at 9.1 per cent. Infection prevention and control indicators 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 had long-lasting insecticidal nets or LLIN vouchers, indicating weak malaria prevention readiness in facilities. The report flagged gaps in preventive healthcare measures nationwide.

The 2025 NHFS was conducted by the NBS in collaboration with the Federal Ministry of Health and Social Welfare, with World Bank support.

The 2025 survey built on earlier rounds conducted in 2016, 2019 and 2023, providing trend data for assessing progress and identifying persistent gaps in Nigeria’s healthcare system over time.

According to the report, 3,330 health facilities were selected and visited across the 36 states and the FCT, with a nominal sample of 90 facilities per state and territory.

Coverage extended to public primary and secondary health facilities, as well as private facilities, ensuring a comprehensive assessment of service delivery and resource availability across Nigeria’s health sector.

(NAN)