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.

This is according to findings from the National Health Facility Survey released by the National Bureau of Statistics in Abuja on Tuesday.

The report, which assessed diagnostic accuracy using vignettes across five priority diseases—diarrhoea, pneumonia, malaria, postpartum haemorrhage and asphyxia—highlighted gaps in healthcare delivery nationwide.

It showed that the North-East recorded the highest diagnostic accuracy of clinical conditions at 54.3 per cent, while the South-West had the lowest at 36.7 per cent.

At the state level, the report showed that Zamfara recorded the highest diagnostic accuracy with 79.0 per cent, while Osun recorded the lowest with 13.4 per cent.

Further breakdown revealed that secondary health facilities performed better with 68.1 per cent diagnostic accuracy, compared to 44.6 per cent in primary facilities.

It said by cadre, doctors recorded the highest diagnostic accuracy at 74.3 per cent, followed by nurses/midwives at 56.3 per cent, with 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, with 53.9 per cent of health workers complying with history-taking protocols nationwide.

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

The report said disease-specific adherence to history-taking guidelines showed 56.0 per cent for diarrhoea, 46.7 per cent for pneumonia, and only 26.1 per cent for postpartum haemorrhage, highlighting gaps in obstetric emergency care.

It said adherence to physical examination guidelines was notably low nationwide at 31.0 per cent, with the North-East at 46.1 per cent and the South-West at 24.4 per cent, underscoring persistent weaknesses in clinical practice standards.

On the availability of essential drugs, the report indicated a slight improvement to 37.4 per cent in 2025 from 35.0 per cent in 2023.

Primary health facilities recorded 36.2 per cent availability, while secondary facilities had 60.6 per cent, it noted, with Edo having the highest health facilities with essential drugs at 57.3 per cent, while Katsina had the lowest at 15.7 per cent.

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 survery showed.

It said 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.

Bauchi, Borno, Ebonyi, Gombe, Jigawa, Ondo, Sokoto, Katsina and the FCT, recorded 100 per cent availability of basic equipment, while Osun had the lowest at 9.1 per cent.

It said infection prevention and control indicators showed that 82.0 per cent of facilities had safety boxes, 51.0 per cent had medical waste containers, 74.1 per cent had hand-washing units, and 79.9 per cent had disposable gloves.

“However, only 26.5 per cent had long-lasting insecticidal nets (LLINs) or  LLIN vouchers, indicating weak malaria prevention readiness in facilities.”

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.