Nigeria’s preparedness to manage non-communicable diseases (NCDs), including cardiovascular diseases, diabetes, and chronic respiratory illnesses, remains weak, with public primary healthcare facilities emerging as the weakest link in the country’s health system.
The study, published in The Lancet Regional Health – Africa on October 2, 2026, found that Nigeria recorded a national mean Non-Communicable Disease Facility Readiness Index (NCD-FRI) score of 14.22 out of 100.
A major gap existed between public primary and secondary healthcare facilities. While primary healthcare centres recorded an average readiness score of 12.80, secondary facilities scored 44.85, a difference of more than 32 points.
The researchers said the poor performance of primary healthcare facilities was particularly concerning because they are expected to serve as the first point of contact for most Nigerians seeking medical care.
Disease-specific findings also showed significant weaknesses. Cardiovascular disease services recorded a national mean score of 16.49, and diabetes services scored 13.82, while chronic respiratory disease services performed worst at just 4.23.
The study further revealed considerable differences among states. The Federal Capital Territory recorded the highest readiness score of 30.93, followed by Lagos State with 30.05 and Rivers State with 28.27.
Gombe State ranked lowest with 4.65, followed by Osun with 5.04 and Katsina with 5.82. Oyo State recorded 15.10, placing it 12th among the states and the Federal Capital Territory.
A breakdown by geopolitical zones showed that the South-South had the highest average score of 18.10, followed by the South-West with 16.89. The North-Central recorded 14.22, while the South-East had 13.84. The North-West and North-East recorded the lowest scores, at 11.52 and 11.11 respectively.
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To address the gaps, the researchers recommended increased investment in primary healthcare, improved access to essential medicines and diagnostic equipment, and better training for health workers.
They also called for urgent attention to chronic respiratory diseases through the provision of clinical guidelines, salbutamol inhalers and spacers, as well as training to improve diagnosis and treatment.
The study drew on data from Nigeria’s 2023 National Health Facility Survey. Although the survey covered primary, secondary, and private facilities, the final analysis was restricted to public primary and secondary facilities because the required NCD indicators were available for those categories.
The researchers cautioned that the findings measured the structural readiness of facilities rather than the actual quality of care delivered or patients’ health outcomes. Private, mission, and tertiary health facilities were also excluded, a limitation they said should be considered when interpreting the results.
The findings come against the background of the substantial burden of non-communicable diseases in Nigeria. The study estimated that cardiovascular diseases, diabetes, and chronic respiratory diseases accounted for more than 9.3 million disability-adjusted life years in 2023.
The researchers stressed that improving NCD services would require sustained investment, stronger health workforce capacity, and a more equitable distribution of healthcare resources across the country.
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