Adoption and Barriers to Molecular Diagnostics in Private Hospitals in Port Harcourt: Implications for AMR Surveillance

Private hospitals in Nigeria's major cities manage a substantial proportion of clinical consultations and antibiotic prescriptions, yet their participation in antimicrobial resistance (AMR) surveillance networks remains limited. Understanding adoption barriers for molecular diagnostics in private healthcare settings is essential for inclusive AMR surveillance infrastructure design. This study assessed molecular diagnostic adoption levels and AMR surveillance participation barriers in private hospitals in Port Harcourt, Rivers State, South-South Nigeria. A cross-sectional survey of 35 registered private hospitals with functional laboratory services was conducted. Structured interviews with medical directors, laboratory managers, and senior clinicians captured data on available diagnostic technologies, AMR data collection practices, cost considerations, and institutional knowledge of Nigeria's National AMR Action Plan. Only 17% of surveyed private hospitals had access to PCR or other nucleic acid amplification platforms. Reasons cited for non-adoption included procurement cost (89%), maintenance burden (74%), and absence of trained molecular biology staff (68%). Only three facilities contributed AMR data to any external surveillance database. Awareness of the Nigeria National AMR Action Plan was low at 31% among clinical decision-makers. These findings identify private-sector molecular capacity gaps as a critical weakness in AMR surveillance coverage in Port Harcourt and call for public-private partnership frameworks to improve data inclusivity. Keywords: molecular diagnostics adoption, AMR surveillance, private hospitals, Port Harcourt, Rivers State.