If you are a registered nurse working in a federal or state hospital in Nigeria, your salary is governed by a specific pay framework, the Consolidated Health Salary Structure, commonly known as CONHESS. Yet many Nigerian nurses have never seen the full breakdown of what they are supposed to earn at each grade level.
This article gives you exactly that: a clear, honest, grade-by-grade breakdown of the 2026 CONHESS salary structure for nurses, the allowances you are entitled to, the recent changes you should know about, and what it all means for your take-home pay. Whether you are just starting or have been in the profession for years, understanding your place on the CONHESS scale is not optional; it is your right.
What Is CONHESS and Why Does It Matter to Nurses?
CONHESS stands for Consolidated Health Salary Structure. It is the official pay framework designed and administered by the National Salaries, Incomes and Wages Commission (NSIWC) for all non-physician health professionals in Nigeria’s public sector. This means it covers nurses, midwives, pharmacists, medical laboratory scientists, physiotherapists, radiographers, and others, everyone except medical and dental doctors, who operate under a separate structure called CONMESS.
The CONHESS structure was introduced by the federal government and came into full effect in 2010. Before it existed, pay for health workers was inconsistent, poorly standardised, and often subject to the whims of individual hospital administrations. CONHESS changed that by creating a transparent ladder: 15 grade levels, each with multiple steps based on years of service.
CONHESS applies across:
- Federal government hospitals (teaching hospitals, federal medical centres)
- Federal Ministry of Health facilities
- Most state government health institutions (though states vary in how strictly they implement it)
If you work in any of these settings and your salary does not reflect the figures in this guide, you may have grounds to query your payroll officer or your union, the National Association of Nigerian Nurses and Midwives (NANNM).
The CONHESS Grade Levels for Nurses: Where Do You Fall?
The CONHESS structure spans 15 levels. For nurses, the entry point is CONHESS 07; no registered nurse should be placed below this level regardless of qualification. Here is how nurses map onto the structure based on qualification and experience:
| CONHESS Level | Who It Applies To |
|---|---|
| CONHESS 07 | Entry-level nurses with an RN (from the School of Nursing diploma) |
| CONHESS 08 | Nurses with 2–3 years post-registration experience |
| CONHESS 09 | University graduates (BNSc) or nurses with several years of service |
| CONHESS 10 | Experienced nurses, nurses with post-basic qualifications |
| CONHESS 11 | Senior staff nurses, unit leads |
| CONHESS 12 | Principal nursing officers |
| CONHESS 13 | Assistant chief nursing officers |
| CONHESS 14 | Chief nursing officers |
| CONHESS 15 | Deputy directors of nursing and above |
It is important to note that within each level there are multiple steps (typically up to 9–15 steps per level), and your salary increases with each step as you complete another year of service. This means two nurses at CONHESS 09 may earn different amounts depending on how long they have been at that level.
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CONHESS Salary Breakdown for Nurses — 2026 Figures
The following figures reflect the basic monthly salary for nurses at each CONHESS grade level as of 2026, informed by the NSIWC pay adjustments that followed the national minimum wage review of mid-2024:
| CONHESS Level | Estimated Basic Monthly Pay |
|---|---|
| CONHESS 07 | ₦80,000 – ₦100,000 |
| CONHESS 08 | ₦90,000 – ₦130,000 |
| CONHESS 09 | ₦100,000 – ₦160,000 |
| CONHESS 10 | ₦120,000 – ₦190,000 |
| CONHESS 11 | ₦150,000 – ₦220,000 |
| CONHESS 12 | ₦180,000 – ₦260,000 |
| CONHESS 13 | ₦230,000 – ₦320,000 |
| CONHESS 14 | ₦280,000 – ₦380,000 |
| CONHESS 15 | ₦350,000 – ₦500,000+ |
Important note: These are basic salary figures. Your total take-home pay will be higher once allowances are added. Federal hospitals tend to pay at the top end of these ranges, while many state hospitals, particularly in northern and less-funded states, pay closer to the lower end.
CONHESS Allowances: The Part Nobody Tells You About
The CONHESS basic salary is only part of what you are entitled to. Nigerian nurses in the public sector receive a range of statutory allowances on top of their basic pay. Here is a breakdown of what nurses can legitimately claim:
1. Uniform Allowance
This is one of the most talked-about allowances in 2026 because of a significant policy change. In January 2026, the NSIWC approved a 300% increase in the annual uniform allowance for nurses in federal employment, raising it from ₦20,000 to ₦80,000 per year (approximately ₦6,667 per month), paid through the Integrated Payroll and Personnel Information System (IPPIS). If you are on the federal payroll and this is not reflected in your salary from January 2026 onwards, follow up with your payroll department immediately.
2. Hazard Allowance
Nurses working in direct patient-care environments, especially in infectious disease wards, ICUs, operating theatres, and emergency rooms, are entitled to a hazard allowance. Figures range from ₦15,000 to ₦30,000 per month, depending on the facility and the specific risk environment.
3. Call Duty Allowance
If you are on an emergency roster and called in outside your regular shift, you are entitled to call duty allowance. This typically ranges from ₦10,000 to ₦40,000 per activation, depending on institutional policy.
4. Shift Duty Allowance
Nurses working night shifts, public holiday shifts, or weekend shifts qualify for shift duty allowance, usually between ₦10,000 and ₦25,000 per month.
5. Rural Posting Allowance
Nurses posted to underserved or rural communities as part of government deployment receive a rural posting allowance ranging from ₦20,000 to ₦50,000 per month. This is an incentive to ensure health coverage outside urban centres.
6. Leave Allowance
Nurses in the public sector receive an annual leave allowance, typically a percentage of their basic salary, paid when they go on annual leave.
7. Housing and Transport Allowances
Some federal and state institutions include housing and transport components as part of the total remuneration package. These vary widely by institution.
The Real Purchasing Power Problem
Let’s be honest about what these numbers mean in 2026. With Nigerian inflation projected at 25–30% in 2026, the real purchasing power of a CONHESS salary continues to erode year on year. A nurse on CONHESS 07 earning ₦100,000 per month in Lagos faces a monthly cost-of-living reality that far exceeds that figure.
According to data from Numbeo, monthly expenses for a single person in a major Nigerian city, excluding rent, can easily exceed ₦200,000 at current prices.
This is why the conversation about nurse salaries in Nigeria is not just about the CONHESS figures. It is about inflation adjustment, the implementation gap between federal and state hospitals, and the broader systemic underinvestment in health worker welfare that continues to fuel the japa phenomenon. According to the National Association of Nigerian Nurses and Midwives, more than 75,000 nurses and midwives left Nigeria in the five years leading up to 2023, with the numbers growing since.
Federal vs. State: The Implementation Gap
One of the most confusing aspects of CONHESS for Nigerian nurses is that being on the same grade level does not guarantee the same pay everywhere. Federal hospitals are most likely to implement CONHESS fully and consistently. Many state hospitals, however, implement it partially, sometimes paying the basic salary without the full range of allowances or applying outdated salary scales.
A mid-level nurse at CONHESS 09 in a federal teaching hospital in Lagos could be earning ₦220,000–₦300,000 in total monthly pay. The same CONHESS 09 nurse in a state hospital in a fiscally constrained northern state might take home ₦130,000–₦170,000; the gap is significant and represents a structural inequity within the profession.
What BNSc Graduates Should Know
If you hold a Bachelor of Nursing Science (BNSc) degree, you should not be starting at CONHESS 07. University-trained nurses have an entry advantage in the CONHESS system:
- Diploma RN (School of Nursing): Entry at CONHESS 07
- BNSc graduates: Entry at CONHESS 08 or 09, depending on institution
- Postgraduate qualification (MSc, specialist certification): Can accelerate placement to CONHESS 10 and above
A BNSc premium typically adds a 20–30% increase over diploma-level earnings at entry, and specialist certifications (ICU, theatre, anaesthesia) can push earnings into the ₦350,000–₦700,000 range in high-end private facilities.
How to Know If You’re Being Underpaid
Here are the practical steps every nurse should take to verify their CONHESS placement:
- Request your appointment letter and salary computation slip from your HR department. Your letter should state your CONHESS level clearly.
- Cross-reference with the official NSIWC circular, the most recent CONHESS circular was issued in September 2024 and remains in effect.
- Contact your NANNM branch if your pay does not match the official structure. Your union representative can escalate the matter through internal channels.
- Document everything, dates, figures, and correspondence before raising a formal complaint.
FAQs About CONHESS
What is the starting salary for a nurse in Nigeria in 2026?
An entry-level nurse on CONHESS 07 earns a basic salary of approximately ₦80,000 to ₦100,000 per month in a federal institution. With allowances, total pay can reach ₦130,000–₦180,000 depending on shift patterns and role.
What is the highest salary a nurse can earn under CONHESS?
A director-level nurse on CONHESS 15 can earn basic pay between ₦350,000 and ₦500,000+ per month, with total compensation potentially exceeding ₦600,000 when all allowances are included.
Do private hospital nurses use CONHESS?
No. CONHESS is a public sector framework. Private hospitals set their own salaries. Some reputable private facilities in Lagos and Abuja pay competitively, top-tier private hospitals can offer ₦280,000–₦800,000 for specialist nurses, but smaller private clinics often pay less than government equivalents.
Is the 2026 uniform allowance increase real, and when will it be paid?
Yes. The NSIWC approved a 300% increase in the annual uniform allowance in January 2026, raising it from ₦20,000 to ₦80,000 per year, effective from January 1, 2026, and distributed via IPPIS. If it has not appeared on your payslip, query your payroll or finance department.
Do state hospitals follow the same CONHESS scale as federal hospitals?
They are supposed to, but in practice, there are significant variations. Many states implement CONHESS partially or use outdated figures. Southern and oil-producing states generally offer closer alignment with federal rates, while some northern states fall below the official figures.
Will CONHESS salaries increase further in 2026?
Discussions are ongoing within NANNM and the NSIWC for further upward reviews, particularly given the 25–30% projected inflation rate for 2026. Keep an eye on official NSIWC communications (https://nsiwc.gov.ng) for any new circulars.
I am a BNSc graduate. Should I start on CONHESS 07? No. As a university graduate with a BNSc, you should typically be placed at CONHESS 08 or 09 at the entry level. If you are placed at CONHESS 07, it may be an administrative error; raise it with your HR department.
Wrapping Up: CONHESS Salary Structure
Understanding CONHESS is not just about knowing what you earn; it is about knowing what you deserve. The pay structure exists to protect you and to provide a clear career trajectory. As a Nigerian nurse, you should know your grade level, your entitled allowances, and the official channels available to you if something does not add up.
If you have questions about your specific situation, speak to your NANNM branch or a trusted colleague with HR experience. And if you found this guide useful, share it with a fellow nurse who may not know they are being underpaid.
References and further reading:
- National Salaries, Incomes and Wages Commission (NSIWC): https://nsiwc.gov.ng
- National Association of Nigerian Nurses and Midwives (NANNM): https://nannm.com.ng
- Nursing and Midwifery Council of Nigeria (NMCN): https://nmcn.gov.ng
- Fellow Nurses Africa — State-by-State Salary Guide 2026: https://www.fellownurses.com/2026/02/registered-nurse-salaries-nigeria-2026-state-by-state-guide.html
- Legit.ng — Nigerian vs UK Nurse Salary Comparison 2026: https://www.legit.ng/business-economy/money/1700570-how-a-nigerian-nurse-earn-compared-a-uk-nurse-public-private-hospitals/
- Numbeo Nigeria Cost of Living Data: https://www.numbeo.com/cost-of-living/country_result.jsp?country=Nigeria
