File
Mbada C.1, Olawuyi A.1, Fatoye F.2
1Obafemi Awolowo University, Department of Medical Rehabilitation, Ile Ife, Nigeria, 2Manchester Metropolitan University, Health Professions, Manchester, United Kingdom
Background: Demand for Physiotherapy is on the increase due to increasing ageing population and disability, and demand for good health. However, due to limited resources including physiotherapists in developing countries, the supply of physiotherapy services may be particularly challenging for eligible populations in rural communities. Availability and accessibility to physiotherapy in the rural settings may help reduce the burden of disability and in turn enhance efficiency of the health care systems.
Purpose: This study investigated the characteristics and determinants of demand and supply of community physiotherapy in Nigeria.
Methods: A total of 336 rural dwellers volunteered for this door-to-door cross-sectional survey. Households were considered as the Primary Sampling Unit (PSU) in this study. In each PSU, every consenting participant, aged 18 years and older were included in the study. A validated self-administered questionnaire developed from previous studies was used as the survey instrument in this study. Data was analyzed using descriptive statistics of mean, standard deviation and percentages. Inferential statistics of Chi-square was used to test the association between physiotherapy utilization and each socio-demographic variable. Statistical significance was set at p 0.05.
Results: The mean age of the respondents was 34.1± 16.2 years. Lifetime, 12-month and point utilization of physiotherapy was 21.7%, 7.4% and 2.7% respectively. Physiotherapy utilization was mainly exercise (46.6%) and massage (41.1%). Determinants of physiotherapy services included travel cost (32.6%), time (27.9%) and work commitments (24.8%). Availability and supply of physiotherapy services were mostly at the township teaching hospital (47.9%) and private hospital (20.5%). Physiotherapy services within the communities were mostly through non-permanent (24.7%) and visiting physiotherapists (21.4%). Factors that significantly influenced physiotherapy utilization were belief that cause of pain was of spiritual origin ((ᵡ2 = 7.826; p = 0.020), religion (ᵡ2 = 14.181; p = 0.001), stigmatization and wrong labeling (ᵡ2 = 9.855; p = 0.007) and educational level (ᵡ2 = 11.980; p = 0.007).
Conclusion(s): Utilization of physiotherapy services was low with lifetime, 12-month and point utilization rate of 21.7%, 7.4% and 2.7%, respectively. Travel costs, time constraints and work commitments were determinants of demands for physiotherapy services. Supply of physiotherapy services were mostly at township teaching hospital and private hospitals. Community-based physiotherapy services were mostly through non-permanent and visiting physiotherapists. Educational status and patients beliefs about pain and stigmatization and wrong labelling were significant associated with physiotherapy utilization.
Implications: Understanding the intrinsic and extrinsic determinants of utilization of, and access to, community physiotherapy is needed in bridging service delivery gap between urban and rural settings.
Funding acknowledgements: No funding was received in relation to this work
Topic: Globalisation: health systems, policies & strategies
Ethics approval: Ethical approval was granted by Research Ethics Committee, Obafemi Awolowo University. Consent was obtained from the participants.
All authors, affiliations and abstracts have been published as submitted.
