Patient Access to Physiotherapy or Physical Therapy Services / Entry Point[edit | edit source]
In the Nigerian public health sector, physiotherapy services are available in the secondary and tertiary hospitals. Initial access to physiotherapy services for patients in public health facilities is often via referral from a physician. However, there is direct access to physiotherapy in Nigeria, and patients of both private and public health services are able to refer themselves to a physiotherapist without going through another health professional.
Physiotherapists in Nigeria have clinical autonomy; they may assess patients, make diagnoses, provide treatment and/or prevention services, and refer to other health services. Also, physiotherapists are permitted to offer private services to patients as long as they maintain their registration/licensure.
Therapist Preparation[edit | edit source]
Degree/Credentialing[edit | edit source]
In Nigeria, entry-level physiotherapy education is a 5-year Bachelor of Physiotherapy programme. Only seven universities presently run entry-level physiotherapy programmes, and four of them also have postgraduate (Advanced Masters and Doctor of Philosophy) physiotherapy courses.
New graduates of physiotherapy must undergo a 1-year internship in an accredited hospital. Successful completion of the clinical internship provides eligibility to apply for a full practicing license, which is renewable annually. The Medical Rehabilitation Therapists Board of Nigeria (MRTB) regulates academic and internship programmes, as well as clinical practices, of physiotherapy and other rehabilitation professions.
Specialization[edit | edit source]
Specialization as a Physiotherapist in Nigeria is typically gained through post-graduate physiotherapy studies.
The Nigerian Society of Physiotherapy has the following Special Interest Groups:
- Musculoskeletal Physiotherapy
- Cardio-Pulmonary Physiotherapy
- Paediatric Physiotherapy
- Neurological Physiotherapy
- Exercise and Sports Physiotherapy
- Women’s Health Physiotherapy
- Community Physiotherapy
- Palliative Care Physiotherapy
Professional Associations[edit | edit source]
There are about 2,450 registered physiotherapists currently practicing in Nigeria. The Nigeria Society of Physiotherapy (NSP), the main professional association of Physiotherapists in Nigeria, was formed in 1959, gained federal government recognition in 1962, and became a member of World Physiotherapy in 1967. The NSP had 722 physiotherapists as members, as at 2020.
Information about the Patient Community[edit | edit source]
Nigeria has a population of 219,463,862, 52% of whom are urban-dwellers while 48% are rural-dwellers. The population is largely young; 42.54% of Nigerians are between the ages of 0–14, and over 60% of Nigerians are less than 25 years old. Nigeria has a life expectancy of 60.87 years.
Top 10 Causes of Death
- Lower respiratory infections
- Neonatal disorders
- Diarrheal diseases
- lschemic heart disease
- 20% could benefit from rehabilitation
- 5.2million years have been lived with disability
- 11million people have been affected by low back pain
Social/Cultural Influences[edit | edit source]
Nigeria is a multi-ethnic nation, with about 300 ethnic groups, and so cultural beliefs and practices vary across the nation. However, while specific cultural practices may vary, it has been observed that geography and socioeconomic status influence health behaviours. Studies have shown that Nigerians living in rural areas tend to have less appropriate health-seeking behaviours than those in urban areas, and that a higher socioeconomic status is associated with better health-seeking behaviours.
Modern and traditional medicine are both popular in Nigeria. Traditional medicine is mostly made from plants and other locally-sourced materials. Traditional medicine in Nigeria is not only limited to herbal medicine products, but also includes health services rendered by traditional healers. For example, traditional birth attendants and traditional bone-setters provide child birth and physical rehabilitation services respectively. Preference for either modern or traditional medicine is influenced by individuals’ health beliefs; beliefs such as mistrust of western medicine, superstition regarding illness, and fewer side-effects compared to modern drugs have been cited as factors influencing the high patronage of traditional medicine among rural-dwellers. The government is working to integrate traditional and alternative medicine into the national healthcare system, to ensure proper regulation and standardization.
Delivery of Care[edit | edit source]
There are 40,368 operational hospitals and clinics in Nigeria, 27% of which are privately-owned while 73% are public facilities. Healthcare is provided through a network of facilities at different levels of care - primary, secondary and tertiary institutions. 85.1% of health facilities are primary facilities, 14.5% are secondary facilities, and 0.4% are tertiary facilities.
Nigeria's healthcare delivery system faces several challenges including underfunding, health facilities being in a state of dilapidation, unavailability of modern equipment, regular commodity stock-outs, inadequate staff remuneration, and shortage of qualified personnel.
Type of Health System[edit | edit source]
The Nigerian health system consists of public and private health service providers. There are three tiers of public health services:
- Tertiary care is provided by university teaching hospitals, Federal Medical Centres, military hospitals etc, and they are under the coordination of the federal government.
- Secondary care is provided by general hospitals, which are under the coordination of the state government.
- Primary care is provided by Primary Health Centres (PHCs), which are coordinated by the local government with regulation from the National and State Primary Health Care Development Agencies.
Private health centres are regulated by the professional regulatory bodies of the services they render and they must maintain operational registration and licensing from the federal and state governments.
Payment System[edit | edit source]
There are public and private health insurance schemes that offer a variety of health insurance packages, however, subscription to health insurance is very poor. Less than 5% of the Nigerian population has access to health insurance, and out-of-pocket payments account for over 76% of the total health expenditure.
Both the public and private health insurance provide some coverage for physiotherapy services to varying degrees, depending on the package/plan. Also, health insurance coverage for physiotherapy and other health services are typically fixed to specific health providers, most of which are in urban areas.
References[edit | edit source]
- World Physiotherapy. Member Organization: Nigeria Society of Physiotherapy. Available from: https://world.physio/membership/nigeria (accessed 28th March 2021).
- Medical Rehabilitation Therapists (Registration) Board of Nigeria, Harmonized curriculum of studies for the Bachelor of Physiotherapy (B.PT) degree programme in Nigerian universities. 2009. Available from: http://www.mrtbnigeria.org/docs/curr/BPTCurriculum.pdf. (accessed 28th March 2021).
- The Africa Region of the World Confederation for Physical Therapy. Physiotherapy Education Programs in Africa. Available from: https://www.wcptafrica.org/education-practice/physiotherapy-education-programs-in-africa/ (accessed 28th March 2021).
- Medical Rehabilitation Therapists (Registration) Board of Nigeria. Induction and Application for Internship. Available from: https://www.mrtb.gov.ng/en/Registration/Application-for-Internship (accessed 28th March 2021).
- Nigeria Society of Physiotherapy. NSP Specialty Groups. Available from: https://www.nsphysio.org/nsp-specialty-groups (accessed 28th March 2021).
- Central Intelligence Agency, The World Factbook — Countries: Nigeria. 2021. Available from: https://www.cia.gov/the-world-factbook/countries/nigeria/ (accessed 28th March 2021).
- Institute for Health Metrics and Evaluation. GBD Compare 2019: Nigeria. Available from: http://www.healthdata.org/nigeria (accessed 28th March 2021).
- Institute for Health Metrics and Evaluation. WHO Rehabilitation Need Estimator: Nigeria. Available from: https://vizhub.healthdata.org/rehabilitation/ (accessed 28th March 2021).
- Onwujekwe O, Onoka C, Uzochukwu B, Hanson K. Constraints to universal coverage: inequities in health service use and expenditures for different health conditions and providers. International journal for equity in health 2011;10(1):50.
- Fagbamigbe AF, Bamgboye EA, Yusuf BO. et al. The Nigeria wealth distribution and health seeking behaviour: evidence from the 2012 national HIV/AIDS and reproductive health survey. Health Econ Rev 2015;5.
- World Culture Encyclopedia. Culture of Nigeria. Available from https://www.everyculture.com/Ma-Ni/Nigeria.html (accessed 28th March 2021).
- Federal Ministry of Health. Nigeria Health Facility Registry. Available from: https://hfr.health.gov.ng/ (accessed 31st March 2021).
- Adeloye D, David RA, Olaogun AA, et al. Health workforce and governance: the crisis in Nigeria. Hum Resour Health 2017;15(32)
- Enabulele O. Achieving Universal Health Coverage in Nigeria: Moving Beyond Annual Celebrations to Concrete Address of the Challenges. World Medical & Health Policy 2020;12:47-59.
- World Health Organization. Global Health Expenditure database: Nigeria. Available from: https://apps.who.int/nha/database/country_profile/Index/en (accessed 28th March 2021).