Nigeria

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Patient Access to Physiotherapy or Physical Therapy Services / Entry Point

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.

Degree/Credentialing

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

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

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.

Type of Health System

The Nigerian health system consists of public and private health service providers. There are three tiers of public health services:

1. Tertiary care is provided by university teaching hospitals, Federal Medical Centres, military hospitals etc, and they are under the coordination of the federal government.
2. Secondary care is provided by general hospitals, which are under the coordination of the state government.
3. 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

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 70% 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.