Nigerian physiotherapists’ perception of direct access and patients’ self-referral

Chidozie Emmanuel Mbada, Kayode D. Ojetola, Rufus Adesoji Adedoyin, Udoka A. C. Okafor, Olubusola E. Johnson, Abiola Oladele Ogundele, Taofeek Oluwole Awotidebe, Olumide Olasunkanmi Dada


Background: The global advocacy for Direct Access (DA) and Patients’ Self-Referral (PSR) to physiotherapy is consistent with the quest for promoting professional autonomy and recognition. It was hypothesized in this study that the attainment of this clarion call in Nigeria may be hamstrung by challenges similar or different from those reported in other climes.

Objective: This study assessed the perception of DA and PSR among Physiotherapists (PTs) in South-West, Nigeria.

Methods: One hundred PTs from ten purposely selected public-funded out-patient facilities from South-West, Nigeria responded in this cross-sectional study, yielding a response rate of 75% (100/150).  A previously validated questionnaire for World Confederation of Physical Therapists (WCPT) on the global view of DA and PSR for physical therapy was used in this study. Data was analyzed using descriptive statistics.

Results: There was a high awareness on legislation regulating practice (91%) and scope (84%) of the profession. Respondents assert that the extant legislation allows for DA (49%) and PSR (97%). However, 40% of the respondents opined that the baccalaureate qualification of PTs was inadequate for competence in DA and PSR; and a post-professional residency programme was mostly recommended (52%). Public support for DA and PSR to physiotherapy was rated more than the advocacy role of the Nigeria Society of Physiotherapy (60% vs. 40%). Physicians’ (71%) and politicians’ (65%) views were rated the major barrier to achieving DA and PSR status in physiotherapy. Similarly, physicians’ (90%) and politicians’ (88%) support was perceived as the major facilitator.  

Conclusion: Physiotherapy practice in Nigeria has the semblance of autonomy in DA and PSR but is devoid of legislative support. Most Nigerian physiotherapists assume professional autonomy but were not aware of the lack of legal support for DA and PSR. The current entry-level academic curricula were considered to be deficient and inadequate for autonomous practice in Nigeria.  Physicians and politicians were the most important barrier or facilitator to achieving legal support for DA and PSR in physiotherapy in Nigeria.


Direct access; Patients' Self-referral; Physiotherapy; Nigeria

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