Abstract
Physiotherapy practice in Africa faces a number of challenges, one of which is the limited number of therapists in most public hospitals. In Africa, physiotherapy is still mainly institution based with very little community-based practice, leading to lack of access to services for a large part of the population. This study explores users' perceptions of physiotherapy, challenges faced by users, possible options for management, and determines whether current physiotherapy practice in a rural Kilifi District general hospital in Kenya facilitates future self-management of chronic conditions. Eight in-depth interviews, 3 focus groups discussions and 4 participant observations were conducted for data collection. All interviews and focus group discussions were recorded using a digital recorder, transcribed into the Swahili language and then translated into English. The transcriptions were imported to NVivo 9 (www.qsrinternational.com) for management and storage. Inductive data analysis was used to generate themes from the rich-text data of the transcriptions. Many of the users perceived physiotherapy as being effective. Challenges included distance from health facilities, negative experiences with some therapists, and lack of staff and equipment. Rehabilitation options included community- and home-based programs fostering self-management of chronic conditions. Current hospital practice lacks emphasis on self-management skills for patients with chronic conditions who can do their physiotherapy at home. Users' experiences of physiotherapy treatment in this rural hospital indicate that a host of challenges exist. In the face of these challenges, the needs of the users seemed to be compromised, especially those with chronic conditions<b><i>. </i></b>Rehabilitation services that are accessible and affordable would be better options in rural and low-resource settings. There is therefore need for community-based services that place emphasis on self-management of chronic conditions for fostering better health outcomes in rural communities.
Highlights
Physiotherapy practice in Africa faces a number of challenges, one of which is the limited number of therapists in most public hospitals
In Kenya the ratio was estimated as 1:20 0003 and it was observed that physiotherapy services are limited by few trained personnel and funding[4]
The lack of general funds for service development and equipment could indicate that physiotherapy is still regarded as less important for development than others in health care, such as medicine and nursing[5]
Summary
Physiotherapy practice in Africa faces a number of challenges, one of which is the limited number of therapists in most public hospitals. Current hospital practice lacks emphasis on self-management skills for patients with chronic conditions who can do their physiotherapy at home. There is need for community-based services that place emphasis on self-management of chronic conditions for fostering better health outcomes in rural communities. Self-management may lead to efficient use of health services and meet the needs of people with chronic conditions or disability[8]. These processes would seem important in countries where there is a shortage of health professionals
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