Status and availability of physiotherapy in Nepal as reported from facilities and official registers

Abstract

Background Physiotherapy is a growing profession in Nepal, but there are challenges in providing equitable access and availability to physiotherapy services, particularly in underserved areas. There have been several efforts to promote physiotherapy services, however there is still a need to develop and strengthen physiotherapy and its services. Updated information and proper planning for resource allocation are important for addressing these challenges. Objective This study aimed to explore the status and availability of physiotherapy in Province 3 of Nepal. Method Data was collected through a cross-sectional survey of health facilities in the province using stratified purposive sampling. The eligible facilities were selected from the list of Department of Health Services. The survey contained closed-ended questions addressing primarily physiotherapy services in the outpatient department, human resources, charging and record-keeping systems, and accessibility. Visits to governing institutions and reviews of register data and reports were performed to obtain national physiotherapy data. Results The survey included 25 urban and 4 rural facilities, including hospitals and rehabilitation centres; both public (37.9%) and non-public (62.1%). Most facilities (79.3%) employed physiotherapists with bachelor's degrees. On average, there were 29.55 physiotherapy outpatients and 14.17 inpatients per day. Patient records were mainly paper based, with most (69%) using the hospital main card for patient case documentation, while others (31%) had their own physiotherapy assessment card. The majority of referrals came from doctors in different departments. The most commonly offered services were musculoskeletal, neurological, and paediatric physiotherapy. The average charge for a single visit was 311 Nepalese rupees ≈ 2.33 US$, and daily basis charging was common. Accessibility for patients with disabilities was reported as partial by 79% of outpatient departments. Two centres did not have disability-friendly settings, and only one had a disability-friendly toilet. Conclusion Overall, the study highlights the significant variations in physiotherapy services and the need for proper planning. The finding emphasizes the need for a proper data registry to inform resource allocation, as well as the need for monitoring services and further research on physiotherapy provision, particularly in underserved areas.