Factors influencing utilisation of physiotherapy services at Busia County referral hospital in Kenya

Abstract

Background - The surging trend of non-communicable diseases complicated by trauma and infectious diseases has left many all over the world with marked physical limitations to function normally. Physiotherapy is a component of primary healthcare with avital role in prevention, promotion, treatment, and rehabilitation of physical dysfunctions. When well utilised it can prevent the complications of both communicable and non-communicable diseases within the community. It is therefore essential to establish factors that influence physiotherapy utilisation in Busia County, Kenya. Objectives –The purpose of this study was to establish the health-care providers’ level of knowledge and factors that influence the utilisation of physiotherapy services among community members of Busia County in Kenya. The association between level of knowledge and demographic profile of health-care providers, People Living with Disabilities (PWD), and patients attending physiotherapy at Busia County referral hospital was also established. Method – This was a descriptive cross-sectional quantitative study. Healthcare services providers 192 (nurses, doctors, and clinical officers) and 158 physiotherapy patients and people living with disabilities were purposively selected to participate in this study. They completed self-administered questionnaires between August and November 2019.They were both male and female above 18 years of age, drawn from the local community and Busia County Referral Hospital. The self-administered questionnaires developed by Nankwanga and Phillips (2008) for postnatal utilisation of physiotherapy interventions was adapted for this study. The questionnaire was validated by six physiotherapy experts and used for this study. Data collected was cleaned organised and analysed by Microsoft excel and Statistical Package for Social Sciences (SPSS) version 25. Results – The majority (92%)of the healthcare services providers at Busia County Referral Hospital had adequate knowledge about the importance of physiotherapy service right from their training to working experience. They had excellent communication (86.03% ) with physiotherapists and helped to refer patients at BCRH for physiotherapy where necessary. They had trust (91.56%) that physiotherapists were knowledgeable enough to handle both referred and self-referred patients on their own. The patients and PWD had a lower level of knowledge about the importance of physiotherapy services. There was limited information about the importance of physiotherapy in the community compared to the hospital (88.60%) physiotherapy patients and People living with disabilities agreed. Most of them (67%) attended treatment sessions once a week, which was inadequate to meet their needs of treatment, making it difficult for them (87.42%) to recommend a friend or colleagues for physiotherapy. The main challenge encountered by patients and PWD to attend physiotherapy was lack of money (55.71%) and distance from home to hospital (63.3%). The level of knowledge about the importance and use of physiotherapy services was determined by period one had worked in BCRH, the department one worked and the profession of the health care providers. The monthly income for the physiotherapy patients and PWD determined how satisfied they were with the amount of money they paid for physiotherapy services. Conclusion - The healthcare services providers are knowledgeable about the importance of physiotherapy and have done what it takes to foster its utilisation at Busia County Referral Hospital. However, there is inadequate knowledge of the use and the importance of physiotherapy among the community members. Thus the lower utilisation of physiotherapy services in Busia County could be factors associated with dynamics within the community and the health service providers. Example of this dynamics could be lack of finances, attitude of the health care providers towards physiotherapy and inadequate infrastructure both physical structures and equipment in the health facility. Recommendation - There is need to create awareness of the importance of physiotherapy among the community members to facilitate utilisation and to improve both general and physical health of the community members. There is also need to integrate physiotherapy service at all levels of training and practice of the components of primary health care to the health care providers in Busia County