Evidence map›Paper›PMID 39090613›Full record

ArticleBMC health services research2024

Barriers and facilitators for strengthening physiotherapy services in Nepal: perspectives from physiotherapists and health providers.

Nishchal Ratna Shakya, Amanda Emén, Gillian Webb, Hellen Myezwa, Biraj Man Karmacharya, Ann-Katrin Stensdotter

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Article in BMC health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Nishchal Ratna ShakyaDepartment of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, 7491, Norway. nishchal.r.shakya@ntnu.no.
Amanda EménDepartment of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
Gillian WebbFaculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia.
Hellen MyezwaSchool of Therapeutic Sciences, University of the Witwatersrand, Johannesburg-Braamfontein, Gauteng, South Africa.
Biraj Man KarmacharyaDepartment of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal.
Ann-Katrin StensdotterDepartment of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, 7491, Norway.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPhysiotherapy provides non-invasive and non-pharmaceutical intervention for curative, rehabilitation and preventative purposes. Physiotherapy is also a central provider of health promotion. As the global burden of non-communicable diseases and chronic health conditions is rising, the importance of physiotherapy services increases. Unfortunately, physiotherapy services in low- and middle-income countries (LMICs) are generally unsatisfactory. In Nepal, the earthquake in 2015 and the COVID pandemic have clearly illuminated the importance of physiotherapy.

objectiveThis qualitative study aimed to identify barriers and facilitators at different system levels for strengthening physiotherapy services in Nepal.

methodsForty semi-structured individual interviews were performed with different health providers. Transcribed interviews were assessed with thematic analysis. A five-level socioecological framework conceptualised multilevel determinants of barriers and facilitators.

resultsThe study revealed various factors that were potential barriers and facilitators across five different levels, namely individual (taking the lead, need for advocacy), interpersonal (lack of recognition and autonomy, networking for referrals and coordination), community (lack of knowledge and awareness, social and family support), organisational (accessibility, workplace and clinical practice, educational opportunities, role of organisations and rehabilitation centres), and public policy level (planning and implementation of policies and programs, medical hegemony, priorities). Government officials, local leaders, and clinicians, half of whom were physiotherapists, agreed on many of the same issues, where a lack of awareness of what physiotherapy is and knowledge about what physiotherapists do was central.

conclusionsThe results provide information for the development of physiotherapy by pointing out key elements that need attention. Our broad and structured investigation strategy is applicable to others for a comprehensive analysis of barriers and facilitators for physiotherapy services.

Indexed as

Physical TherapistsPhysical Therapy ModalitiesQualitative ResearchAdultAttitude of Health PersonnelCOVID-19FemaleHealth PersonnelHealth Services AccessibilityHumansInterviews as TopicMaleMiddle AgedNepalSARS-CoV-2Chronic diseases, Socio-ecological modelDisabilityHealth systemNon-communicable disease

Identifiers

PMID39090613
PMCPMC11295310

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.