Journal of Pediatric Medicine and Child Health

ABSTRACT

Background

Primary Health Care (PHC) is the cornerstone of universal health coverage, yet rehabilitative services remain poorly integrated into the primary tier in many developing nations. In rural Nigeria, labor-intensive agrarian occupations predispose residents to high rates of physical impairment. This study investigated the prevalence and clinical distribution of physiotherapy-related conditions in rural PHC centers in North-Eastern Nigeria to characterize the unmet need for rehabilitation.

Methods

We conducted a multi-center, retrospective clinical audit of outpatient registers and patient records at three PHC facilities in Akko Local Government Area, Gombe State. Data covering a five-year period (January 2021 - December 2025) were analyzed. Socio-demographic variables, clinical presentations, and referral outcomes were extracted using a standardized proforma. Analysis was performed using descriptive statistics, with age data expressed as Mean ± SD.

Results

A total of 179 patients presenting with 32 unique physiotherapy-related conditions were identified (note: 2022 records were unavailable). The cohort had a mean age of 29.0 ± 17.03 years, with the 16–25 age group representing the highest proportion of cases (43.6%). Low back pain was the most frequent presentation (27.9%), followed by generalized body pain (11.7%) and trauma (9.5%). Notably, 86.0% of cases were managed at the primary level without formal referral, while only 14.0% were directed to specialized secondary or tertiary centers.

Conclusion

The findings reveal a substantial burden of musculoskeletal and neurological morbidity among the young, productive population of rural North-Eastern Nigeria. The disproportionately low referral rate highlights a critical "referral bottleneck" that restricts access to specialized rehabilitation. There is an urgent need for policy reform to decentralize physiotherapy services and implement rehabilitative triage training for primary healthcare workers to mitigate chronic disability. 

Keywords: Primary Health Care; Clinical Audit; Musculoskeletal Disorders; Physiotherapy; Rural Health; Referral Pathways