PHYSIOTHERAPISTS KNOWLEDGE AND CHALLENGES ASSOCIATED WITH TREATING PELVIC HEALTH CONDITIONS IN GHANA: A MIXED METHODS STUDY

C. Yarfi1, G.S. Lumor1, I.E. Fayison1, D. Adedia2, E.L. Torgbenu11University of Health and Allied Sciences, Physiotherapy and Rehabilitation Sciences, Ho, Ghana, 2University of Health and Allied Sciences, Basic Sciences, Ho, GhanaBackground: The role of physiotherapists in treating pelvic health conditions cannot be underestimated. Physiotherapists treat cases of musculoskeletal and physical presentations using their skills and ability to assess the pelvic floor muscles for tightness, tenderness and pain as a result of muscle weakness and dysfunction. A scope of the literature indicates that physiotherapists in low and middle-income countries are not involved in treating conditions affecting the pelvis. Healthcare professionals such as obstetricians, gynaecologists and midwives are the long established professionals who treat pelvic health conditions. Physiotherapists use core stability exercises, pelvic floor muscle exercises and electrotherapy to treat conditions such as urinary and faecal incontinence, uterine and vaginal prolapse and obstetric fistula.Purpose: The aim of this study was to investigate the knowledge of physiotherapists in the treatment of pelvic health conditions in Ghana and to explore the challenges they face.Methods: The study used a sequential explanatory mixed methods design involving registered physiotherapists in Ghana. Cross-sectional survey of participants were done, followed by a purposive sampling of 8 of the participants recruited for the qualitative interview. The quantitative data were collected using an online pre- validated questionnaire after notice of the study was advertised on the Ghana Physiotherapy Association WhatsApp platform. Information gathered included: demographics, knowledge level and common pelvic health conditions treated by physiotherapists. Participants were eligible to participate in the qualitative interviews if they had at least one year of working experience and/or interest in treating pelvic health conditions. Interview questions focused on participants knowledge of treating pelvic health condition and the challenges they face. The interviews were conducted via telephone. All interviews were audio and recorded after seeking consent from the participants and transcribed verbatim and analysed using thematic areas. The quantitative data were analysed using SPSS version 21.0 and presented using frequencies and percentages. Inferential statistics was done with a level of significance set at p < 0:05.Results: A total of 84 out of 120 sampled participants successfully completed and submitted the questionnaires giving a response rate of 70%. Sixty-one (72.6%) of physiotherapists reported treating pelvic health conditions in their facilities. Out of the 61 physiotherapists who treat pelvic health conditions, 34 (55.7%) have taken short courses and the remaining 27 (44.3%) have not taken any short courses in pelvic health. Physiotherapists use a combination of exercises and electrotherapy in the management of reproductive health conditions. Majority of physiotherapists use Kegel exercises 30 (35.7%), core stability exercises 10 (11.9%) and active exercise 5 (6%) for treatment.Three themes emerged from the qualitative interviews: lack of physiotherapists experience and confidence with case management; non-referral of cases by medical officers and late referrals of cases.Conclusion(s): Physiotherapists in Ghana have general knowledge and interest in treating pelvic health conditions, but further training is needed for them to fully start treating pelvic health conditions. They are also faced with late referrals from medical officers and non-referral of pelvic conditions for treatment.Implications: Physiotherapists knowledge about pelvic health conditions should be a priority to the healthcare system. Educational perspectives should be encouraged regarding pelvic health conditions.Funding, acknowledgements: The study received no funding.Keywords: pelvic health conditions, physiotherapists,, GhanaTopic: Pelvic, sexual and reproductive healthDid this work require ethics approval? YesInstitution: University of Health and Allied SciencesCommittee: Research Ethics CommitteeEthics number: UHAS-REC A.4 [310] 18-19All authors, affiliations and abstracts have been published as submitted.