Referral Practices and Utilisation of Paediatric Oncology Physiotherapy Services in Ghana: A Cross-Sectional Study

Physical rehabilitation is highly recognised in improving the quality of life of cancer survivors through prehabilitation, sequelae management and palliative care, yet its integration into routine care in Ghana has not been characterised, leading to potential gaps in service access.

To determine referral practices and utilisation of physiotherapy services as self-reported by healthcare professionals (HCPs).

A quantitative cross-sectional study involving proportionate sampling was conducted in three major tertiary healthcare facilities offering oncology services in Ghana. The study included 85 HCPs who work in these three facilities. Data were collected from the HCPs between May and September 2025 using a demographic information sheet and an adapted survey tool on cancer referral practices to physical rehabilitation. Data were entered into Microsoft Excel and further summarised using SPSS version 26 into frequencies and percentages.

Most medical practitioners (76.2%, n = 48), including paediatricians, radiotherapists, oncologists, medical officers and paediatric residents, reported referring children/adolescents for physiotherapy. The majority of physiotherapists (72.7%, n = 16) also made referrals to other physiotherapists. Over half (54.0%, n = 34) of the medical practitioners and physiotherapists (68.2%, n = 15) referred between one and 10 cases annually. Medical practitioners (39.7%, n = 25) referred 'sometimes', whilst physiotherapists (36.4%, n = 8) referred 'often'. Reasons prompting referrals included muscle weakness, limitations in activities of daily living and gait alterations. The majority of medical practitioners (61.9%, n = 39) and physiotherapists (63.6%, n = 14) revealed that children/adolescents utilised physiotherapy services. Major reasons for non-utilisation self-reported by the HCPs included caregivers' financial barriers and parental choice.

The majority of HCPs reported referring children/adolescents for physiotherapy because of physical limitations. Most referred cases utilised physiotherapy services; however, reasons for non-utilisation included financial barriers and parental choice. Further investigations are suggested to unearth barriers to non-referrals to improve referral pathways and physiotherapy utilisation.