Physiotherapists’ perceptions of the use of standardised outcome measures in Ghanaian neonatal intensive care units: A cross-sectional survey
Keywords:
Ghana; Neonatal care; Neonatal intensive care units; Outcome measures; Physiotherapy.Abstract
Background: Neonatal intensive care units (NICUs) in low- and middle-income countries (LMICs) such as Ghana are increasingly improving neonatal survival. However, this progress brings a growing population at risk of long-term neuro d e ve l o p me nt a l d i sa b i l i t i e s. Physiotherapists play a vital role in early identification and rehabilitation, yet the routine use of outcome measures (OMs) in these settings remains underexplored. This study described the use of OMs among physiotherapists in Ghanaian NICUs, focusing on awareness, utilisation, and perceived barriers and facilitators.
Subject and Methods: A descriptive cross-sectional online survey was conducted among physiotherapists providing neonatal care in Ghana, recruited via the national online platform of the Ghana Physiotherapy Association. A total of 100 clinicians with NICU experience within the past two years completed a structured questionnaire assessing professional characteristics, awareness, current use of OMs, confidence, and perceived barriers and facilitators to implementation. Data were summarised using proportions with 95% confidence intervals for categorical variables and medians with interquartile ranges for ordinal variables. Analytical methods focused on descriptive reporting consistent with the study design.
Results: Thirty-six per cent of respondents (95% CI 27.1–45.9) reported often or very often using at least one standardised neonatal OM. AIMS (28%) and GMA (26%) were most used, while HINE (4%) and Bayley-III (11%) were uncommon. Confidence was low (median 2.0 [IQR 1.5–2.8]), though higher for GMA. Major barriers were insufficient training (78%), lack of resources (71%), and time constraints (67%). Facilitators included access to protocols (85%) and additional training (81%).
Conclusion and recommendations: Despite widespread awareness, the routine use of standardised outcome measures remains limited, reflecting structural and training gaps that contribute to a persistent knowledge-to-practice divide in Ghanaian NICUs. Integrating OMs into clinical protocols, supported by targeted training and resource provision, is essential to strengthen evidence-based neonatal physiotherapy and advance disability-inclusive health services.
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