Purpose: This study assessed the perception of Nigerian physiotherapists on direct access and patients’ self-referral to Physical Therapy (PT).

Relevance: The global advocacy for direct access and patients’ self-referral to PT is a significant component of professional autonomy and recognition. However, the attainment of this clarion call in sub-Sahara Africa may be hamstrung by challenges similar or different from those observed in the developed nations.

Participants: One hundred physical therapists recruited from ten purposively selected public funded out-patient facilities from South-West, Nigeria volunteered for this study, yielding a response rate of 66.7%.

Methods: This cross-sectional survey employed the use of a previously validated questionnaire for WCPT on global view of direct access and patient self-referral.

Analysis: Data was analyzed using descriptive statistics of frequency, percentages and graphs.

Results: Out-of-pocket reimbursement was the most common method of payment for PT (Private (86%) vs. Public (71%) setting). A majority of respondents reported that there is legislation (91%) regulating the scope of practice (84%) of PT profession in Nigeria. Half (51%) of these respondents believed the legislation is a barrier to first contact practice and self-referral (97%). A majority of the respondents believed there were no inherent limitations in self-referral to PT in private (83%) and public (89%) practice respectively. More than half (60%) of the respondents believed that graduates of entry-level PT programmes were adequately prepared to accept self-referral. The respondents opined that the public (60%) and the Nigeria Society of Physiotherapy (40%) are in support of direct access and patients’ self-referral. About half of the respondents (47%) opined that physicians may not be in favour of direct access to PT. A majority (80%) of the respondents opined medical views as a major current barrier to direct access in PT while medical support (41%) is the most implicated facilitator of direct access in PT.

Conclusions: Direct access and patients’ self-referral to PT in Nigeria is hamstrung by a gamut of factors with medical views and medical support acting as the predominant barrier and facilitator respectively.

Implications: Availability and accessibility of patients/clients to PT service without the gate-keeping of a third party in sub-Sahara Africa still require concerted campaign and advocacy through alliance with medical profession and lobbying the politicians for change in legislation. Furthermore, raising the current educational entry level to the baccalaureate doctor of physical therapy and continuous professional development for practicing physical therapists will strengthen advocacy and alliance.