07/07/2026
NIGERIAN PHYSIOTHERAPISTS WELCOME REHABILITATION 2030 BUT CALL FOR URGENT GOVERNMENT INTERVENTION TO SAFEGUARD PATIENT SAFETY, GOOD GOVERNANCE AND THE RULE OF LAW
The Nigeria Society of Physiotherapy (NSP), in collaboration with the Association of Clinical and Academic Physiotherapists of Nigeria (ACAPN), wishes to reaffirm its unwavering support for the Federal Government's commitment to strengthening rehabilitation services through the implementation of the World Health Organization (WHO) Rehabilitation 2030 Initiative and the integration of rehabilitation into Primary Health Care (PHC).
The physiotherapy profession believes that every Nigerian, irrespective of where they live, deserves timely access to safe, high-quality rehabilitation services delivered by appropriately trained and regulated professionals. Rehabilitation is an essential health service and a critical component of Universal Health Coverage.
While we commend the Federal Government for prioritising rehabilitation, we are compelled to draw the attention of Government and the Nigerian public to emerging governance, legal, professional and patient-safety concerns that, if not urgently addressed, may undermine the successful implementation of Rehabilitation 2030 and create avoidable divisions within the rehabilitation sector.
Background: How We Got Here
The present concerns did not arise suddenly. They followed a sequence of events involving the Nigeria Society of Physiotherapy and the Medical Rehabilitation Therapists Registration Board of Nigeria (MRTBN), with the events later escalated to the Federal Ministry of Health and Social Welfare through the Office of the Honourable Minister of State for Health.
1. The dispute arose after NSP raised concerns that the MRTBN Registrar, Prof Rufai Ahmad, was engaging, through his privately established institute, RAY Institute, in disputed trainings: CPD programmes, Clinical Pathway, Diploma-related and middle-level manpower programmes, while he is still at the helm of MRTBN affairs as MRTBN functions as the statutory regulator responsible for accreditation, oversight and award of CPD points in the same professional space.
2. This and other concerns were escalated to the Federal Ministry of Health (FMOH) for interventions. The Honourable Minister of State for Health convened and presided over a couple of meetings with both NSP leadership and MRTBN Registrar in attendance. Following extensive deliberations, the Honourable Minister of State expressed concerns about the fact that a statutory head of regulatory body simultaneously regulates, approves and awards CPD points for training programmes organised through a private institute associated with him and the organization he oversees. The Honourable Minister of State ultimately directed that the MRTBN Registrar should desist from such training activities with immediate effect and allow all training activities to be conducted by the professional body (NSP). He added that the Registrar should engage the NSP leadership and reach an understanding before implementing any form of training or policies. He emphatically stated that government does not implement policies by fiat but through extensive stakeholders engagements and consensus. He confirmed the interest of the present federal government in implementing the WHO Rehabilitation 2030 Framework and make rehabilitation available at the PHC level. He therefore further directed the MRTBN Registrar to engage the NSP leadership to advise on the model to be implemented and workforce/manpower to be utilised.
3. Following that directive, NSP wrote to the MRTBN Registrar on three occasions requesting for an engagement. It is disheartening that though the letters were received, as it is his practice, no formal acknowledgement or response was received from him till date. Hence, no meeting has been held. Nigerian Physiotherapists view this as high-handedness and disregard to lawful directive by the Registrar, a misconduct according to the Public Service Rules (PSR).
4. Despite the Ministerial directive on training, evidence at the NSP disposal indicates continued promotion of MRTBN-linked trainings. It has also been observed that the WHO Rehabilitation 2030 Framework implementation activities are being carried out by the Registrar through/ in collaboration with another body, the Foundation for Empowering Persons with Disabilities through Medical Rehabilitation (FEPDMR) while the professional Associations (NSP/ACAPN) are left uninvolved despite Physiotherapy being a pillar of rehabilitation. A greater concern is the recently circulated flyer announcing a proposed launch of rehabilitation services in Primary Health Care in Nigeria, presented as involving the Federal Ministry of Health and Social Welfare in collaboration with FEPDMR, with ministerial branding (picture of the Honourable Minister of Health - Prof. Pate) and a PHC venue in Bauchi State. The available records from the Corporate Affairs Commission (C.A.C.) and related materials confirm links between FEPDMR, persons associated with RAY Institute and the MRTBN leadership. This raises further questions about governance, transparency, conflict-of-interest safeguards. For example, the 2026 Physiotherapy Clinical Pathway Training Schedule presents MRTBN and FEPDMR in collaboration, with advertised CPD points, registration processes, workshop fees and payment into an FEPDMR Medical Rehabilitation Training account. We want to publicly state that there are suspicions about FEPDMR which needs to be investigated by the FMOH - it's not a known NGO till Registrar started collaborating with it, no other activities of the organization is known except that which it's being subjected to by MRTBN Registrar, its leadership had never paid a courtesy visit or officially address MRTBN Registrants and/or constituting MRTBN professional associations, and whether the organization was approved by the FMOH before the Registrar started collaboration with it. It is also of interest to NSP whether such an organization can be made to replace the professional associations being regulated by the MRTBN and if or not, the NSP and other professional associations under MRTBN have a role to play in approval of collaboration with such organization. These actions run contrary to ministerial directive to the MRTBN Registrar, and appear to be driven by personal interests rather than national interest. We therefore reinstate that the Ministerial directive has not been complied with by the Registrar.
5. NSP and ACAPN Support Rehabilitation at PHC level - But not Lower-Cadre Substitution.
The Nigeria Society of Physiotherapy and the Association of Clinical and Academic Physiotherapists of Nigeria fully support the expansion of rehabilitation services to Primary Health Care facilities and underserved communities. However, we are deeply concerned by proposals that appear to favour the introduction or deployment of non-physiotherapist cadres to provide clinical rehabilitation services in circumstances where qualified physiotherapists are available but remain unemployed or underutilised.
Our position is clear: the challenge facing Nigeria is increasingly one of workforce deployment, structured absorption and equitable distribution, rather than the absence of qualified physiotherapists.
Nigeria already has a rapidly expanding physiotherapy workforce. More than sixty universities currently train physiotherapists, and annual graduate output is expected to increase significantly over the coming years. At the same time, many qualified physiotherapists remain unemployed or underemployed despite the enormous unmet need for rehabilitation services across the country. In other climes, where Nigeria-trained migrated to, they work at the PHC and community levels. Nigeria cannot afford to subject her own citizens to the care of a middle or low level manpower for rehabilitation services.
We therefore believe that the most efficient, lawful and economically sustainable approach is to deploy existing qualified physiotherapists through structured internship, National Youth Service Corps (NYSC) and Primary Health Care employment pathways rather than create additional cadres whose legal authority, scope of practice and governance framework remain unresolved.
Nigeria Already Has a Deployable Physiotherapy Workforce
Nigeria does not need to wait three to five years to produce a new cadre before expanding rehabilitation into Primary Health Care. The country already has a growing university-trained physiotherapy workforce that can be mobilised immediately.
1. Current professional estimates indicate that Nigeria has over 80 active or emerging universities offering Physiotherapy or Doctor of Physiotherapy programmes. Annual output is currently estimated at about 2,500 physiotherapists, with projections rising to about 8,000 physiotherapists annually within the next two to three years as new programmes mature and carrying capacity increases.
2. Many of these qualified physiotherapists remain unemployed or underemployed, not because they are unwilling to serve in rural communities, but because Nigeria has not yet created a structured employment and deployment pathway for physiotherapists at PHC and community levels.
3. NSP therefore proposes a practical alternative:
Deploy qualified physiotherapists through Internship โ NYSC Rehabilitation Posting โ PHC Deployment โ Permanent Public-Sector Absorption.
This model can begin immediately with unemployed and underemployed physiotherapists, while newly qualified graduates are channelled into PHC service through internship and NYSC. It is faster, safer, more lawful and more sustainable than creating a new lower-cadre manpower pathway that may take years to produce its first graduates.
Therefore, Nigeriaโs problem is not the absence of physiotherapists; it is the absence of a national deployment, absorption and retention framework for physiotherapists at the PHC and community levels.
Governance and Statutory Concerns Require Clarification
The Society has submitted a comprehensive policy and governance representation to the Honourable Coordinating Minister of Health and Social Welfare requesting an administrative review of several matters relating to the implementation of recent rehabilitation initiatives.
These issues include:
- statutory interpretation of the Medical Rehabilitation Therapists (Registration, etc.) Act;
- Governance and approval processes relating to recent rehabilitation initiatives;
- Stakeholder consultation and inclusiveness;
- Patient-safety implications of lower-cadre substitution;
-Transparency in continuing professional development (CPD) and training arrangements; and
- The legal and institutional framework for proposed new rehabilitation workforce initiatives.
Our representation does not seek to prejudge any individual or institution. Rather, it respectfully requests the Ministry to verify that all relevant statutory approvals, governance processes and regulatory safeguards have been properly observed before major reforms are implemented.
Patient Safety Must Remain Paramount
Physiotherapy is an autonomous, first-contact health profession whose practitioners are trained and licensed to undertake comprehensive patient assessment, clinical examination, functional diagnosis, treatment planning, implementation, reassessment and discharge planning. These responsibilities require advanced clinical reasoning, professional accountability and regulatory oversight. Any policy that permits substitution of these functions without an appropriate legal framework, competency standards and professional supervision raises legitimate patient-safety concerns and should be subjected to careful review before implementation. The Society emphasises that our concern is not with supportive community-based personnel working within clearly defined roles under professional supervision, but with any model that substitutes qualified physiotherapists in the delivery of professional rehabilitation services.
Stakeholder Engagement Is Essential
Successful health-sector reforms require collaboration, transparency and meaningful engagement with recognised professional stakeholders. The Nigeria Society of Physiotherapy is concerned that decisions capable of fundamentally altering rehabilitation workforce policy should be developed through broad consultation involving the relevant professional bodies, regulatory institutions, educational regulators and government agencies. Inclusive dialogue will strengthen ownership, reduce avoidable conflict and ensure that reforms are both legally sustainable and professionally acceptable.
Our Recommendations
The Nigeria Society of Physiotherapy and all Nigerian Physiotherapists respectfully call on the Federal Government to:
1. Strengthen rehabilitation services by deploying existing qualified physiotherapists into Primary Health Care facilities;
2. Establish a National Physiotherapy InternshipโNYSCโPHC Deployment Framework;
3. Urgently reconstitute the MRTBN Board to restore lawful statutory governance;
4. Verify all approvals, mous, fee arrangements, CPD processes and stakeholder consultations relating to MRTBNโFEPDMR activities;
5. Ensure that no major rehabilitation workforce reform proceeds without broad stakeholder consultation; and
6. Keep patient safety, quality of care, public confidence and statutory compliance at the centre of rehabilitation policy.
A Call for Partnership
The Nigeria Society of Physiotherapy and the Association of Clinical and Academic Physiotherapists of Nigeria remain committed to working constructively with the Federal Ministry of Health and Social Welfare, the Medical Rehabilitation Therapists Registration Board, other rehabilitation professions, development partners and all relevant stakeholders to achieve a common national goal: ensuring that every Nigerian has access to safe, effective and evidence-based rehabilitation services. Our objective is not confrontation but collaboration. Partnership must, however, be based on lawful governance, transparency, stakeholder inclusion and respect for the statutory roles created under the Medical Rehabilitation Therapists (Registration, etc.) Act. We believe that with lawful governance, meaningful stakeholder engagement and optimal utilisation of Nigeria's existing rehabilitation workforce, the country can successfully implement Rehabilitation 2030 while protecting patient safety, professional standards and the public interest. NSP has consistently pursued dialogue and constructive engagement. Having formally presented this representation to the Honourable Minister, the Society looks forward to the Ministry's prompt consideration of the issues raised in the interest of patients, the rehabilitation professions and the Nigerian health system. The Society sincerely hopes that these matters will be resolved through constructive administrative engagement. However, should the outstanding governance and statutory concerns remain unresolved after the Ministry has had a reasonable opportunity to consider this representation, the NSP and ACAPN reserve the right to pursue any lawful administrative, regulatory or judicial remedies available to protect patient safety, uphold the rule of law and safeguard the integrity of rehabilitation services in Nigeria.
Signed:
Professor UAC Okafor (President, ACAPN).
Dr Felix Oyinlola Odusanya (President, NSP).
