Radiologist workforce challenges and the burden of image interpretation in Ghana: Perspectives of frontline doctors and implications for healthcare delivery.

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Learn more: PMC Disclaimer | PMC Copyright Notice PLOS Glob Public Health . 2026 Jun 3;6(6):e0006456. doi: 10.1371/journal.pgph.0006456 Radiologist workforce challenges and the burden of image interpretation in Ghana: Perspectives of frontline doctors and implications for healthcare delivery Bismark Ofori-Manteaw 1, ¤ , Eric Kwasi Ofori 2 , Klenam Dzefi-Tettey 3 , Jacob Leonard Ago 4 , Seth Kwadjo Angmorterh 1 , Frempong Acheampong 5, * Editor: Julia Robinson 6 Author information Article notes Copyright and License information 1 Department of Medical Imaging, University of Health and Allied Sciences, Ho, Ghana 2 Department of Imaging Technology and Sonography, University of Cape Coast, Cape Coast, Ghana 3 Department of Radiology, School of Medicine, University of Health and Allied Sciences, Ho, Ghana 4 School of Health and Biomedical Sciences, RMIT University, Bundoora, Australia 5 School of Basic and Biomedical Sciences, University of Health and Allied Sciences‌‌, Ho, Ghana 6 PLOS: Public Library of Science, UNITED STATES OF AMERICA ✉ * E-mail: facheampong@uhas.edu.gh The authors have declared that no competing interests exist. ¤ Current address: Medical Radiation Science Discipline, Faculty of Science and Health, Charles Sturt University, Wagga Wagga, Australia Roles Bismark Ofori-Manteaw : Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Writing – original draft Eric Kwasi Ofori : Conceptualization, Data curation, Methodology, Project administration, Supervision, Validation, Writing – review & editing Klenam Dzefi-Tettey : Conceptualization, Formal analysis, Methodology, Project administration, Supervision, Writing – review & editing Jacob Leonard Ago : Data curation, Formal analysis, Investigation, Methodology, Writing – review & editing Seth Kwadjo Angmorterh : Conceptualization, Methodology, Supervision, Validation, Writing – review & editing Frempong Acheampong : Conceptualization, Data curation, Investigation, Methodology, Writing – review & editing Julia Robinson : Editor Received 2025 Oct 2; Accepted 2026 Apr 24; Collection date 2026. © 2026 Ofori-Manteaw et al This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. PMC Copyright notice PMCID: PMC13232841  PMID: 42234708 Abstract Interpreting radiological images, a primary responsibility of radiologists, is crucial for accurate diagnosis and informed clinical decisions. However, many low-and-middle-income countries (LMICs) face severe radiologist shortages, leading to diagnostic delays, uncertainty, and potential compromises in patient care. This study explored the perspectives of frontline medical doctors on the challenges posed by radiologist shortages in Ghana concerning image interpretation and its impact on healthcare delivery and patient care. A qualitative descriptive study was conducted using semi-structured interviews with eight medical doctors working across public and private healthcare facilities at different levels of the Ghanaian health system. Data were thematically analysed with NVivo 14, following Braun and Clarke’s reflexive thematic analysis framework. Three key themes emerged: the vital role of radiological imaging in clinical practice, difficulties in accessing radiological reports, and suggested strategies to address the challenges posed by radiologist shortages. Subthemes identified include barriers such as delayed access to radiologist reports, underlying causes for report unavailability, insufficient training in image interpretation, and clinician burnout. Participants proposed expanding radiology training, strengthening radiology education in undergraduate medical curricula, involving trained radiographers in preliminary image evaluation, and integrating teleradiology and artificial intelligence technologies as potential solutions to these challenges. Radiologist shortages in Ghana significantly affect the availability and quality of image interpretation services, which impacts diagnostic accuracy and patient care. Addressing this gap requires a multifaceted approach involving radiologist workforce development and enhancing the image interpretation skills of front-line medical practitioners. Efforts should include enhancing radiology training in undergraduate medical education and expanding access to remote reporting technologies particularly in underserved areas. Introduction Radiological imaging is crucial in modern clinical practice for diagnosis, treatment planning, monitoring disease progression, and guiding interventions across various medical specialities [ 1 – 4 ]. Radiologists play a crucial role in enhancing diagnostic accuracy through their expertise in interpreting medical images, which significantly contributes to improved patient outcomes. The comprehensive reports they produce enable clinicians to identify subtle imaging findings, reducing the likelihood of misdiagnosis and facilitating informed decisions about the most suitable treatment options [ 1 , 5 ]. The value of timely radiological reporting has been highlighted in several studies [ 2 , 6 – 9 ] linking delayed or absent reports to inappropriate clinical management and adverse events. In emergency care settings, even brief reporting delays can compromise treatment decisions, with potentially life-threatening consequences [ 2 ]. Healthcare systems globally are faced with acute radiologist shortages [ 1 , 8 , 10 – 14 ] amid growing demand for imaging services, resulting in reporting delays and backlogs of X-ray images [ 1 , 12 , 15 , 16 ]. In Australia, for instance, emergency department X-ray reports could be delayed by more than four hours [ 12 ]. In South Africa, X-ray reporting could take up to 10 days, with most radiographs unreported [ 16 ]. The golden rule, however, is that all radiological investigations should be accompanied by radiological reports to enhance the accuracy of patient diagnoses [ 17 ]. In low- and middle-income countries (LMICs), significant gaps in diagnostic workforce hinder the achievement of universal health coverage and exacerbate systemic health inequities [ 4 , 10 , 18 ] Many under-resourced countries have radiologist densities far below international benchmarks [ 8 , 9 , 19 ]. Ghana has a poor radiologist-to-population ratio of 0.31 per 100,000 [ 8 ]. To contextualise the scale of the problem, findings from a recently published national facility audit conducted as part of a broader doctoral study provide important background. That study reported that 53.8% of X-ray facilities in Ghana had no radiologist on site, with only 19.7% having full-time radiologist coverage and 16.2% relying on remote reporting. Among facilities with access to radiologists, emergency cases were commonly reported within 24 hours, whereas non-emergency examinations frequently experienced delays of two to three days. Notably, over half of facilities indicated that all radiographs produced remained unreported, despite many performing more than 10,000 general radiographic examinations annually [ 20 ]. These findings highlight the magnitude of reporting gaps within the Ghanaian health system and underscore the clinical context within which frontline doctors are required to make diagnostic decisions. While these quantitative data describe the scale of the challenge, they do not capture how frontline doctors experience, navigate, and respond to these diagnostic gaps in everyday practice. Consequently, X-ray images are often interpreted only upon specific request, compromising timely diagnosis and patient care. In the absence of radiologists, interpretation typically falls to non-specialist medical officers, house officers, or radiographers, whose training and confidence in diagnostic interpretation vary widely [ 9 , 18 , 21 ]. In the Ghanaian context, radiographers are not authorised to provide formal diagnostic reports, and their involvement in image interpretation is generally limited to informal support or preliminary image evaluation (PIE) rather than clinical reporting. The contrast with high-income countries is stark: the EU averages 12 radiologists per 100,000 population, Canada 7, and the UK [ 5 , 8 , 15 ]. These disparities highlights global inequities in radiology workforce distribution, posing serious risks to timely care in countries with fragile health systems. Addressing radiologist shortages is not only a clinical necessity but also a global development priority aligned with Sustainable Development Goals 3 and [ 10 , 22 , 23 ]. Radiologist shortages have far-reaching implications. Doctors are often forced to interpret complex images with limited training, increasing the risk of diagnostic errors [ 4 , 9 , 11 , 24 ]. These errors may lead to inappropriate treatment, delayed care, and potential harm or death [ 9 , 25 – 27 ]. The burden on junior doctors to make critical decisions without radiologist input can also contribute to stress and burnout [ 28 ] Moreover, the lack of timely radiological support delays patient flow in emergency and outpatient settings and undermines system efficiency [ 9 , 29 ]. Rural and underserved facilities without radiologists face major challenges, resulting in poorer diagnostic services compared to urban centres [ 8 ]. This urban-rural gap deepens structural inequalities in access to quality care, especially in countries with known regional disparities in radiologist health workforce distribution [ 8 ]. Although radiologist workforce challenges are well documented globally [ 1 , 4 , 8 , 10 – 13 ], empirical studies that explores the experiences of frontline doctors is limited [ 16 ]. Little is known about how frontline doctors cope with these shortages, their views on potential solutions, and their training needs in image interpretation. Understanding these perspectives is crucial for informing workforce planning, education, and sustainable service delivery. Also, in many medical training programmes, radiology education for medical students is relatively limited and often delivered as short modules within broader clinical curricula [ 27 , 30 , 31 ]. Training typically focuses on basic principles of imaging and introductory interpretation of common radiographs, particularly chest and musculoskeletal X-rays. However, opportunities for structured practical training in image interpretation may be constrained in settings with limited radiology workforce capacity [ 8 , 20 ]. In resource-constrained health systems such as Ghana, radiologist shortages may further restrict the time available for clinical teaching and supervision, as available radiologists are often required to prioritise service provision, including reporting workloads [ 32 ]. Consequently, newly qualified doctors may enter practice with variable confidence and competence in image interpretation, particularly when radiologist support is unavailable [ 31 ]. This study explored the experiences and perspectives of frontline medical doctors in Ghana regarding radiologist shortages, with a particular focus on their implications for image interpretation, healthcare delivery, and patient care. Materials and methods Ethical clearance The study received ethical approval from the University of Health and Allied Sciences Research Ethics Committee (UHAS-REC A.6 [3] 22–23). All participants provided verbal consent before participating in the study. Study design and participants This study employed a qualitative descriptive design to explore frontline doctors’ experiences and perspectives on radiologist shortages in Ghana and their impact on patient care following. This qualitative study forms part of a broader multi-phase doctoral study; quantitative findings relating to radiologist availability, reporting turnaround times, and volumes of unreported radiographs have been published separately and are referenced here for contextual framing only. A qualitative approach enabled in-depth understanding of frontline doctors’ daily practices, decision-making, and proposed solutions in settings with limited radiologist support [ 33 ]. Participants (medical doctors) were recruited using purposive sampling, aimed at achieving maximum variation in terms of healthcare facility level and geographic location across Ghana. Eligible participants included frontline medical doctors who routinely request radiological examinations as part of patient management. Potential participants were identified through professional networks and selected based on their clinical roles and experience in requesting and interpreting radiological examinations. These included senior medical officers (SMOs), medical officers (MOs), senior house officers (SHOs), and house officers (HOs) working across district, regional, and tertiary healthcare facilities. Ghana’s healthcare system is structured into four tiers. At the base is the primary healthcare level, comprising basic clinics and community-based services that serve as the first point of call for patients. The second level (district hospitals) functions as the first referral facilities, while the regional level offers specialized medical services and supports the lower tiers. At the top is the tertiary level, which provides advanced, complex medical care and serves as the apex referral system within the country’s healthcare structure [ 34 ]. This variation enabled a broader exploration of the issues across diverse resource settings, increasing the transferability of findings. Specialists and consultants were excluded to focus on frontline doctors who often make independent diagnostic decisions without formal radiology reports. Potential participants were identified through professional networks and contacted through telephone calls or email invitations. Follow‑up contact was made to confirm willingness to participate, and lack of response after follow‑up was interpreted as non‑participation. Only fourteen potential participants initially agreed to participate in the study. Data collection Data were collected semi-structured interviews conducted in English between 1 st September 2023 and 20 th October 2023. The interviews were conducted by the lead researcher, an academic who has experience in image interpretation education and training in conducting semi-structured interviews. Participants were briefed on the researcher’s professional background and the purpose of the study prior to the interviews, which helped establish trust and facilitate open dialogue during the data collection process. Interviews were conducted on a one‑to‑one basis, allowing participants sufficient opportunity to expand on their experiences and viewpoints and to offer detailed, context‑rich accounts. Interviews explored participants’ experiences with accessing radiology reports, the clinical impact of report unavailability on patient care, and suggestions for improving radiological support. Verbal consent was obtained from all participants and audio recorded, with participants informed that they could withdraw from the study at any time. Each interview was conducted via telephone, audio-recorded and lasted approximately 20–35 minutes. A literature-informed interview guide was developed based on the study objectives and previous research on radiology workforce shortages, image interpretation practices, and access to radiological reporting in resource-limited settings [ 9 , 11 , 21 , 35 ]. The guide included questions exploring the use of radiology in clinical practice, challenges in accessing radiological reports, radiology training and doctors’ experience in image interpretation, report turnaround times, perspectives on radiographer role extension, and potential strategies to improve access to radiological support. The credibility of the interviews was strengthened through prolonged engagement, iterative questioning, member checking, and peer debriefing with an experienced qualitative researcher. This approach ensured consistency in the data collection process and minimised interviewer bias. In qualitative research, sample size is guided by the concept of information power [ 36 ], with adequacy assessed by the richness of data in relation to the study’s aim, sample specificity, and quality of dialogue. In this study, interviews were analysed concurrently with data collection to assess the emergence of new concepts. The final sample size was considered sufficient at the point of data saturation, where no new insights or themes were identified and responses became repetitive across interviews [ 37 , 38 ], indicating that saturation had been reached. This indicated that the data collected were both comprehensive and adequate to address the study objectives. In all, eight medical doctors were interviewed at the point where thematic saturation was reached. Data analysis Identifiable information was anonymised during transcription, analysis, and reporting. Interviews were transcribed verbatim and analysed thematically using NVivo 14 software to support data organisation and coding, following Braun and Clarke’s six-phase framework [ 39 ]. The analysis began with familiarisation with the data through repeated readings of the interview transcripts to gain an in-depth understanding of participants’ accounts. Initial coding was undertaken independently by two members of the research team to enhance analytical rigour using a combination of inductive and deductive coding strategies. Codes were subsequently collated into potential themes representing patterned responses relevant to the research objectives. These themes were reviewed iteratively to ensure coherence within themes and alignment with the coded extracts and the full dataset. Through a reflexive process of refinement, themes were clearly defined and named to capture the essence of the participants’ perspectives. Peer debriefing and regular team discussions were also used to enhance analytical rigour and credibility throughout the process. Discrepancies in coding or theme development were resolved through discussion and consensus. The study was conducted and reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist [ 40 , 41 ]. Results Eight participants were interviewed: three (3) senior medical officers (SMOs), two (2) medical officers (MOs), two (2) senior house officers (SHOs), and one (1) house officer (HO). Four participants were based in district hospitals, two in regional hospitals, and two in tertiary-level hospitals. The mean age of participants was 33 ± 4 years, and their clinical experience ranged from 1 to 10 years. Analysis of the interview data generated three key themes and nine subthemes, as illustrated in Fig 1 . Fig 1. Key themes and subthemes‌‌ Identified. Open in a new tab Theme one: Relevance of radiological imaging in clinical practice Theme one highlights the central role that radiological imaging plays in routine clinical decision-making. Participants consistently described imaging as an essential diagnostic tool used across multiple clinical contexts. Sub-theme 1: Frequency of imaging requests. Participants indicated that radiological imaging forms a routine component of clinical decision-making across different levels of care. Several doctors described requesting imaging on a daily basis as part of patient assessment and management. “Quite a lot; I can’t count, almost every day I request Xray imaging.” (DR05) According to them, requests for imaging were more frequent at the accident and emergency and outpatient departments. “Very often [but] it depends [on] where you are. …but at the accident and emergency and the OPD, you tend to request a lot” (DR06). Sub-theme 2: The need for formal radiologist reports. While some doctors expressed confidence in interpreting basic radiographs, most underscored the added value of formal reports, particularly in complex or acute cases. “In as much as I may find some one or two anomalies on the X-ray, the radiologist interpretation goes a long way to help as well” (DR04). “It is very important because it increases quality care and decision-making, especially in acute cases…” (DR07). Inadequate undergraduate radiology training was also noted, with most doctors advocating for radiologist support to ensure diagnostic reliability. “… But even when you enter the field, because you haven’t studied radiology as a full program, you don’t really have all the answers. You might think you see something when it’s something else” (DR01). Sub-theme 3: Reasons for report unavailability. Despite recognizing the value of formal radiologist reports, participants noted that radiographs were often delivered without accompanying interpretations. This was attributed to assumptions that senior medical officers could interpret images independently, as well as uncertainty surrounding reporting protocols. “The specialists are trained to read the images. So, they interpret it on their own. They only request for [a report] when they are having difficulties.” (DR02) “I don’t know if I have to request [for] a report or if they are supposed to do that, but honestly, it doesn’t come with any radiological report.” (DR04) Another reason was the limited access to radiologists. Participants explained: “One of the causes would be the number of radiologists we have; I only know of a few in the hospital.” (DR01) Sub-theme 4: Strategies used in the absence of radiological reports. When radiologist reports aren’t available, frontline doctors adopt various strategies. “I use my knowledge from school and what I learnt during my radiology rotation. Then sometimes [too], I discuss with my senior colleagues.” (DR03). “If I see something that I’m not too sure about, I ask a senior colleague…because getting the radiologist is a bit difficult.” (DR01) Theme two: Challenges in accessing radiological reports The participants emphasized several challenges they face in accessing X-ray interpretation. Sub-theme 1: Delayed reporting. Participants reported noticeable variation in reporting turnaround times between facilities, with some doctors indicating that reports were sometimes delayed or unavailable at the time of clinical decision-making. One participant explained: “Some come with reports and some too don’t or they report later. At least some take a day.” (DR07) Another elaborated on these disparities by comparing experiences across different locations: “In [XYZ], I used to get report within 72 hours, but in [ABC], it takes 24 to 48 hours to get radiological report.” (DR03) Sub-theme 2: Clinician burnout. The burden of interpreting radiographs without adequate support contributed to doctors’ stress and burnout. One participant reflected on the emotional toll of this situation: “It’s frustrating when you don’t understand what you’re looking at and can’t get the help you need.” (DR05) Another participant highlighted the added stress of seeking radiologist interpretation while simultaneously managing competing clinical demands: “Looking for specialists to help interpret the radiographs can be stressful, particularly when other patients are waiting to be attended to.” (DR04) Sub-theme 3: Impact on patient care and outcomes. Frontline doctors noted that in the absence of radiologist reports, diagnostic uncertainty increased. “…Once you don’t know, you resort to guesswork, which can lead to misdiagnosis.” (DR05) Some participants also linked the lack of timely radiological report to delayed treatment decisions and poorer clinical outcomes. “It affects the quality of care, because if there’s probably something in there which you could have identified, an immediate action would have been taken.” (DR07). These challenges were considered most acute in under-served regions. One participant stated: “… They [junior doctors] cannot make any major decisions because they’ll be waiting for a report from a qualified person, and so it’ll delay their interventions.” (DR03) Theme three: Support and training needs The third theme highlights the critical need for enhanced support and training in X-ray interpretation among frontline doctors. Sub-theme 1: Inadequate image interpretation training. Several participants highlighted inadequate radiology training in medical school curricula, which limited doctors’ ability to independently interpret imaging findings. “We were taught how to interpret these images, mostly chest X-rays but it was a semester course.” (DR01) “With the curriculum I believe it’s inadequate because the duration is very short.” (DR08) Sub-theme 2: Image interpretation strategies/support. Participants proposed strategies to address radiologist shortages, including improved radiology education during medical training and regular continuing professional development (CPD) to enhance image interpretation skills among non-specialists. “The basics at the MBCHB level should be reinforced so that it encourages more people to enter radiology training after school.” (DR02) “In medical school you just do it [radiology] for a short period… So, doctors need refresher courses, so that at least they can handle the basics and refer complex cases to radiologists.” (DR06) Some participants suggested leveraging the expertise of trained radiographers to provide preliminary image comments, particularly in facilities without radiologists to support junior doctors. “Some of them [radiographers] assist us interpret images, if they are given proper support, they can really assist us.” (DR07) Technology such as Artificial intelligence (AI), teleradiology and remote reporting systems were also endorsed as viable options. “Facilities could rely on artificial intelligence and teleradiology to overcome some of the challenges in accessing radiological reports.” DR01 As a long-term measure, some participants advocated for increased radiologist training and decentralization particularly in regional and district-level hospitals. “…There should be more training of specialists [radiologists] and then after, we should decentralize them to all the various regions.” (DR03) On the whole, participants emphasised the need for additional training opportunities and institutional support to improve clinicians’ ability to interpret radiological images when specialist input is not readily available. Discussion This study aimed to explore the experiences and perspectives of frontline medical doctors in Ghana regarding radiologist shortages and their implications for image interpretation, healthcare delivery, and patient care. The findings highlight substantial challenges in accessing timely radiological reports, which compromise diagnostic decision-making and place additional responsibility on frontline doctors. Role of radiological reporting in clinical care Participants emphasized the critical role of radiological reports in clinical practice, consistent with global literature identifying radiologist interpretation as essential to high-quality care [ 2 , 6 – 9 ]. While doctors regularly relied on imaging to inform decisions, many acknowledged limited training in image interpretation and expressed a strong preference for formal radiologist input, particularly in complex cases. In low-resource settings like Ghana, where diagnostic resources are limited, radiological reports play a pivotal role in clinical decision-making. However, this study found that X-rays are often provided without accompanying reports, a trend also observed in other low- and middle-income countries (LMICs) facing radiologist shortages [ 9 , 11 , 13 , 42 , 43 ]. This has led to task-shifting and increased reliance on clinician self-interpretation, which is associated with a higher risk of misdiagnosis, especially among junior doctors with limited experience [ 1 , 5 ]. Ensuring the consistent availability of radiologist reports is therefore essential for improving diagnostic accuracy, supporting clinical learning, reducing uncertainty, and enhancing patient outcomes. Barriers to accessing radiology reports Best practices recommend that radiological reports be delivered within 4 hours for urgent cases and 24 hours for non-urgent ones to support timely clinical management [ 44 ]. However, this goal is often unattainable in settings with a limited radiologist workforce [ 12 ]. Prolonged turnaround times for X-ray interpretation remain a global challenge to effective healthcare delivery [ 45 , 46 ]. This study identified several structural and systemic barriers to timely report access, key among them being the acute shortage of radiologists, particularly in district and regional hospitals. This gap results in delayed or absent reporting, compelling doctors to rely on limited imaging expertise, a trend consistent with evidence from sub-Saharan Africa, where radiologist-to-population ratios are critically low [ 4 , 8 , 9 , 19 , 47 ]. Even in facilities with radiologists, heavy workloads and competing duties often delay reporting [ 1 ]. Participants expressed frustration over diagnostic uncertainty and indicated instances where delays adversely affected patient outcomes. These findings imply that workforce shortages are not only numerical and but also functional [ 48 ]. Moreover, the lack of support systems, standardized reporting protocols, and the uneven geographic distribution of radiologists further compromise equitable access to quality care [ 49 ]. It is important to note that the interpretation challenges described in this study largely relate to plain radiography, which constitutes the most commonly available imaging modality in many Ghanaian healthcare facilities. Coping strategies and suggested solutions Frontline doctors reported relying on strategies such as consulting senior colleagues and drawing on limited undergraduate training in the absence of formal X-ray reports. However, these were seen as temporary solutions inadequate for ensuring diagnostic accuracy, especially in complex cases. The findings highlight the urgent need to expand CPD in image interpretation, consistent with previous studies [ 9 , 50 ]. Participants also stressed the importance of strengthening radiology education at the undergraduate level. Although included in medical curricula, radiology exposure is often minimal, leaving many graduates underprepared for independent interpretation [ 27 ]. Enhancing radiology instruction through structured clinical rotations and supervised practice could help develop foundational skills and reduce reliance on overburdened radiologist services. The findings of this study also highlight concerns regarding the level of radiology training and image interpretation preparedness among referring doctors. This issue is not unique to Ghana. Studies from several countries have reported that radiology education is often underrepresented within undergraduate medical curricula, resulting in many medical graduates feeling insufficiently prepared to interpret basic radiographic images independently [ 31 ]. Similar concerns have been raised in broader reviews of radiology education, which indicate considerable variability in how imaging is taught across medical schools and limited structured training in image interpretation for non-radiologist doctors [ 51 ]. These findings align with the experiences reported by participants in the present study, suggesting that strengthening radiology education during undergraduate medical training may be an important component of addressing diagnostic challenges in settings affected by radiologist shortages. Technology was widely proposed as a potential solution to radiologist shortages [ 10 , 52 ]. Teleradiology was especially highlighted for their ability to mitigate geographic disparities in radiologist availability, an observation consistent with literature demonstrating their feasibility and impact in LMICs [ 2 , 10 , 53 , 54 ]. Establishing reliable remote reporting systems could improve access to specialist interpretation and help address uneven workforce distribution [ 55 ]. However, successful teleradiology implementation requires coordinated national strategies, sustained investment in digital infrastructure, and capacity-building efforts to ensure effective and ethical use [ 56 – 58 ]. Participants also saw AI as a promising tool, particularly in low-resource settings, but emphasized the need for careful clinical, ethical, and contextual integration to ensure it supports rather than replaces professional judgment [ 2 , 56 ]. Participants advocated for radiographer involvement in image interpretation as a potential strategy to support doctors in facilities without radiologists. Emerging developments across Africa suggest a growing interest in radiographer role extension in image interpretation and reporting. For example, Uganda and Zimbabwe have implemented a structured training programme in plain film image interpretation as part of efforts to strengthen healthcare delivery [ 59 ]. In addition, there are ongoing discussions and exploratory initiatives in other countries within the region [ 11 , 13 , 16 , 53 , 60 ]. However, the extent to which these developments represent fully established clinical reporting roles remains unclear due to limited published evidence. Nevertheless, these regional trends highlight a broader recognition of the potential role of radiographers in supporting diagnostic pathways, particularly in contexts affected by radiologist workforce shortages. While formal radiographer clinical reporting remains limited in many African countries, several studies have also explored the potential role of radiographers in preliminary image evaluation as a strategy to support doctors in settings affected by radiologist unavailability. In these contexts, PIE typically involves radiographers providing initial written comments or opinions on radiographs to assist clinical decision-making [ 14 , 18 , 61 ]. Among the study participants, this model was viewed as a practical means to bridge gaps in image interpretation in remote and underserved areas [ 13 , 18 , 32 , 61 ]. Participants however emphasized that such approach would require clear regulatory frameworks, defined role boundaries, and targeted training to ensure competence and patient safety [ 35 ].` Furthermore, expanding the radiology workforce is a critical long-term strategy to address systemic shortages. Increasing the number of trained radiologists, alongside targeted incentives for deployment to underserved regions, could help reduce geographic disparities in access. Strengthening district and regional hospitals with modern radiological equipment may further attract and retain radiologists. Additionally, investing in CPD and clear career advancement pathways can enhance retention and support workforce sustainability. These measures collectively have the potential to strengthen diagnostic capacity, reduce delays in care, and improve patient outcomes across Ghana’s health system. Implications for health workforce planning and system reform Addressing radiologist workforce shortages requires more than increasing personnel, it calls for a comprehensive, systems-level approach to workforce planning, training, and task allocation. The challenges highlighted in this study point to broader systemic flaws within the healthcare system. These gaps hinder timely access to imaging interpretation services and place excessive pressure on frontline doctors, contributing to burnout and impaired clinical decision-making. Building a resilient diagnostic system necessitates strengthening radiology education, leveraging technologies such as teleradiology and AI, and enhancing the image interpretation skills of front-line medical practitioners. Sustainable solutions must be embedded within national health workforce frameworks and broader service delivery reforms to ensure equitable access to radiology services and enhance overall health system performance in resource-limited settings. Study limitations This study has several limitations that should be acknowledged. The qualitative design and relatively small sample size may limit the generalisability of the findings across all clinical settings in Ghana. Although data saturation was achieved, the purposive sampling approach may introduce selection bias, as participants with particularly strong views or experiences may have been more likely to respond. The exclusion of radiologists’ perspectives is another important limitation, as their insights could have enriched the analysis and offered a more comprehensive understanding of the systemic barriers and potential solutions to radiological reporting challenges. In addition, the study relied solely on self-reported data from doctors without triangulation through observation or institutional records, which may affect the objectivity of some findings. Future research should incorporate a broader range of stakeholder views to enhance evidence-based policy and practice. Additionally, future studies may also consider examining subgroup-specific experiences across different levels of healthcare or clinical roles to further enhance contextual understanding. Conclusion Radiologist shortages in Ghana have significant implications for timely image interpretation, diagnostic accuracy, and overall healthcare delivery. The findings highlight the challenges frontline medical doctors face in accessing radiological reports and the resulting impact on clinical decision-making and patient care. Addressing these challenges requires a multifaceted approach that includes strengthening the radiologist workforce, improving radiology training for referring clinicians, and expanding access to technologies such as teleradiology. Importantly, the findings also highlight the potential value of radiographer role extension, including preliminary image evaluation and the future development of reporting radiographers, as part of broader strategies to improve diagnostic imaging services in resource-constrained settings. Data Availability Due to ethical and confidentiality restrictions related to the qualitative interview data, the full interview transcripts cannot be made publicly available. De-identified excerpts relevant to the study findings are included within the paper. Additional de-identified data may be made available upon reasonable request and subject to approval by the University of Health and Allied Sciences Research Ethics Committee (UHAS-REC) via https://ihr.uhas.edu.gh/research-center/uhas-research-ethics-committee-uhas-rec . Data are stored in accordance with the University’s Research Data Management Policy to ensure confidentiality and security. Funding Statement The authors received no specific funding for this work. References 1. Jeganathan S. The Growing Problem of Radiologist Shortages: Australia and New Zealand’s Perspective. Korean J Radiol. 2023;24(11):1043–5. doi: 10.3348/kjr.2023.0831 [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 2. Mohammad R. Image interpretation and understanding in medicine. Imaging Med. 2024;16(6):254–5. doi: 10.47532/1755-5191.2024.16(6).254-255 [ DOI ] [ Google Scholar ] 3. Brady AP, Bello JA, Derchi LE, Fuchsjäger M, Goergen S, Krestin GP, et al. Radiology in the era of value-based healthcare: A multi-society expert statement from the ACR, CAR, ESR, IS3R, RANZCR and RSNA. J Med Imaging Radiat Oncol. 2021;65(1):60–6. doi: 10.1111/1754-9485.13125 [ DOI ] [ PubMed ] [ Google Scholar ] 4. Idowu BM, Okedere TA. Diagnostic Radiology in Nigeria: A Country Report. JGR. 2020;6(1). doi: 10.7191/jgr.2020.1072 [ DOI ] [ Google Scholar ] 5. RANZCR. Clinical radiology workforce census report: Australia. 2022. 6. Royal College of Radiologists. Unreported X-rays, computed tomography (CT) and magnetic resonance imaging (MRI) examinations: results of the September 2015 snapshot survey of English NHS acute trusts. Clin Radiol. 2015;:1–5. [ Google Scholar ] 7. Royal College of Radiologists. The radiology crisis in Scotland: sustainable solutions are needed now. 2017. https://www.rcr.ac.uk/posts/radiology-crisis-scotland-sustainable-solutions-are-needed-now [ DOI ] [ PubMed ] 8. Sarkodie BD, Ohene-Botwe B, Mensah YB, Tagoe E, Jimah BB, Brakohiapa EK, et al. Density and regional distribution of radiologists in a low-income country: the Ghana situation. Chin J Acad Radiol. 2023;6(4):188–95. doi: 10.1007/s42058-023-00130-z [ DOI ] [ Google Scholar ] 9. Ofori-Manteaw BB, Dzidzornu E. Accuracy of appendicular radiographic image interpretation by radiographers and junior doctors in Ghana: Can this be improved by training?. Radiography (Lond). 2019;25(3):255–9. doi: 10.1016/j.radi.2019.04.003 [ DOI ] [ PubMed ] [ Google Scholar ] 10. Kesselman A, Soroosh G, Mollura DJ. 2015 RAD-AID Conference on International Radiology for Developing Countries: The Evolving Global Radiology Landscape. J Am Coll Radiol. 2016;13(9):1139–44. doi: 10.1016/j.jacr.2016.03.028 [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 11. Bwanga O, Mulenga J, Chanda E. Need for Image Reporting by Radiographers in Zambia. mjz. 2020;46(3):215–20. doi: 10.55320/mjz.46.3.223 [ DOI ] [ Google Scholar ] 12. Neep MJ, Steffens T, Owen R, McPhail SM. Radiographer commenting of trauma radiographs: a survey of the benefits, barriers and enablers to participation in an Australian healthcare setting. J Med Imaging Radiat Oncol. 2014;58(4):431–8. doi: 10.1111/1754-9485.12181 [ DOI ] [ PubMed ] [ Google Scholar ] 13. Hazell L, Motto J, Chipeya L. The Influence of Image Interpretation Training on the Accuracy of Abnormality Detection and Written Comments on Musculoskeletal Radiographs by South African Radiographers. J Med Imaging Radiat Sci. 2015;46(3):302–8. doi: 10.1016/j.jmir.2015.03.002 [ DOI ] [ PubMed ] [ Google Scholar ] 14. Ofori-Manteaw B, Dzefi-Tettey K, Ofori EK. A sequential mixed-methods design for role extension research in radiography: Methodological Insights from a framework development study in Ghana. Radiography (Lond). 2026;32(3):103366. doi: 10.1016/j.radi.2026.103366 [ DOI ] [ PubMed ] [ Google Scholar ] 15. Brady AP, Loewe C, Brkljacic B, Paulo G, Szucsich M, Hierath M, et al. Guidelines and recommendations for radiologist staffing, education and training. Insights Imaging. 2025;16(1):57. doi: 10.1186/s13244-025-01926-6 [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 16. van de Venter R, du Rand S, Grobler T. Reporting of Trauma-related Radiographic Images in After-hours Trauma Units: Experiences of Radiographers and Medical Practitioners in the Eastern Cape, Republic of South Africa. J Med Imaging Radiat Sci. 2017;48(2):128–36. doi: 10.1016/j.jmir.2016.11.004 [ DOI ] [ PubMed ] [ Google Scholar ] 17. The College of Radiographers. The Radiography Workforce Current Challenges and Changing Needs. U.K.: College of Radiographers. https://www.sor.org/getmedia/d0bc53e1-a01d-4d23-90ac-541e842b1543/appg_a4_2.pdf [ Google Scholar ] 18. Ofori-Manteaw B, Ofori EK, Dzefi-Tettey K, Angmorterh SK. Ghanaian radiographers’ perspectives on participating in preliminary image evaluation: A qualitative study. J Med Imaging Radiat Sci. 2025;56(6):102087. doi: 10.1016/j.jmir.2025.102087 [ DOI ] [ PubMed ] [ Google Scholar ] 19. Okeji MC, Udoh BE, Onwuzu SWI. Appraisal of Reporting of Trauma Images: Implications for Evolving Red-Dot System in Nigeria. ARPN Journal of Science and Technology. 2012;2(6):2011–3. [ Google Scholar ] 20. Ofori-Manteaw B, Agyemang PN, Ofori EK, Angmorterh SK, Dzefi-Tettey K. A snapshot of unreported radiographs, image interpretation turn-around times and implications for radiography practice in a resource-constrained setting. J Med Imaging Radiat Sci. 2025;56(6):102108. doi: 10.1016/j.jmir.2025.102108 [ DOI ] [ PubMed ] [ Google Scholar ] 21. Wuni A-R, Courtier N, Kelly D. Opportunities for radiographer reporting in Ghana and the potential for improved patient care. Radiography (Lond). 2020;26(2):e120–5. doi: 10.1016/j.radi.2019.09.011 [ DOI ] [ PubMed ] [ Google Scholar ] 22. Weeks WB, Weinstein JN, Lavista JM. All Sustainable Development Goals Support Good Health and Well-Being. Int J Public Health. 2023;68:1606901. doi: 10.3389/ijph.2023.1606901 [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 23. Bhandari MP. What is next for the sustainable development goals, what are the challenges concerning SDG 10—reduced inequalities?. Sustainable Earth Reviews. 2024;7(1):23. doi: 10.1186/s42055-024-00093-8 [ DOI ] [ Google Scholar ] 24. Murphy A, Neep M. An investigation into the use of radiographer abnormality detection systems by Queensland public hospitals. J Med Radiat Sci. 2018;65(2):80–5. doi: 10.1002/jmrs.278 [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 25. Kim YW, Mansfield LT. Fool me twice: delayed diagnoses in radiology with emphasis on perpetuated errors. AJR Am J Roentgenol. 2014;202(3):465–70. doi: 10.2214/AJR.13.11493 [ DOI ] [ PubMed ] [ Google Scholar ] 26. Sprivulis P, Frazer A, Waring A. Same-day X-ray reporting is not needed in well-supervised emergency departments. Emerg Med (Fremantle). 2001;13(2):194–7. doi: 10.1046/j.1442-2026.2001.00211.x [ DOI ] [ PubMed ] [ Google Scholar ] 27. McLauchlan CA, Jones K, Guly HR. Interpretation of trauma radiographs by junior doctors in accident and emergency departments: a cause for concern?. Emergency Medicine Journal. 1997;14(5):295–8. doi: 10.1136/emj.14.5.295 [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 28. Shanafelt TD, West CP, Sinsky C, Trockel M, Tutty M, Satele DV, et al. Changes in Burnout and Satisfaction With Work-Life Integration in Physicians and the General US Working Population Between 2011 and 2017. Mayo Clin Proc. 2019;94(9):1681–94. doi: 10.1016/j.mayocp.2018.10.023 [ DOI ] [ PubMed ] [ Google Scholar ] 29. Siewert B, Brook OR, Hochman M, Eisenberg RL. Impact of Communication Errors in Radiology on Patient Care, Customer Satisfaction, and Work-Flow Efficiency. AJR Am J Roentgenol. 2016;206(3):573–9. doi: 10.2214/AJR.15.15117 [ DOI ] [ PubMed ] [ Google Scholar ] 30. Friloux L 3rd. The vital role of radiology in the medical school curriculum. AJR Am J Roentgenol. 2003;181(5):1428; author reply 1428. doi: 10.2214/ajr.181.5.1811428 [ DOI ] [ PubMed ] [ Google Scholar ] 31. Dmytriw AA, Mok PS, Gorelik N, Kavanaugh J, Brown P. Radiology in the Undergraduate Medical Curriculum: Too Little, Too Late?. Med Sci Educ. 2015;25(3):223–7. doi: 10.1007/s40670-015-0130-x [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 32. Ofori-Manteaw B, Omari G, Angmorterh SK, Ofori EK, Dzefi-Tettey K. Exploring radiographers’ readiness and perceived barriers to preliminary image evaluation in Ghana. Radiography (Lond). 2026;32(1):103225. doi: 10.1016/j.radi.2025.103225 [ DOI ] [ PubMed ] [ Google Scholar ] 33. Creswell JW. Research design: Qualitative, quantitative, and mixed methods approaches. 3rd ed. Sage. 2009. [ Google Scholar ] 34. Ofori EK, Angmorterh SK, Ofori-Manteaw BB, Acheampong F, Aboagye S, Yarfi C. An audit of MRI machines and services in Ghana. Radiography. 2020. doi: 10.1016/j.radi.2020.07.004 [ DOI ] [ PubMed ] [ Google Scholar ] 35. Wuni A-R, Courtier N, Kelly D. Developing a policy framework to support role extension in diagnostic radiography in Ghana. J Med Imaging Radiat Sci. 2021;52(1):112–20. doi: 10.1016/j.jmir.2020.09.013 [ DOI ] [ PubMed ] [ Google Scholar ] 36. Malterud K, Siersma VD, Guassora AD. Sample Size in Qualitative Interview Studies: Guided by Information Power. Qual Health Res. 2016;26(13):1753–60. doi: 10.1177/1049732315617444 [ DOI ] [ PubMed ] [ Google Scholar ] 37. Hennink M, Kaiser BN. Sample sizes for saturation in qualitative research: A systematic review of empirical tests. Soc Sci Med. 2022;292:114523. doi: 10.1016/j.socscimed.2021.114523 [ DOI ] [ PubMed ] [ Google Scholar ] 38. Saunders B, Sim J, Kingstone T, Baker S, Waterfield J, Bartlam B, et al. Saturation in qualitative research: exploring its conceptualization and operationalization. Qual Quant. 2018;52(4):1893–907. doi: 10.1007/s11135-017-0574-8 [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 39. Ahmed SK, Mohammed RA, Nashwan AJ, Ibrahim RH, Abdalla AQ, M. Ameen BM, et al. Using thematic analysis in qualitative research. Journal of Medicine, Surgery, and Public Health. 2025;6:100198. doi: 10.1016/j.glmedi.2025.100198 [ DOI ] [ Google Scholar ] 40. Ahmed SK. The pillars of trustworthiness in qualitative research. Journal of Medicine, Surgery, and Public Health. 2024;2:100051. doi: 10.1016/j.glmedi.2024.100051 [ DOI ] [ Google Scholar ] 41. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–57. doi: 10.1093/intqhc/mzm042 [ DOI ] [ PubMed ] [ Google Scholar ] 42. Mung’omba B, Botha ADH. Core competencies of radiographers working in rural hospitals of KwaZulu-Natal, South Africa. Afr J Prim Health Care Fam Med. 2017;9(1):e1–8. doi: 10.4102/phcfm.v9i1.1389 [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 43. Murphy A, Ekpo E, Steffens T, Neep MJ. Radiographic image interpretation by Australian radiographers: a systematic review. J Med Radiat Sci. 2019;66(4):269–83. doi: 10.1002/jmrs.356 [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 44. Australian Council on Healthcare Standards. Australasian Clinical Indicator Report 2004–2011. 2012:112–112. https://www.achs.org.au/media/50245/achs_clinical_indicators_report_web.pdf 45. Snaith B, Hardy M, Lewis EF. Radiographer reporting in the UK: A longitudinal analysis. Radiography. 2015;21(2):119–23. doi: 10.1016/j.radi.2014.10.001 [ DOI ] [ Google Scholar ] 46. Hardy M, Hutton J, Snaith B. Is a radiographer led immediate reporting service for emergency department referrals a cost effective initiative?. Radiography. 2013;19(1):23–7. doi: 10.1016/j.radi.2012.11.002 [ DOI ] [ Google Scholar ] 47. Mollura DJ, Mazal J, Everton KL, RAD-AID Conference Writing Group. White paper report of the 2012 RAD-AID Conference on International Radiology for Developing Countries: planning the implementation of global radiology. J Am Coll Radiol. 2013;10(8):618–24. doi: 10.1016/j.jacr.2013.01.019 [ DOI ] [ PubMed ] [ Google Scholar ] 48. Aluttis C, Bishaw T, Frank MW. The workforce for health in a globalized context--global shortages and international migration. Glob Health Action. 2014;7:23611. doi: 10.3402/gha.v7.23611 [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 49. Boyer B, Huber K, Zimlichman E, Saunders R, McClellan M, Kahn C, et al. Advancing the future of equitable access to health care: recommendations from international health care leaders. Health Aff Sch. 2024;2(8):qxae094. doi: 10.1093/haschl/qxae094 [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 50. Stevens BJ, Thompson JD. The impact of focused training on abnormality detection and provision of accurate preliminary clinical evaluation in newly qualified radiographers. Radiography (Lond). 2018;24(1):47–51. doi: 10.1016/j.radi.2017.08.007 [ DOI ] [ PubMed ] [ Google Scholar ] 51. Linaker KL. Radiology Undergraduate and Resident Curricula: A Narrative Review of the Literature. J Chiropr Humanit. 2015;22(1):1–8. doi: 10.1016/j.echu.2015.09.004 [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 52. Shaw J, Abejirinde I-OO, Agarwal P, Shahid S, Martin D. Digital health and equitable access to care. PLOS Digit Health. 2024;3(9):e0000573. doi: 10.1371/journal.pdig.0000573 [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 53. Rugut D, Motto J. Kenyan radiographers’ willingness to train in image interpretation of the chest and musculoskeletal systems. IOSR Journal of Humanities and Social Science. 2017;22(8):58–61. doi: 10.9790/0837-22080115861 [ DOI ] [ Google Scholar ] 54. Tahir MY, Mars M, Scott RE. A review of teleradiology in Africa - Towards mobile teleradiology in Nigeria. SA J Radiol. 2022;26(1):2257. doi: 10.4102/sajr.v26i1.2257 [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 55. Coulborn RM, Panunzi I, Spijker S, Brant WE, Duran LT, Kosack CS, et al. Feasibility of using teleradiology to improve tuberculosis screening and case management in a district hospital in Malawi. Bull World Health Organ. 2012;90(9):705–11. doi: 10.2471/BLT.11.099473 [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 56. Geis JR, Brady A, Wu CC, Spencer J, Ranschaert E, Jaremko JL, et al. Ethics of artificial intelligence in radiology: summary of the joint European and North American multisociety statement. Insights Imaging. 2019;10(1):101. doi: 10.1186/s13244-019-0785-8 [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 57. Hansson SO, Fröding B. Digital Technology in Healthcare—An Ethical Overview. DISO. 2024;3(3). doi: 10.1007/s44206-024-00121-2 [ DOI ] [ Google Scholar ] 58. Stoumpos AI, Kitsios F, Talias MA. Digital transformation in healthcare: technology acceptance and its applications. Int J Environ Res Public Health. 2023;20(4). doi: 10.3390/ijerph20043407 [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 59. Kawooya MG. Training for rural radiology and imaging in sub-saharan Africa: addressing the mismatch between services and population. J Clin Imaging Sci. 2012;2:37. doi: 10.4103/2156-7514.97747 [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 60. Ekpo EU, Egbe NO, Akpan BE. Radiographers’ performance in chest X-ray interpretation: the Nigerian experience. Br J Radiol. 2015;88(1051):20150023. doi: 10.1259/bjr.20150023 [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 61. Ofori-Manteaw B, Angaag NA, Angmorterh SK, Dzefi-Tettey K, Ofori EK. Assessing Ghanaian radiographers’ competency in preliminary image evaluation: A pre- and post-test study. Radiography (Lond). 2026;32(1):103224. doi: 10.1016/j.radi.2025.103224 [ DOI ] [ PubMed ] [ Google Scholar ] PLOS Glob Public Health. doi: 10.1371/journal.pgph.0006456.r001 Decision Letter 0 Ilse Bloom Author information Copyright and License information Roles Ilse Bloom : Staff Editor © 2026 Ilse Bloom This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. PMC Copyright notice 26 Nov 2025 PGPH-D-25-02975 Radiologist workforce challenges and the burden of image interpretation in Ghana: Implications for healthcare delivery and patient care PLOS Global Public Health Dear Dr. Acheampong, Thank you for submitting your manuscript to PLOS Global Public Health. After careful consideration, we feel that it has merit but does not fully meet PLOS Global Public Health’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please note that we have only been able to secure a single reviewer to assess your manuscript. We are issuing a decision on your manuscript at this point to prevent further delays in the evaluation of your manuscript. Please be aware that the editor who handles your revised manuscript might find it necessary to invite additional reviewers to assess this work once the revised manuscript is submitted. However, we will aim to proceed on the basis of this single review if possible. The comments from the reviewer can be found below. In addition to their comments we would like to request the following: • Please include more detail on how participants were selected/recruited in the methods section. • Please upload a copy of the interview guide & COREQ checklist as supplementary files. • Please provide more detail on how the themes were developed. • Include further discussion of the study limitations. • If available, authors should provide the data requested by reviewer 1, or else at a minimum present more local/national/regional statistics in the Introduction/Discussion on the topics cited by the reviewer. Please review these comments and those provided in Reviewer 1's assessment below and make the appropriate revisions to your manuscript alongside a point-by-point response to the concerns raised. Please submit your revised manuscript by Jan 10 2026 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at globalpubhealth@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pgph/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. We look forward to receiving your revised manuscript. Kind regards, Ilse Bloom Staff Editor PLOS Global Public Health Journal Requirements: If the reviewer comments include a recommendation to cite specific previously published works, please review and evaluate these publications to determine whether they are relevant and should be cited. There is no requirement to cite these works unless the editor has indicated otherwise. Additional Editor Comments (if provided): [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions --> Comments to the Author 1. Does this manuscript meet PLOS Global Public Health’s publication criteria ? Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe methodologically and ethically rigorous research with conclusions that are appropriately drawn based on the data presented.--> Reviewer #1: Partly ********** -->2. Has the statistical analysis been performed appropriately and rigorously?--> Reviewer #1: Yes ********** -->3. Have the authors made all data underlying the findings in their manuscript fully available (please refer to the Data Availability Statement at the start of the manuscript PDF file)? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception. The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.--> Reviewer #1: Yes ********** -->4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS Global Public Health does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.--> Reviewer #1: Yes ********** -->5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)--> Reviewer #1: The manuscript is well written and investigates the critical challenges in accessing timely radiological reports in a low-resource setting, using Ghana as a case study. The core claim is that systemic barriers, primarily a severe radiologist shortage, lead to prolonged report turnaround times. This, in turn, forces frontline clinicians to rely on their own, often limited, image interpretation skills, resulting in a cascade of negative outcomes: compromised diagnostic accuracy, delayed treatment, increased diagnostic uncertainty, and an elevated risk of misdiagnosis. The manuscript positions this issue not just as a logistical bottleneck, but as a critical failure point in the clinical care pathway that disproportionately affects low- and middle-income countries (LMICs). However, its impact is limited by a lack of empirical data to quantify the scale and severity of the problem it describes. The summary describes the findings but does not present the underlying data. A key weakness (e.g., actual average turnaround times, the frequency of report-less X-rays, rates of clinician-reported diagnostic uncertainty) to substantiate the powerful qualitative claims. All assertions about frequency and impact should be directly backed by the study's own data. Without knowing the population size at each of the participating hospitals, there is a risk that the findings, while likely representative, may be overgeneralized for the entire country or region. All assertions about frequency and impact should be directly backed by the study's own data. Key Areas Requiring Attention: The manuscript describes findings but lacks the underlying data necessary to quantify the problem's scale. To substantiate its powerful claims, it is preferable if it could include more detail: Quantitative metrics (if possible) such as average report turnaround times for different case urgencies. Data on the frequency and percentage of X-rays provided without an accompanying report (if possible). Systematically collected data on clinical impact, such as rates of diagnostic uncertainty or changes in treatment plan upon receiving the formal report (if possible). Justification for the sample size and the selection of participating hospitals. To ensure claims are appropriately scoped and supported: All assertions about the frequency and impact of the described challenges (e.g., "clinicians regularly relied," "prolonged turnaround times remain a global challenge") must be directly backed by the study's own data. The population sizes and clinical contexts of the participating hospitals should be provided to contextualize the findings and prevent overgeneralization for the entire country or region without sufficient evidence. ********** -->6. PLOS authors have the option to publish the peer review history of their article ( what does this mean? ). If published, this will include your full peer review and any attached files. Do you want your identity to be public for this peer review? If you choose “no”, your identity will remain anonymous but your review may still be made public. For information about this choice, including consent withdrawal, please see our Privacy Policy .--> Reviewer #1: No ********** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] -->Figure Resubmissions: -->-->While revising your submission, we strongly recommend that you use PLOS’s NAAS tool ( https://ngplosjournals.pagemajik.ai/artanalysis ) to test your figure files. NAAS can convert your figure files to the TIFF file type and meet basic requirements (such as print size, resolution), or provide you with a report on issues that do not meet our requirements and that NAAS cannot fix.-->--> After uploading your figures to PLOS’s NAAS tool - https://ngplosjournals.pagemajik.ai/artanalysis , NAAS will process the files provided and display the results in the "Uploaded Files" section of the page as the processing is complete. If the uploaded figures meet our requirements (or NAAS is able to fix the files to meet our requirements), the figure will be marked as "fixed" above. If NAAS is unable to fix the files, a red "failed" label will appear above. When NAAS has confirmed that the figure files meet our requirements, please download the file via the download option, and include these NAAS processed figure files when submitting your revised manuscript.--> PLOS Glob Public Health. 2026 Jun 3;6(6):e0006456. doi: 10.1371/journal.pgph.0006456.r002 Author response to Decision Letter 1 Article notes Copyright and License information Collection date 2026. PMC Copyright notice 14 Jan 2026 Attachment Submitted filename: Response to reviewers.docx pgph.0006456.s001.docx (21.7KB, docx) PLOS Glob Public Health. doi: 10.1371/journal.pgph.0006456.r003 Decision Letter 1 Helen Howard Author information Copyright and License information Roles Helen Howard : Staff Editor © 2026 Helen Howard This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. PMC Copyright notice 15 Mar 2026 PGPH-D-25-02975R1 Radiologist workforce challenges and the burden of image interpretation in Ghana: Implications for healthcare delivery and patient care PLOS Global Public Health Dear Dr. Acheampong, Thank you for submitting your manuscript to PLOS Global Public Health. After careful consideration, we feel that it has merit but does not fully meet PLOS Global Public Health’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please submit your revised manuscript by Apr 27 2026 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at globalpubhealth@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pgph/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A letter that responds to each point raised by the editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. We look forward to receiving your revised manuscript. Kind regards, Helen Howard Staff Editor PLOS Global Public Health Journal Requirements: If the reviewer comments include a recommendation to cite specific previously published works, please review and evaluate these publications to determine whether they are relevant and should be cited. There is no requirement to cite these works unless the editor has indicated otherwise. Additional Editor Comments (if provided): [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions --> Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.--> Reviewer #1: All comments have been addressed Reviewer #2: (No Response) Reviewer #3: (No Response) ********** -->2. Does this manuscript meet PLOS Global Public Health’s publication criteria ? Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe methodologically and ethically rigorous research with conclusions that are appropriately drawn based on the data presented.--> Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes ********** -->3. Has the statistical analysis been performed appropriately and rigorously?--> Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes ********** -->4. Have the authors made all data underlying the findings in their manuscript fully available (please refer to the Data Availability Statement at the start of the manuscript PDF file)? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception. The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.--> Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes ********** -->5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS Global Public Health does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.--> Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes ********** -->6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)--> Reviewer #1: Thank you for addressing all the comments and additional clarification. Reviewer #2: Peer review report Manuscript #: PGPH-D-25-02975R1 Thank you for the opportunity to review this interesting research. The manuscript has the potential to make a valuable and engaging contribution. However, several aspects of the work require further clarification and development before it is suitable for publication. Title: The title effectively reflects the topic and its implications; however, it does not identify the study population. Clarify whether the perspectives or experiences are those of radiologists, radiographers, or clinicians, and incorporate this information into the title. Abstract • State whether participants are from the public, private, or both sectors, as this could influence outcomes. • Please ensure consistency in terminology. In the aim, the term frontline clinicians (line 39) is used, whereas in the conclusion, front-line medical practitioners appear (Line 53). This inconsistency may confuse readers. • Under the results line 224, some participants suggested the need to introduce reporting radiographers like other Western countries and in Africa, Uganda and Zimbabwe (Approved in November 2025). This is an important point which is missing in the abstract. • Keywords should be arranged in alphabetical order (Line 57). Introduction • Line 82: The term “radiographers” is used; however, some are reporting radiographers trained in clinical reporting. Please be specific. • The aim stated in the abstract does not align with the aim in the introduction. The abstract uses the verb “explore”, whereas the introduction uses “examine”. The research aim should be stated consistently throughout the paper. The research aim should be more explicitly stated at the end of the introduction. • Please clarify whether image interpretation by referring clinicians in Ghana is limited to plain radiography (X-rays) or also includes advanced imaging modalities. This distinction should be clearly stated. This can be made in the introduction or discussion sections of the manuscript. • Important contextual information appears to be missing regarding the education and training in radiology of referring clinicians. Including details on medical doctors’ training and experience in radiology and image interpretation, both theoretical and practical, would strengthen the argument. This may include time allocated to radiology training. Additionally, the shortage of radiologists may result in greater emphasis on clinical service provision (reporting) than on clinical teaching, which is relevant to the study context. This may affect future clinicians. Materials and methods • What is qualitative descriptive study? Why was it used? State whether participants are from the public, private, or both sectors, as this could influence outcomes. • The description of the recruitment process lacks sufficient detail, particularly regarding sampling strategies. Please clarify how participants were selected. • It is unclear on what basis the interview guide was developed. • The claim of data saturation is not justified. Provide more details. E.g., contacting additional interviewees to avoid early termination of data collection. • The explanation of data analysis is incomplete. Please briefly outline all five relevant steps of Braun and Clarke’s six-phase thematic analysis framework. Additionally, clarify whether transcription and coding were conducted manually or using electronic tools. • Data collection and data analysis should be presented as distinct sections. Consider writing about each in separate paragraphs for clarity. This also applied to ethical considerations. How did the researchers applied the 4 ethical principles of autonomy, beneficence, non-maleficence and justice? • Trustworthiness strategies are not sufficiently described beyond peer debriefing. Include additional methods used to enhance credibility, dependability, confirmability, and transferability. You may use a table. Results • Line 134 does not address demographics but rather emerging themes. This content should be presented in a separate paragraph for clarity and logical flow. • The themes are well presented; however, the supporting explanations are limited. Expanding the narrative would help readers better understand the findings and follow the progression of ideas. • Consider presenting sub-theme names explicitly and consistently in the results section. For example: Sub-theme 1: Frequency of Imaging Requests. This approach would improve structure and readability. Discussion • Begin the discussion by restating the aim of the study to orient readers and frame the interpretation of the findings. • Lines 289 to 300- This section focuses on the establishment of reporting radiographers in Ghana. Consider strengthening the discussion by providing examples from other settings where this practice has been implemented and outlining its benefits. For instance, in November 2025, the scope of practice for radiographers in Zimbabwe was expanded to include clinical reporting, making it the second country in Africa, after Uganda, to implement this model. Additionally, countries such as South Africa, Zambia and Nigeria are currently exploring the establishment of reporting radiographers. Including such comparisons would provide regional context and support the relevance of your findings. • Education and training in radiology within medical schools require further discussion, as this appears to be a central issue. Consider comparing your findings with evidence from studies conducted outside Ghana to highlight similarities or differences in training experiences, competency development, and clinical preparedness. Conclusion • Among the strategies is the establishment of reporting radiographers. This is important to the development of quality imaging services. Reviewer #3: thank you for this important work. Abstract and introduction are clear and lead well into the study itself. There is a rationale for this study articulated. The methodology is appropriate and the rationale for the sampling strategy is well addressed. Interviewer bias and means to ensure credibility are addressed. Researcher triangulation seems to also have been used, although not named explicitly as such. A good point is made regarding the sufficiency of the sample size and this does not need to be changed for this article, however, consideration might be given in future to the sub divisions of the sample and considering the sufficiency of the sample within these. Further detail on the researchers’ approach would be useful – how many authors generated initial codes? What was the procedure in cases of discrepancy? Was there an impartial researcher also who was not involved in the interviews? Were the interviews conducted with one researcher present? Were any field notes taken to support transcription? It would be useful to have the script available as part of the paper also. Were there differences found in the perspectives of the various levels of experience of the doctors? It would be very useful to have a table to indicate the code and the year of experience of the clinician, however as there is only one interviewee in one experience band, I understand that this might not be appropriate. Comments from the previous review have been addressed and there has been significant changes made to the original submission. ********** -->7. PLOS authors have the option to publish the peer review history of their article ( what does this mean? ). If published, this will include your full peer review and any attached files. Do you want your identity to be public for this peer review? If you choose “no”, your identity will remain anonymous but your review may still be made public. For information about this choice, including consent withdrawal, please see our Privacy Policy .--> Reviewer #1: No Reviewer #2: No Reviewer #3: No ********** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] -->Figure Resubmissions: -->-->While revising your submission, we strongly recommend that you use PLOS’s NAAS tool ( https://ngplosjournals.pagemajik.ai/artanalysis ) to test your figure files. NAAS can convert your figure files to the TIFF file type and meet basic requirements (such as print size, resolution), or provide you with a report on issues that do not meet our requirements and that NAAS cannot fix.-->--> After uploading your figures to PLOS’s NAAS tool - https://ngplosjournals.pagemajik.ai/artanalysis , NAAS will process the files provided and display the results in the "Uploaded Files" section of the page as the processing is complete. If the uploaded figures meet our requirements (or NAAS is able to fix the files to meet our requirements), the figure will be marked as "fixed" above. If NAAS is unable to fix the files, a red "failed" label will appear above. When NAAS has confirmed that the figure files meet our requirements, please download the file via the download option, and include these NAAS processed figure files when submitting your revised manuscript.--> Attachment Submitted filename: Review report.docx pgph.0006456.s002.docx (20.5KB, docx) PLOS Glob Public Health. 2026 Jun 3;6(6):e0006456. doi: 10.1371/journal.pgph.0006456.r004 Author response to Decision Letter 2 Article notes Copyright and License information Collection date 2026. PMC Copyright notice 24 Mar 2026 Attachment Submitted filename: Response to reviewers updated new.docx pgph.0006456.s003.docx (28.6KB, docx) PLOS Glob Public Health. doi: 10.1371/journal.pgph.0006456.r005 Decision Letter 2 Julia Robinson Author information Copyright and License information Roles Julia Robinson : Staff Editor © 2026 Julia Robinson This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. PMC Copyright notice 27 Apr 2026 Radiologist workforce challenges and the burden of image interpretation in Ghana: Perspectives of frontline doctors and implications for healthcare delivery PGPH-D-25-02975R2 Dear MR Acheampong, We are pleased to inform you that your manuscript 'Radiologist workforce challenges and the burden of image interpretation in Ghana: Perspectives of frontline doctors and implications for healthcare delivery' has been provisionally accepted for publication in PLOS Global Public Health. Before your manuscript can be formally accepted you will need to complete some formatting changes, which you will receive in a follow up email. A member of our team will be in touch with a set of requests. Please note that your manuscript will not be scheduled for publication until you have made the required changes, so a swift response is appreciated. IMPORTANT: The editorial review process is now complete. PLOS will only permit corrections to spelling, formatting or significant scientific errors from this point onwards. Requests for major changes, or any which affect the scientific understanding of your work, will cause delays to the publication date of your manuscript. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they'll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact globalpubhealth@plos.org. Thank you again for supporting Open Access publishing; we are looking forward to publishing your work in PLOS Global Public Health. Best regards, Julia Robinson Executive Editor PLOS Global Public Health *********************************************************** Reviewer Comments (if any, and for reference): Reviewer's Responses to Questions --> Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.--> Reviewer #2: All comments have been addressed Reviewer #3: All comments have been addressed ********** -->2. Does this manuscript meet PLOS Global Public Health’s publication criteria ? Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe methodologically and ethically rigorous research with conclusions that are appropriately drawn based on the data presented.--> Reviewer #2: (No Response) Reviewer #3: Yes ********** -->3. Has the statistical analysis been performed appropriately and rigorously?--> Reviewer #2: (No Response) Reviewer #3: Yes ********** -->4. Have the authors made all data underlying the findings in their manuscript fully available (please refer to the Data Availability Statement at the start of the manuscript PDF file)? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception. The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.--> Reviewer #2: (No Response) Reviewer #3: No ********** -->5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS Global Public Health does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.--> Reviewer #2: (No Response) Reviewer #3: Yes ********** -->6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)--> Reviewer #2: I have carefully reviewed the revised version of the manuscript. The authors have addressed all previously raised concerns and implemented the necessary corrections thoroughly. In my opinion, the manuscript is now suitable for publication, and I recommend its acceptance. Reviewer #3: Thank you for this revised version of the manuscript. Chages have been appropriately made. I feel that the interview script (that is, the questions asked to the interviewees, rather than the transcript of their responses), should be included. I feel that this will strengthen the work. All other comments of mine are addressed. Thank you. ********** -->7. PLOS authors have the option to publish the peer review history of their article ( what does this mean? ). If published, this will include your full peer review and any attached files. Do you want your identity to be public for this peer review? If you choose “no”, your identity will remain anonymous but your review may still be made public. For information about this choice, including consent withdrawal, please see our Privacy Policy .--> Reviewer #2: No Reviewer #3: Yes: Dr Clare Rainey ********** Associated Data This section collects any data citations, data availability statements, or supplementary materials included in this article. Supplementary Materials Attachment Submitted filename: Response to reviewers.docx pgph.0006456.s001.docx (21.7KB, docx) Attachment Submitted filename: Review report.docx pgph.0006456.s002.docx (20.5KB, docx) Attachment Submitted filename: Response to reviewers updated new.docx pgph.0006456.s003.docx (28.6KB, docx) Data Availability Statement Due to ethical and confidentiality restrictions related to the qualitative interview data, the full interview transcripts cannot be made publicly available. De-identified excerpts relevant to the study findings are included within the paper. Additional de-identified data may be made available upon reasonable request and subject to approval by the University of Health and Allied Sciences Research Ethics Committee (UHAS-REC) via https://ihr.uhas.edu.gh/research-center/uhas-research-ethics-committee-uhas-rec . Data are stored in accordance with the University’s Research Data Management Policy to ensure confidentiality and security. Articles from PLOS Global Public Health are provided here courtesy of PLOS ACTIONS View on publisher site PDF (588.4 KB) Cite Collections Permalink RESOURCES Similar articles Cited by other articles Links to NCBI Databases Follow NCBI NCBI on X (formerly known as Twitter) NCBI on Facebook NCBI on LinkedIn NCBI on GitHub NCBI RSS feed Connect with NLM NLM on X (formerly known as Twitter) NLM on Facebook NLM on YouTube National Library of Medicine 8600 Rockville Pike Bethesda, MD 20894 Web Policies FOIA HHS Vulnerability Disclosure Help Accessibility Careers NLM NIH HHS USA.gov Back to Top

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