# Climate-smart radiography in Ghana: training needs of diagnostic radiographers mapped to the WHO operational framework and UNFCCC Action for Climate Empowerment (ACE)

## TL;DR

This study identifies the training needs of radiographers in Ghana to adopt sustainable practices in line with global climate goals.

## Contribution

The study maps radiographers' training needs in Ghana to the WHO and UNFCCC frameworks for climate-smart healthcare.

## Key findings

- Most radiographers recognize sustainability's importance but lack confidence and training.
- Key training priorities include energy reduction, eco-friendly protocols, and waste management.
- Barriers include limited resources, knowledge, and management support.

## Abstract

Medical imaging contributes approximately 1% of global carbon emissions and 10% of healthcare waste. Diagnostic radiographers influence this impact through decisions related to energy use, waste generation, and sustainable practice adoption. This study examined the training and educational needs of diagnostic radiographers in Ghana regarding sustainable radiography and mapped these needs against the WHO Operational Framework (Component 2: Climate-Smart Health Workforce) and the UNFCCC Action for Climate Empowerment (ACE) pillars.

A descriptive cross-sectional online survey was conducted among 126 diagnostic radiographers in Ghana between December 2024 and April 2025, representing 72% of the calculated target sample size of 175. Participants completed a self-administered questionnaire via Google Forms, coordinated through the Ghana Society of Radiographers. Descriptive statistics and Spearman’s rank correlations (p < .05) were performed. The findings were interpreted as post-hoc using the WHO and ACE frameworks to identify alignment with global sustainability competencies.

Most participants (65.9%) were at least somewhat familiar with sustainability concepts, and 85.0% considered them highly relevant. However, only 35.7% felt very confident in eco-friendly practices. Nearly 40% had received no prior training, and over half reported no workplace programmes. Priority training areas included reducing energy consumption (75.4%), developing eco-friendly protocols (73.0%), and waste management (67.5%). Key barriers were lack of resources and funding (68.3%), limited knowledge (62.7%), and limited management support (61.9%). Familiarity correlated positively with confidence (ρ = 0.319, p < .001) and negatively with perceived knowledge gaps.

Radiographers in Ghana recognize the importance of sustainable radiography but face knowledge, training, and resource limitations that restrict implementation. Developing targeted, cost-effective, and context-specific training that are aligned with the WHO Operational Framework and UNFCCC ACE pillars is essential to strengthen capacity for climate-smart radiography in Ghana and comparable lower-middle-income countries.

The online version contains supplementary material available at 10.1186/s12913-025-13881-5.