Advancing Radiographic Quality in Resource-Limited Countries: An Audit of Quality Assurance Practices in Ghana.

The article focuses on assessing the quality assurance (QA) and radiation protection practices in clinical radiography systems across Ghanaian diagnostic imaging facilities, with an emphasis on resource-limited settings. An empirical audit of 41 facilities and 43 digital radiography systems evaluated compliance with internationally harmonized QA and radiation protection guidelines, alongside quality control (QC) testing of x-ray exposure indicator (EI) metrics based on International Atomic Energy Agency (IAEA) protocols. Results showed high compliance in equipment maintenance and radiation safety gear but revealed significant gaps, including the near absence of comprehensive QA manuals, QA committees, pediatric immobilization devices, and local diagnostic reference levels. The study recommends strengthened regulatory oversight, increased involvement of clinically qualified medical physicists (CQMPs), and adoption of structured QA, QC, and radiation protection programs to enhance radiographic quality and safety in Ghana and similar resource-limited countries.