Developing an Original Conceptual Model of Radiography Workforce Sustainability for Sub-Saharan African Health Systems: Evidence from Nigeria

Radiography workforce sustainability in sub-Saharan African health systems is threatened by a combination of production pipeline deficiencies, attrition, international emigration, geographic maldistribution, and training-deployment misalignment, yet no theoretically grounded conceptual model of workforce sustainability specific to the sub-Saharan African radiography context has been developed. This study develops an original conceptual model of radiography workforce sustainability using Nigeria as the primary empirical source. The model is developed through a sequential mixed-methods design comprising: an eighteen-month longitudinal tracking of 280 radiography graduates from twelve programmes across all six Nigerian geopolitical zones documenting employment trajectories, attrition events, and migration intentions; qualitative in-depth interviews with 45 senior radiographers, NRBN officials, and health ministry workforce planners providing systemic explanatory data; and a comparative document analysis of radiography workforce policies from Nigeria, Ghana, Kenya, and South Africa. Structural equation modelling in AMOS tests the proposed sustainability pathways. The original Radiography Workforce Sustainability Model integrates four interconnected subsystems: production adequacy, deployment equity, retention drivers, and regulatory governance. The model makes an original theoretical contribution by incorporating the African health system context factors of migration pressures, informal sectoral employment, and non-standard training pathways that are absent from existing workforce sustainability frameworks developed for high-income healthcare systems. Available radiography workforce literature from sub-Saharan Africa identifies fragmented workforce planning as the dominant structural sustainability challenge. Keywords: radiography workforce sustainability, conceptual model, sub-Saharan Africa, Nigeria, health workforce.