Table 1_Preparedness of the Ghana Health Service for field epidemiology and applied biostatistics: a systematic review of infectious disease surveillance, outbreak investigation methodologies, and statistical modeling capacities in resource-limited settings.docx

Searches were conducted in PubMed, African Index Medicus, AJOL, and Google Scholar, supplemented by grey literature, covering January 2000 to February 2026. Two reviewers independently screened 328 unique records, assessed 75 full-text articles, and included 38 studies with Ghana-specific disaggregated data. Quality was assessed using design-specific tools with transparent reconciliation into low, moderate, and high risk-of-bias categories.

Narrative synthesis was the principal analytic approach.</p>Results<p>Surveillance completeness ranged from 71% to 94% (median 82%); timeliness ranged from 48% to 91% (median 76%), with regional performance substantially exceeding district performance. The GFELTP produced 420 graduates from 2007 to 2017, representing 45% of WHO-benchmarked workforce requirements. Outbreak response times improved from 14 to 3 days for comparable outbreaks.

Laboratory capacity remained concentrated in 2 to 6 sentinel sites. No included study examined biostatistical modeling capacity. The 2017 WHO Joint External Evaluation rated overall IHR capacity at 67%.</p>Discussion<p>Ghana demonstrates advancing but incomplete preparedness.

Priority interventions should address workforce expansion, peripheral surveillance strengthening, laboratory decentralization, and indigenous biostatistical capacity development.</p>Systematic review registration<p>crd.york.ac.uk/PROSPERO/view/CRD420261299788, identifier: CRD420261299788.</p>