Participation in Continuing Professional Development Among Radiographers in Lilongwe District, Malawi.

Background: Continuing Professional Development (CPD) enables healthcare workers to continuously update their medical knowledge, skills, and clinical practices, ultimately enhancing patient care, improving health outcomes, and maintaining professional competence. However, a significant gap remains in the literature regarding the specific challenges that affect radiographers' engagement in CPD from the perspectives of key stakeholders. Purpose: This study explored challenges to CPD participation in radiography from the triadic perspectives of radiographers, professional body, and employers. Methods: Utilizing a qualitative, multiple-case design in Lilongwe District, Malawi, a multi-stage purposive sampling matrix recruited participants across primary, secondary, and tertiary healthcare tiers. Verbatim data were subjected to thematic analysis and systematic horizontal and vertical cross-case comparisons via a master synthesis matrix. Results: Cross-case synthesis demonstrated that radiography CPD participation is heavily modulated by institutional healthcare tier rather than individual motivation. Disparate codes consolidated into a multi-level framework revealing critical vertical misalignments between macro-level regulatory standards, meso-level institutional resource constraints, and micro-level clinical workloads. Conclusion: Low radiography CPD engagement is a structural consequence of vertical misalignments across macro, meso, and micro strata. These findings establish a contextualized diagnostic baseline to inform future targeted clinical interventions and broader multi-district investigations.