Occupational health and safety standards compliance among construction workers in West Africa: A systematic review of available evidence from Ghana and Nigeria

The construction industry remains one of the most dangerous sectors globally, with West African workers facing particular risks due to labour-intensive methods and limited regulatory enforcement. No previous systematic review has synthesized evidence on compliance with occupational health and safety (OHS) standards among construction workers in West Africa. We searched PubMed, IEEE Xplore, EBSCOhost, Science Direct and Google Scholar for quantitative studies published from June 2001 to August 18, 2026. Studies required extractable data on occupational health and safety compliance outcomes. Quality assessment used the JBI critical appraisal tool for cross-sectional studies. Studies rated as high risk of bias were excluded. Twelve cross-sectional studies met inclusion criteria: seven from Ghana and five from Nigeria. No eligible low- or moderate-risk studies from the other 14 West African countries were identified through this review. PPE use, access and provision varied substantially with helmet use 16.9%, hard-hat use 34.1% and respirator use of 1.7% during relevant tasks. 54.5% respondents in a Nigerian study reported that they did not wear a mask for silica-dust exposure. Welfare facilities were severely neglected, with flushable toilets on only 14.3% of sites. Safety knowledge and training were often more favourable than behavioural measures, but these constructs were not treated as equivalent to compliance. A study found that lack of safety training and inconsistent PPE use were associated with occupational injury, but the causality was not established. Factors associated with poorer compliance included younger age, lower educational level, casual employment, physical barriers and the absence of a construction‑specific regulatory framework. Evidence from Ghana and Nigeria identifies heterogeneous gaps across OHS compliance-related domains, particularly selected PPE practices, organisational implementation and welfare-facility provision. Knowledge, training, PPE availability and PPE use should not be interpreted as interchangeable compliance measures. Standardised multicountry observational studies and evaluations of proposed interventions are needed. Trial registration This systematic review followed PRISMA guidelines and was registered with PROSPERO (CRD420250649740).