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. 2023 Sep 15;18(9):e0291454. doi: 10.1371/journal.pone.0291454

Table 5. Individual hospitals with Level 3, 2, and 1 care, personnel and additional services offered.

Hospitals are Randomly Assigned a Letter.

Treatment Level Hospital Region Additional treatment services offered beyond requirement for Level Hospital Personnel on staff at facility
Level 3* (NCCN Basic) A Central Chemotherapy
Aromatase Inhibitors
Sentinel Lymph Node Biopsy
Her2 Therapy
12 General Surgeons
1 Plastic Surgeon
2 Anesthesia Providers
36 General Practitioners
B Greater Accra Chemotherapy
Aromatase Inhibitors
1 General Surgeon
1 Plastic Surgeon
2 Anesthesia Providers
1 Oncologist
6 General Practitioners
C Greater Accra Aromatase Inhibitors
Breast Reconstruction
3 General Surgeons
1 Plastic Surgeon
3 Anesthesia Providers
20 General Practitioners
D Greater Accra Chemotherapy
Aromatase Inhibitors
Breast Reconstruction
2 General Surgeons
1 Plastic Surgeon
7 Anesthesia Providers
65 General Practitioners
E Greater Accra Chemotherapy
Aromatase Inhibitors
Her2 Therapy
8 General Surgeons
2 Plastic Surgeons
28 Anesthesia Providers
80 General Practitioners
F Northern Chemotherapy 7 General Surgeons
1 Plastic Surgeon
45 Anesthesia Providers
140 General Practitioners
G Western Aromatase Inhibitors
Breast Reconstruction
1 General Surgeon
9 Anesthesia Providers
1 Oncologist
6 General Practitioners
H Volta Chemotherapy 2 General Surgeons
4 Anesthesia Providers
10 General Practitioners
I Volta Chemotherapy
Aromatase Inhibitors
Her2 Therapy
6 General Surgeons
12 Anesthesia Providers
4 Oncologists
10 General Practitioners
Level 2 (NCCN Core) None n/a n/a
Level 1 (NCCN Enhanced) J Ashanti 22 General Surgeons
7 Plastic Surgeons
13 Anesthesia Providers
223 General Practitioners
K Greater Accra 25 General Surgeons
18 Plastic Surgeons
19 Anesthesia Providers
207 General Practitioners

Each level 3 hospital offered simple mastectomy, axillary lymph node dissection, and endocrine therapy with tamoxifen. Level 2 hospitals offer Level 3 service plus lumpectomy, sentinel lymph node biopsy, aromatase inhibitors, combination chemotherapy, radiation therapy. Level 1 hospitals offer all Level 1 and Level 2 services in addition to Her2 therapy and breast reconstruction.