This study systematically surveys 37 Technical and Vocational Education and Training (TVET) institutions in Ghana's Volta Region to examine the implementation of Competency-Based Training (CBT). Since the establishment of the National Technical and Vocational Education and Training Qualifications Framework, CBT has emerged as the primary reform model in Ghana. However, findings indicate that although 74.19% of institutions formally adopt CBT, substantial institutional weaknesses hinder its effective implementation, leaving graduates not fully prepared for the workforce. Notably, only 18.92% of institutions use simulated production-line assessments or engage industry co-assessors, and none offer enterprise resource planning training. Additionally, formal employment placement in garment factories averages only 20.70%, even among the most robust governance types. Grounded in institutional theory and skills ecosystem frameworks, this paper argues that a disconnect exists between the formal adoption of CBT and its practical application. Institutions maintain CBT's procedural elements primarily to secure accreditation while retaining traditional, craft-oriented teaching methods. A TVET Alignment Diagnostic Tool has been developed to evaluate institutional-industrial fit across six dimensions, revealing that no governance category aligns with the requirements of export-oriented garment manufacturing and that deficits are systemic. The study proposes a public-private co-governance model for TVET reform that emphasises demand-side accountability, outcome-based financing, and shared infrastructure, offering insights applicable to skills planning across Sub-Saharan Africa.