Early identification and referral of children with disabilities in Mainland Tanzania: A qualitative study using the system level analysis approach

Summary

This paper presents findings from a qualitative study which examined the existing systems and services for early detection of disabilities and referral support for children with and at risk of disability in Mainland Tanzania. The research draws on face-to-face in-depth interviews and focus group discussions with purposely selected stakeholders, complemented by document review and stakeholder mapping.

Findings reveal challenges in coordination between government ministries and non-governmental organisations (NGOs), including inconsistent communication of policies and limited alignment between NGO-led efforts and national systems. Additionally, while international definitions of disability are formally adopted, their practical application differs across sectors, leading to uncertainty around eligibility for services. Stigma and misinformation at the community level further hinder early detection and care-seeking behaviours.

Furthermore, findings suggest that community health workers (CHWs), despite playing a vital role, often lack sufficient training and resources, and systems for documenting disability remain underdeveloped. The study underscores the need for enhanced inter-agency collaboration, improving data systems and stakeholder coordination and strategic investments in workforce capacity-building. Strengthening referral systems and empowering families to recognise early signs of disability are critical to improving outcomes.