Barriers and Facilitators to Accessing Stroke Care Services in Tanzania: An Explorative Qualitative Study

Abstract

Introduction Stroke is a leading cause of death and disability globally, posing a significant burden in low- and middle-income countries (LMICs). The government of Tanzania has initiated public health campaigns to raise stroke awareness on non-communicable diseases and established acute stroke units in tertiary hospitals to bridge the stroke care gaps. However, lack of universal health coverage and underdeveloped primary healthcare infrastructures remain significant obstacles to delivering high-quality acute care services. Objective To explore barriers and facilitators to accessing acute stroke care services in Tanzania. Materials and Methods The study adopted a descriptive phenomenology design and included 45 purposively recruited healthcare providers, stroke survivors and care givers at Muhimbili National Hospital-Mloganzila (MNH-Mloganzila) in Tanzania. In-depth interviews were conducted from June to September, 2024. Inductive thematic analysis was performed using Dedoose software. The study was approved by the Institutional Review Board of Muhimbili University of Health and Allied Sciences (Ref. No. MUHAS-REC-04-2024-2139). Results Thematic analysis revealed five barriers and three facilitators to accessing acute stroke care services in Tanzania. The barriers included low health literacy, poor health seeking behavior, high costs related to stroke care access and utilization, inadequacy of essential healthcare resources for stroke care, and limitations in care process. The facilitators included improved healthcare delivery at the national hospital, availability of social support systems, and increased funding allocation for healthcare. Conclusion There is a need for raising public awareness on stroke symptoms, and increasing availability of medical supplies, diagnostics and stroke experts especially in primary healthcare facilities. Also, there is a need to explore the use digital platforms to connect primary healthcare facilities with tertiary hospitals to provide real-time teleconsultation services.