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85 Strengthening community-level systems for early childhood development in Tanzania: a qualitative systems thinking study

bmjpo · 2026-07-14 · canonical JSON source

1 visible annotations · policy: published · automated confidence ≥ 75.00%

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Rationale In Tanzania, there is significant political commitment to early childhood development (ECD) evidenced by development and implementation of a National Multi-sectoral ECD Programme. However, this has not yet translated into integrated ECD service delivery and access at the community level.Objectives This study aims to map community-level ECD systems and identify and understand the systemic barriers and enablers that influence access to integrated ECD services at the community level in Tanzania.Methods This formative qualitative research study is being conducted across four purposively selected regions of Tanzania, representing different geographical contexts, availability of ECD services, and Early Childhood Development Index 2030 performance. It involves focus group discussions and interviews with community-based ECD service providers and village leaders. Thematic analysis will be undertaken using both deductive and inductive methods. Using a systems lens, the study explores how access is shaped by formal and informal rules, everyday practices, resource flows, coordination, power dynamics, and prevailing mindsets. Participatory systems mapping and thematic analysis will visualise relationships and identify barriers, opportunities and possible solutions across settings.Results Data will describe community-level ECD systems and service provider perspectives of barriers and enablers to integrated ECD service provision and access. Data collection is scheduled for August 2025.Conclusions By capturing the perspectives of frontline workers, this study will generate practical insights to support more equitable and effective implementation of ECD policy. Findings will be relevant for other low- and middle-income countries working to close the gap between national commitments and community-level implementation.