ArticleBMJ open2026
Organisation and support of orthopaedic and trauma services in Tanzania: a national cross-sectional survey.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
designNational cross-sectional survey.
settingHospitals delivering orthopaedic and trauma services across all levels of care and ownership categories in Tanzania.
participantsLicensed orthopaedic and trauma surgeons practising in Tanzania served as key informants for their respective hospitals. A total of 171 surgeons provided data on 92 unique hospitals nationwide. PRIMARY OUTCOME MEASURES: Primary outcomes included orthopaedic departmental structural capacity, availability of multidisciplinary specialist support, external support mechanisms and in-hospital orthopaedic training activities.
resultsA response rate of 77.7% yielded data on 92 hospitals delivering orthopaedic and trauma services nationwide. Structural capacity varied widely, with only 19.6% of hospitals reporting more than 50 orthopaedic beds, 43.5% relying on a single orthopaedic surgeon, and 47.8% operating with one or two functional theatres. Access to specialist support was limited, with vascular trauma surgeons available in 9.8% of hospitals and plastic and reconstructive surgeons in 8.7%. Intensivists were available in 41.3% of facilities and anaesthesiologists in 57.6%, while physiotherapists were present in 90.2% of hospitals but occupational therapists in only 28.3%. External dependence was common, with 41.3% of hospitals relying on donated implants and 29.3% participating in outreach programmes. In-hospital orthopaedic training opportunities were limited, with seminars or workshops available in 25.0% of hospitals. Across domains, higher-tier hospitals demonstrated significantly greater structural capacity and specialist availability.
conclusionsOrthopaedic and trauma services in Tanzania are available across multiple levels of the health system but are characterised by inequitable workforce distribution, limited capacity at lower-tier hospitals and substantial reliance on external assistance. Integrated strategies linking infrastructure development, multidisciplinary workforce expansion, sustainable procurement and decentralised training are essential to strengthen the organisation and resilience of orthopaedic and trauma services nationwide.
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