Barriers to Child Protection and Mental Health Service Provision for Trauma-Affected Youth in Dar es Salaam, Tanzania

In Tanzania, limited mental health service availability and structural flaws in child protection reporting and justice processes lead to significant underreporting of child victimization. A better understanding of help-seeking behaviors for trauma-affected youth and sociocultural barriers to help-seeking will inform screening, triage, and intervention design and inform policy-level child protection service processes, including linkages to health services. Participants included 30 youth (7–17 years) with trauma experiences and 15 child healthcare professionals (CHPs) with experience treating trauma-affected youth in Dar es Salaam, the most populous region in Tanzania. In-depth qualitative interviews explored (1) current help-seeking behaviors and (2) barriers to help-seeking for trauma-affected youth. Thematic analyses were conducted within an inductive qualitative approach. Four major themes emerged: (1) youth-reporting patterns of victimization and mental health needs, (2) child protection and mental health care system capacity in Dar es Salaam, (3) consequences of non-reporting, and (4) youth and CHP recommendations. Results highlight predictors of underreporting, leading to self-directed coping and increased risk of further traumatization. Multichannel interventions are needed to provide universal child rights education, promote child reporting and procedural justice, expand mental health care access and provision, and ultimately reduce traumatization in urban Tanzanian youth.