Informal caregiver perspectives on mental health reported in studies from Tanzania – a scoping review

Background: Caring for people with mental health conditions has traditionally been a family issue. In industrialized countries, responsibility shifted in the early 19th century to large psychiatric institutions, often located in rural, tranquil settings where nature was considered therapeutic. More recently, policy has emphasized recovery-oriented, community-based models in which informal caregivers collaborate closely with healthcare professionals. In many low- and middle-income countries, limited formal services, shortages of trained staff, and long distances to care mean families remain the primary caregivers, often alongside traditional healers and religious leaders. Methods: This scoping review, conducted in accordance with Joanna Briggs Institute guidelines, synthesizes informal caregivers' perspectives on mental healthcare in Tanzania. A comprehensive search completed on June 30, 2025, across Embase, MEDLINE, PsycINFO, Web of Science, and Scopus identified 1795 unique records; 153 were reviewed in full. Of 95 Tanzania-focused articles, 12 examined informal caregiving. Results: The studies reported discontinuity of care and follow-up, limited access to psychotropic medications, transportation problems, and challenges managing patients' symptoms and behaviors. Informal caregivers described healthcare system constraints, including family violence, shortages of healthcare personnel, centralized services, medication scarcity, and weak infrastructure, which limit delivery of best practices, particularly in rural regions. Conclusion: Overall, mental health in Tanzania remains profoundly family-centred: informal caregivers are consistently present yet experience work overload, emotional distress, and unmet support needs. These findings underscore the importance of strengthening community-based services and integrating informal caregiver support.