One doctor, 10,000 children: Tanzania’s paediatric shortfall explained

The imbalance means that in many regions, a single paediatrician is responsible for more than 10,000 children, a ratio far below international standards and slowing progress in reducing child mortality.

According to the World Health Organisation, one paediatrician should care for no more than 50 children with complex health needs. In Tanzania, however, access to specialised care remains limited, particularly outside major urban centres.

The country’s health professionals told The Citizen that the shortage is one reason neonatal deaths, particularly those occurring within the first 28 days of life, continue to account for a significant share of under-five mortality. While Tanzania has made notable progress in reducing maternal deaths, improvements in newborn and child survival have been slower.

“This gap explains why preventable deaths still occur,” said Prof Pascal Rugajo, Dean of the Aga Khan University (AKU) Medical College in Tanzania. He noted that as maternal mortality declines, national health priorities are increasingly shifting toward strengthening specialised care for children.

Under President Samia Suluhu Hassan, maternal mortality reportedly dropped from about 556 deaths per 100,000 live births to around 104, a milestone that earned international recognition. However, specialists caution that achieving similar gains in child health will require significantly expanding the number of trained paediatricians.

Dr Elisamia Ngowi, one of the newly graduated paediatric specialists, said the current ratio is not sustainable. “One specialist cannot adequately serve thousands of children,” he said, adding that advanced training improves early diagnosis and management of complex childhood illnesses.