Mental health and behavioural problems in pre-primary school children in Tanzania and their association with age, gender, and location

This study examined mental health and behavioural problems among n = 403 Tanzanian pre-primary school children aged 5–7 years using the Strengths and Difficulties Questionnaire (SDQ) across 12 schools in three districts classified by location (high-, middle-, and low-performing districts based on educational performance). Overall, 41% of children scored in the abnormal range and 30% in the borderline range. Conduct problems (33%), peer difficulties (28%), and emotional problems (18%) were the most prevalent difficulties. Age differences were significant, with older children showing higher levels of mental health and behavioural problems, particularly in total difficulties, internalizing, and externalizing domains (Total Difficulties: F(2, 400) = 5.30, p = .006, η² = 0.025), whereas gender differences were non-significant (t = 0.98, p = .375, d = 0.17). Location significantly influenced outcomes, with children in low-performing districts exhibiting greater difficulties (F(2, 400) = 53.32, p < .001, η² = 0.120), suggesting that location-related disparities may be associated with children’s mental health and behavioural outcomes. Findings highlight the need for early, location-sensitive interventions, routine mental health screening, and targeted teacher training to support school readiness in Tanzanian pre-primary education.