Spectrum of neurodevelopmental disorders in children attending a developmental clinic in Dar es Salaam, Tanzania

Neurodevelopmental disorders (NDDs) in children present significant challenges for healthcare systems globally. In Tanzania, children with NDDs and their families face significant challenges due to late diagnosis, lack of standardized screening tools, widespread stigma and cultural beliefs that deter health-seeking behaviours. Awareness about NDDs is low, and financial constraints further complicate access to necessary medical interventions. The country suffers from a severe shortage of specialized healthcare providers, and general healthcare providers often lack adequate training. Additionally, limited specialized facilities, high treatment costs and insufficient healthcare policies dedicated to NDDs make it difficult to manage these conditions effectively. Understanding the demographics, clinical profiles and treatment needs of these disorders is crucial for planning and developing effective intervention strategies. This study aimed to identify the demographics, clinical profiles, management strategies and range of NDDs among children attending neurodevelopmental services over a 19-month period from September 2023 to March 2025. This was a cross-sectional study which analysed medical records of children attending a neurodevelopmental clinic in Dar es Salaam, Tanzania. The study population included children aged 0–14 years (developmental or chronological age) who presented with neurodevelopmental concerns during the study period. Data was collected on parental concerns, demographics, diagnoses, previous interventions, management strategies, along with data on the number of patients who attended follow-up clinics, thereby assessing the follow-up culture. Healthcare financing (medical insurance versus self-paying patients) was also captured. Descriptive analysis was done and data presented in tables and charts. In this retrospective review, most patients were males (78%) aged 3–6 years (44.5%), primarily from Kinondoni District (41.3%). The leading parental concerns involved speech delays (65.9%) and behavioural difficulties (50.5%), typically co-occurring. Autism Spectrum Disorder (58.2%) and Global Developmental Delay (64.8%) were the most frequent diagnoses. Speech therapy (84.6%), delivered via a multidisciplinary approach, was the most commonly recommended intervention. However, follow-up was poor (14%), and the majority of families paid out-of-pocket (61%) for services. Urgent efforts are needed to strengthen neurodevelopmental services through improved follow-up systems, subsidized care models, community awareness for early identification, and better integration of multidisciplinary care to enhance access and long-term outcomes for affected children.