Awareness of alcohol treatment options and barriers to treatment-seeking in Rombo District, Tanzania

Abstract Introduction Problematic alcohol use is a major public health concern in Tanzania, with particularly high prevalence in the Kilimanjaro region. Despite the availability of evidence-based alcohol treatment, the treatment gap remains wide, partly because awareness of available services is low, and individuals are unlikely to use services they do not know exist. This study aimed to assess the awareness of alcohol treatment options and identify barriers to treatment-seeking among adults in the Rombo district, Kilimanjaro, Tanzania. Methods A cross-sectional survey was conducted among 409 adults in the district. Awareness of treatment options was measured using a set of binary items, and a latent awareness index was constructed using item response theory (IRT). Ordinary least squares regression was used to identify factors associated with awareness, guided by Andersen’s Behavioural Model. Binary logistic regression estimated correlates of ever having sought treatment. Logistic regression results are presented as average marginal effects (AMEs) to improve interpretability. Reasons for not seeking help were described using proportions. Results/findings Awareness of treatment options was found to be low, with less than one in five respondents able to name a common treatment option. Higher awareness was associated with more years of schooling and belonging to a religion that restricts alcohol use. Lower awareness was observed among individuals raised by both parents, and current drinkers. Among problematic alcohol users, treatment-seeking was associated with higher awareness, greater alcohol severity, and being married. The most common reasons for not seeking help were lack of awareness, addiction, and lost hope. Conclusion With awareness of alcohol treatment options in the district critically low, particularly among current drinkers and those most in need, interventions to close the treatment gap should prioritise raising awareness through community-based education, engaging religious and family networks, and integrating routine screening for alcohol related consequences into primary healthcare.