Socio-Cultural Understanding of Schizophrenia among Caregivers in Meatu District, Tanzania

Introduction: Schizophrenia remains a major public health concern in rural Tanzania, where families carry the primary responsibility for long-term care. Local cultural beliefs, religious interpretations and everyday observations shape how caregivers recognise and respond to the condition. This paper explored the socio-cultural understanding of schizophrenia among caregivers in Meatu District. Methods: A qualitative case study design guided by the constructivist paradigm was used. Data were collected through interviews with 13 family caregivers in Mshikamano and Mwanbegwa villages of Mwanhuzi Ward. In-depth interviews with key informants and focus group discussions with selected participants were also included. Thematic analysis followed the six stages proposed by Braun and Clarke (2022). Key Findings: Caregivers recognized schizophrenia mainly through observable behavioral changes such as wandering, self-neglect, incoherent speech, hallucinations and aggression. Explanations of causes combined supernatural beliefs such as witchcraft, ancestral spirits, curses and spiritual attacks with psychosocial, biological and substance-related factors. These understandings influenced stigma, social exclusion and initial preference for traditional or religious help before biomedical care. Exposure to health services and observed improvement after treatment gradually increased acceptance of biomedical explanations among some caregivers. Conclusions: Local meanings of schizophrenia are socially constructed through everyday experience, cultural knowledge and interaction with formal health services. Strengthening community mental health education that engages existing beliefs can improve early recognition and support for affected families.