{
  "abstract": "Formal healthcare utilisation remains persistently low across sub-Saharan Africa, yet utilisation patterns among individuals with mental health needs are poorly understood in low- and middle-income country contexts. Using data from the fifth wave of the Tanzania National Panel Survey (2020/21), this study examined patterns and determinants of formal healthcare utilisation among individuals aged 15 years and above with and without proxy-identified mental health need. A nationally representative cross-sectional sample of 11,891 individuals with non-missing outcome data was analysed. Proxy-identified mental health need was determined using the Washington Group Short Set item on difficulty remembering or concentrating at the severe threshold, a proxy associated with common mental disorders. The outcome was any formal provider visit in the four weeks prior to the interview, regardless of reason. Survey-weighted logistic regression estimated odds ratios and predicted probabilities within the Andersen Behavioural Model. Missing outcome data affected 505 individuals in a Missing Not At Random pattern; extreme bounds sensitivity analysis assessed implications for subgroup estimates. Overall weighted formal healthcare utilisation was 19.2%. Proxy-identified mental health need was observed in 54 individuals (weighted prevalence 0.45%). Female sex, older age (55 and above), and Southern Highlands zone residence were independently associated with higher utilisation. Household wealth showed a strong dose-response gradient: individuals in the richest quintile had 2.71 times higher adjusted odds than those in the poorest. Proxy-identified mental health need was not significantly associated with utilisation (adjusted odds ratio 1.27; 95% confidence interval: 0.53–3.04; p = 0.588). Extreme bounds analysis indicated that true utilisation could range from 2.0% to 92.7%, confirming subgroup findings are exploratory. Formal healthcare utilisation in Tanzania is strongly patterned by household wealth, sex, age, and geographic zone. Addressing wealth-related barriers and strengthening service availability in lower-utilisation zones should be the priorities for advancing equitable healthcare utilisation in Tanzania.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Business Management, Mbeya University of Science and Technology, Mbeya, Tanzania",
    "Department of Economics, University of Dodoma, Dodoma, Tanzania"
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Gallen Mlenge"
    },
    {
      "affs": [
        1
      ],
      "name": "Odass Bilame"
    },
    {
      "name": "Lutengano Mwinuka"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/0r2vzdbcat523.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pmen.0000644",
  "fulltext_url": "https://journals.plos.org/mentalhealth/article?id=10.1371/journal.pmen.0000644",
  "id": "0r2vzdbcat523",
  "issns": [
    "2837-8156"
  ],
  "landing_url": "https://journals.plos.org/mentalhealth/article?id=10.1371/journal.pmen.0000644",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "3207|Mental Health Treatment and Access"
    ],
    [
      "plos",
      "/Biology and life sciences/Neuroscience/Cognitive neuroscience/Cognitive neurology/Cognitive impairment"
    ],
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      "/Biology and life sciences/Neuroscience/Cognitive science/Cognitive neuroscience/Cognitive neurology/Cognitive impairment"
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      "plos",
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      "plos",
      "/Medicine and health sciences/Mental health and psychiatry"
    ],
    [
      "plos",
      "/Medicine and health sciences/Neurology/Cognitive neurology/Cognitive impairment"
    ],
    [
      "plos",
      "/People and places/Geographical locations/Africa/Tanzania"
    ],
    [
      "plos",
      "/Research and analysis methods/Research design/Survey research/Surveys"
    ],
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      "plos",
      "/Social sciences/Economics/Labor economics/Employment"
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      "/Social sciences/Human geography/Urban geography"
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  "openalex": "W7213465870",
  "pdf_url": "https://journals.plos.org/mentalhealth/article/file?id=10.1371/journal.pmen.0000644&type=printable",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-17",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/0r2vzdbcat523.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:49Z",
      "native_id": "10.1371/journal.pmen.0000644",
      "source": "plos",
      "url": "https://journals.plos.org/mentalhealth/article?id=10.1371/journal.pmen.0000644"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "plos:cognitive neuroscience",
      "subfield": "neuroscience"
    },
    {
      "field": "medicine",
      "origin": "plos:neurology",
      "subfield": "neurology"
    },
    {
      "field": "medicine",
      "origin": "plos:mental health and psychiatry",
      "subfield": "psychiatry"
    }
  ],
  "title": "Patterns and determinants of formal healthcare utilisation among individuals with and without proxy-identified mental health need in Tanzania: A cross-sectional analysis of the National Panel Survey",
  "title_text": "Patterns and determinants of formal healthcare utilisation among individuals with and without proxy-identified mental health need in Tanzania: A cross-sectional analysis of the National Panel Survey",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:49Z",
  "url": "https://research.draconitic.com/paper/0r2vzdbcat523",
  "venue": "PLOS Mental Health",
  "versions": []
}