Global Audiology/Africa/Tanzania

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General Information

The United Republic of Tanzania, is a country in East Africa within the African Great Lakes region, located along the eastern coast of Africa with a long Indian Ocean shoreline. It includes the islands of Zanzibar and Pemba and shares borders with Kenya to the northeast, Uganda to the northwest, Rwanda, Burundi, and the Democratic Republic of the Congo to the west, Zambia and Malawi to the southwest and south, Mozambique to the south, and the Indian Ocean to the east. Tanzania is linguistically diverse, with more than 100 languages spoken, representing four of Africa’s major language families: Bantu, Cushitic, Nilotic, and Khoisan.

History of Audiology

Incidence and Prevalence of Hearing Loss

Like many low- and middle-income countries (LMICs), Tanzania faces a double burden of disease, with both infectious and non-communicable conditions contributing to hearing impairment. Infectious diseases such as malaria, meningitis, measles, and chronic otitis media, along with non-communicable conditions including hypertension, diabetes, congenital disorders, trauma, occupational injuries, and ototoxic exposure, all contribute to the burden of hearing loss. Occupational noise exposure is also a significant concern in industrial sectors such as mining, textiles, and metal fabrication.

The 2024 World Health Organization (WHO) report estimates that about 40 million people in Africa live with hearing loss. Hearing loss is economically costly, with the WHO estimating an annual burden of US$27 billion in the African region. The burden falls disproportionately on poor and rural communities.

Nationally representative data on hearing loss are still lacking, but hospital-based and occupational studies provide useful insight. A 2020 cross-sectional study conducted in Mwanza reviewed 6,234 patients at the ENT and audiology clinic. Five hundred and twenty-six patients (8.4%) had reduced or no ability to hear. Sensorineural hearing loss accounted for 51% and conductive hearing loss for 41%. Females were slightly more affected, and adults aged 40–59 years represented the largest group with sensorineural hearing loss. Common contributing factors included allergic rhinitis (38%), otitis media (34%), and impacted wax (9.5%).

A 2023 study at Muhimbili tertiary hospital screened 380 elderly patients and found age-related sensorineural hearing loss in 27.6% of participants. The hearing loss was predominantly bilateral, and severity increased with age. Associated factors included hypertension, diabetes, smoking, and ototoxic medication exposure. A 2018 study reported that 0.5% of Tanzanian neonates (5 per 1,000 births) had hearing loss, based on screening of about 600 newborns.

Occupational studies indicate a substantial burden among workers. Studies in industrial settings highlight the magnitude of the risk. For example, research among iron and steel factory workers reported an average noise exposure of 90.4 dB(A) and found that 85.5% of workers experienced a temporary threshold shift during a shift. Similar surveys in textile factories, gas-fired power plants, and cement plants have documented high levels of occupational noise exposure, with self-reported hearing loss ranging from 40% to 54% among workers. A cross-sectional study of Tanzanian miners analysing 246 audiograms found NIHL in 47% of workers, with prevalence increasing with years of exposure and underground miners being more affected than open-pit miners. Another study of iron and steel factory workers reported average personal noise exposure of 90.4 dB(A) and found that 85.5% developed a temporary threshold shift during a single shift. Previous research cited in the same article reported 48% NIHL among iron and steel workers, 40% hearing loss among textile workers, 53.8% subjective hearing loss among gas-fired power plant workers, and 54% among cement factory workers.

Despite legislation requiring hearing protection, surveys found very low or absent use of hearing protection devices in some workplaces. Children, industrial workers, older adults, and people exposed to recreational or environmental noise remain among the most vulnerable populations. In LMIC settings, preventable causes such as infections, ear disease, birth complications, and ototoxic exposure contribute substantially to childhood hearing loss.

Hearing Care Services

Professionals providing hearing care services

Tanzania continues to experience a significant shortage of hearing health professionals relative to its population size, although the workforce is stronger than older published surveys suggested (WHO, 2024). More than 56% of African countries have only one ENT specialist per million population, and more than three-quarters have fewer than one audiologist or speech therapist per million. Approximately 33 million Africans could benefit from hearing aids, but only about 10% receive them.

Earlier regional surveys reported very low numbers, but current (2026) raw national professional mapping indicates that Tanzania now has more than 100 ENT surgeons and about 29 hearing care professionals. These hearing care professionals include audiologists and other practitioners directly involved in hearing health service delivery. This figure is based on raw professional data that are not yet formally published, but it reflects current service realities more accurately than the older literature.

Even with this progress, the workforce remains inadequate for a population of nearly 69 million people, and professionals remain concentrated in major urban centres such as Dar es Salaam, Mwanza, Arusha, and a limited number of referral hospitals. In practice, hearing care is delivered by a mix of ENT surgeons, audiologists, speech therapists, audiology technicians, hearing aid specialists, ENT clinical officers, and community- based providers who identify and refer patients.

Audiological services

The absence of routine national neonatal hearing screening means many children are still identified only after delayed speech and language development becomes apparent. There are about 10 centres in the country performing newborn hearing screening. Newborn hearing screening remains limited to pilot settings, and school and occupational screening programmes are still intermittent.

Pure-tone audiometry and tympanometry are available in tertiary, regional hospitals and private clinics. Otoacoustic emissions and ABR testing are available at Muhimbili National Hospital and selected centres in Dar es Salaam, supporting earlier diagnosis of paediatric hearing loss. A 2025 pilot of smartphone-based Ear and Hearing Care (EHC) modules trained 24 primary healthcare workers, with post-training assessments showing significant improvements in ear anatomy knowledge, cerumen extraction, infection control, otoscopy, and paediatric referral protocols.

Hearing rehabilitation

Hearing aid services have expanded over the past decade. HearWell Audiology Clinic and other centres provide hearing assessment, fitting, follow-up, cochlear implant mapping, and counselling. Uptake of hearing aids is improving, but affordability, stigma, and limited subsidy mechanisms remain barriers. Cochlear implant services are now available locally, and post-implant follow-up has become more feasible within the country. Aural rehabilitation, including speech therapy, auditory training, and family counselling, remains essential but is still constrained by workforce limitations.

Services offered by otolaryngologists, otologists and otoneurologists

ENT surgeons diagnose and manage ear disease, including chronic otitis media, cholesteatoma, foreign bodies, tympanic membrane perforations, vestibular disorders, and other otologic conditions. They also perform cochlear implant surgery and collaborate with audiologists and speech-language professionals in rehabilitation pathways. Despite the increase in specialist numbers, service demand remains high and access remains uneven across regions. Role of primary health-care providers and community health workers

Primary health-care providers play an important role in the early detection of ear disease, vaccination, basic counselling on ear hygiene, and referral of patients for further assessment. Community health workers may identify chronic ear discharge, impacted wax, or developmental concerns at household level and encourage care- seeking. The smartphone-based EHC training programme demonstrated that targeted training can improve knowledge and practical skills among primary healthcare workers. Integrating hearing screening into antenatal care, immunisation clinics, child health services, and school health systems could substantially improve early detection.

Laws and regulations related to hearing care services

Occupational noise regulations

The Tanzania Mining Act 2010 sets a workplace noise limit of 85 dB(A). The Occupational Health and Safety Act requires employers to conduct periodic medical examinations for workers exposed to hazardous noise and to provide hearing protection devices. However, implementation and compliance remain inconsistent.

Medical device regulation

The Tanzania Medicines and Medical Devices Authority (TMDA) regulates the registration and quality assurance of medical devices, including hearing aids and cochlear implant-related technologies. Importation and sale of hearing aids require regulatory approval, although market control and enforcement can vary.

Disability and inclusion policies

Tanzania’s Persons with Disabilities Act (2010) recognises the rights of people with disabilities, including those with hearing impairment, in relation to education, healthcare, employment, and participation. Implementation remains uneven, and accessibility supports such as sign language interpretation and captioning are still limited in many settings.

Education and professional practice

Education of professionals working in hearing care services

As of 2023 The main formal training pathway for audiologists in Tanzania is the Bachelor of Science in Audiology & Speech-Language Pathology offered at the Muhimbili University of Health and Allied Sciences (MUHAS). Entry requires principal passes in Physics, Chemistry, and Biology at A-level or equivalent entry through a relevant diploma pathway, and the programme lasts four years. This remains the principal degree-level audiology training programme in the country. MUHAS/CUHAS/KCMC also contributes to the training of medical doctors and ENT specialists. In addition, short courses for technicians, hearing aid personnel, and targeted service providers are sometimes supported by private clinics and international partners. Professional development opportunities include workshops and continuing education activities organised by the Cochlear Implant Group of Tanzania, the Tanzania ENT Society (TENTS), HearWell Audiology Clinic, and international partners such as MED- EL,as of recent even Audiology Association of Tanzania in collaboration with TENTS, Smartphone-based EHC training tools have also emerged as useful models for strengthening the skills of primary healthcare workers.

Scope of Practice and Licensing

Audiologists and related hearing care professionals in Tanzania assess hearing and, where relevant, vestibular function; fit and verify hearing aids; support aural rehabilitation; participate in cochlear implant programming and follow-up; and provide patient and family counselling. ENT surgeons remain responsible for medical and surgical management of ear disease, including otologic surgery and cochlear implantation. Speech and language therapists contribute to rehabilitation, especially in children and post-implant care. Licensing and professional regulation for non-medical hearing care professionals are still developing, and practice structures may vary by institution.

Research in Audiology

Research on hearing loss in Tanzania is relatively limited but is steadily growing. Evidence has shown that hearing loss affects diverse population groups, including industrial workers, hospital patients, older adults, and newborns.

Hearing loss rates have been reported among patients attending tertiary hospitals, with sensorineural hearing loss being the most common type. Gaps in routine newborn screening and early identification systems have been highlighted as needed in hearing care. They are some of the challenges within the healthcare system itself, including limited awareness, training, and integration of audiology services. Newer technologies and approaches—such as mobile-based training tools—suggest potential pathways to improve capacity and access to ear and hearing care.

Professional and Regulatory Bodies

• Ministry of Health (MoH) – oversees health policy, planning, service development, and workforce direction.
• Medical Council of Tanganyika (MCT) – regulates and licenses medical practitioners, including ENT surgeons.
• Tanzania Medicines and Medical Devices Authority (TMDA) – regulates medical devices, including hearing aids and cochlear implant-related technologies.
• Occupational Safety and Health Authority (OSHA) – enforces workplace safety requirements, including those related to hazardous noise exposure and hearing protection.
• Audiology Association of Tanzania, the national professional association for hearing health professionals in Tanzania, was formally registered in 2024 as a hearing health professional association. This registration marked an important step in the formal organisation of the profession. The association plays a role in advocacy, public awareness, professional networking, standards development, and engagement with government and other stakeholders on hearing health matters.
• Tanzania ENT Society (TENTS) – represents ENT surgeons and supports the development of otolaryngology services and professional standards.

Challenges, Opportunities and Notes

Challenges

Tanzania’s hearing care sector continues to face major constraints:

1. Workforce limitations. Despite growth to more than 100 ENT surgeons and approximately 29 hearing care professionals, the workforce remains insufficient for the national population, and distribution is still highly urban-centred.
2. Limited screening coverage. OAE and ABR are available in only a limited number of centres, and national newborn and school hearing screening systems are not yet established.
3. Cost barriers. Hearing aids, cochlear implants, batteries, accessories, and long- term rehabilitation remain expensive for many families.
4. Occupational hearing health gaps. Workers in mining, manufacturing, and other noisy sectors continue to face hazardous exposure, and hearing conservation systems remain insufficient weak in many settings.
5. Public awareness and stigma. Delayed care-seeking remains common because hearing loss is often normalised, misunderstood, or stigmatised.
6. Policy integration challenges. Ear and hearing care is not yet fully integrated into primary healthcare, school health, and broader universal health coverage planning.

Opportunities

There are also important areas for progress:

1. Workforce expansion. Scaling up audiology and related training pathways can strengthen national capacity.
2. Primary care integration. Incorporating hearing screening and ear care into maternal-child health, immunisation, and school health programmes can improve early detection.
3. Occupational hearing conservation. Stronger enforcement, worker education, noise monitoring, and hearing protection programmes can reduce noise-induced hearing loss.
4. Technology and tele-audiology. Tele-support, smartphone-based screening tools, and digital training models can extend services into underserved areas.
5. Policy and financing. A national ear and hearing care strategy aligned with WHO priorities could improve planning, financing, and sustainability.
6. Community education. Public awareness campaigns and stigma reduction efforts can improve help-seeking and prevention.

Audiology Charities

A number of organisations support hearing care development in Tanzania:

• Cochlear Implant Group of Tanzania (CIGT). Established in 2013, CIGT coordinates cochlear implant services, rehabilitation, and capacity-building in collaboration with international partners.
• HearWell Audiology Clinic (Dar es Salaam). Founded in 2011, this private clinic provides hearing assessments, hearing aids, cochlear implant mapping, speech therapy, community outreach, and professional training.
• WFA Hearing Centre. Based in Dar es Salaam, the centre provides newborn and infant hearing screening, hearing assessment, hearing aid services
• Starkey Hearing Foundation / Hearing The Call. International NGOs have supported outreach, hearing aid donation, training, and service development in Tanzania, with varying emphasis on sustainability and local partnership.
• Zanzibar Outreach Programme (ZOP). Through work linked with the School for the Deaf and Mnazi Mmoja Hospital, this programme supports identification of deaf children, hearing aid access, and education.

References

External links

• Occupational Safety and Health Authority (OSHA Tanzania)
• Muhimbili University of Health and Allied Sciences (MUHAS, n.d.). Degree Programmes and Entry Qualifications.
• Tanzania ENT Society (TENTS)
• Tanzania Medicines and Medical Devices Authority (TMDA)
• Tanzania Ministry of Health (MOH)
• World Health Organization, 2024. Burden of hearing loss in Africa could rise to 54 million by 2030. WHO Africa news release. Burden of hearing loss in Africa could rise to 54 million by 2030: WHO report | WHO | Regional Office for Africa.

		Contributor to the original text
Dr. James Komanya

Edited by Nausheen Dawood