{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T15:54:59Z","timestamp":1767887699540,"version":"3.49.0"},"reference-count":43,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005292","name":"Brigham and Women's Hospital","doi-asserted-by":"publisher","award":["126365"],"award-info":[{"award-number":["126365"]}],"id":[{"id":"10.13039\/100005292","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>Non-Communicable Diseases (NCDs), such as hypertension, diabetes, sickle cell disease, and rheumatic heart disease, pose significant health burdens in low-income countries, not the least rural Tanzania, exacerbated by limited healthcare infrastructure, human and financial resources. This paper reports the perspectives of key stakeholders on the strengths, weaknesses, opportunities, and challenges (SWOC) in managing and preventing non-communicable diseases (NCDs) in rural districts of Tanzania, prior to the implementation of the WHO PEN Plus model. Using qualitative methods through in-depth interviews and focus group discussions, the study gathered insights from community health workers, teachers, students, health officials, and community members across two districts of Kondoa and Karatu. Findings revealed strong knowledge about common NCDs and risk factors, such as poor dietary habits and heredity, but also highlighted little knowledge and misconceptions to specific NCDs category such as diabetes type one, sickle cell anaemia and rheumatic heart disease. The key challenges included the unavailability of diagnostic tools and medicines, inadequate healthcare resources at the primary care level, financial barriers to accessing services and little heath education. However, the study identified opportunities for strengthening NCDs management and prevention through existing health infrastructure, community health workers, and government commitment. The results underscore the need for enhanced training, improved healthcare access at the primary care facilities, and community-based interventions to address the growing NCDs burden in Tanzania\u2019s rural districts.<\/jats:p>","DOI":"10.1371\/journal.pgph.0005701","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T18:53:58Z","timestamp":1767639238000},"page":"e0005701","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Stakeholders\u2019 perspectives on the management and prevention of non-communicable diseases in rural Tanzania: SWOC analysis prior to PEN Plus implementation"],"prefix":"10.1371","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9131-1784","authenticated-orcid":true,"given":"Elizabeth H.","family":"Shayo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8171-7094","authenticated-orcid":true,"given":"Peter M.","family":"Karoli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katunzi","family":"Mutalemwa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zenais","family":"Kiwale","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4465-5618","authenticated-orcid":true,"given":"Lucy E.","family":"Mrema","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8155-5144","authenticated-orcid":true,"given":"Gibson B.","family":"Kagaruki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0928-8149","authenticated-orcid":true,"given":"Reuben","family":"Mutagaywa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7073-1122","authenticated-orcid":true,"given":"Pilly","family":"Chillo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aidan","family":"Banduka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelvin","family":"Madyo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3880-6320","authenticated-orcid":true,"given":"Edna S.","family":"Majaliwa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stella","family":"Malangahe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renatus","family":"Nyarubamba","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther","family":"Mtumbuka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Mallya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deogratias","family":"Soka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heriel","family":"Zacharia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agnes","family":"Jonathan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emiliana","family":"Donald","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"Mayige","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,1,5]]},"reference":[{"key":"pgph.0005701.ref001","volume-title":"Noncommunicable diseases progress monitor","author":"WHO","year":"2020"},{"key":"pgph.0005701.ref002","unstructured":"Meyrowitsch DW, Bygbjerg IC, Meyrowitsch D, Med D. 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