Accessibility of essential medicines and vaccines among fisherfolk, artisanal miners and pastoralists in Mainland Tanzania: a qualitative study of barriers and strategies from the perspectives of healthcare professionals and community leaders

Objective To explore barriers and strategies related to accessibility of essential medicines and vaccines among fisherfolk, artisanal miners and pastoralists in mainland Tanzania from the perspectives of healthcare professionals and community leaders. Design Qualitative exploratory study using in-depth interviews. Data were collected between July and August 2025, audio-recorded, transcribed verbatim, translated from Kiswahili into English and analysed thematically using ATLAS.ti V.9. Setting The study was conducted at national, regional, district and community levels across three regions of mainland Tanzania representing pastoralist, artisanal mining and fisherfolk populations. Participants 18 purposively selected participants took part in the study, including healthcare professionals involved in pharmaceutical and immunisation services and community leaders. Selection was based on roles and experience relevant to the accessibility of essential medicines and vaccines among hard-to-reach populations. All 18 participants completed the interviews and were included in the analysis. Results Four broad themes related to accessibility emerged: geographic and transport-related barriers, health-system constraints, socio-cultural factors affecting the accessibility of essential medicines, together with strategies for improving accessibility. Participants described long travel distances, unreliable or costly transport, limited availability of services during weekends and at night and emergency transport limitations as important barriers to timely accessibility. Stigma and traditional beliefs also influenced healthcare-seeking and access to medicines and vaccines. Participants further described uneven distribution of health services and difficulties in reaching remote and mobile populations. Strategies identified to improve accessibility included outreach and mobile services, expanded health facility coverage, health education campaigns, emergency preparedness systems and inter-regional coordination mechanisms. Conclusion Healthcare professionals and community leaders identified geographic, transport, health-system and socio-cultural factors that may constrain the accessibility of essential medicines and vaccines among fisherfolk, artisanal miners and pastoralists in mainland Tanzania. Strengthening outreach and mobile services, expanding service coverage, improving emergency transport systems and addressing socio-cultural barriers may support more timely accessibility and promote Universal Health Coverage among these populations.