Arthroscopy Resources and Service Availability in Tanzania: A National Multidomain Assessment

Background: Arthroscopy requires specialised personnel, equipment, and reliable supplies. Resource deficiencies have been documented in sub‑Saharan Africa, but national data from Tanzania are lacking. Objective: To assess arthroscopy resources and service availability in Tanzanian hospitals providing specialist orthopaedic care and examine differences by hospital tier and ownership. Methods: A national cross‑sectional survey was conducted between January and February 2025 using orthopaedic surgeons as key informants to provide hospital‑level data from their primary hospitals of practice. The hospital was the unit of analysis. Arthroscopy‑related resources were assessed across five domains: personnel, infrastructure, procedures, equipment, and supplies. Overall resource availability was summarised using a study‑specific Arthroscopy Resource Availability Score (ARAS) and compared across hospital tiers. Findings: A total of 171 orthopaedic surgeons responded (response rate, 77.7%), providing data on 92 hospitals. Seven hospitals (7.6%) offered arthroscopy services, six of which were in Dar es Salaam. Arthroscopy surgeons were available in eight hospitals (8.7%). Although anaesthesia, rehabilitation, and supporting surgical infrastructure were widely available, 75.0% of hospitals lacked arthroscopy instruments. Arthroscopy‑specific equipment, consumables, and implants were available in fewer than 15% of hospitals. Most facilities (83; 90.2%) had low resource availability (ARAS <50%). Median ARAS was 21.9% (IQR, 18.8–28.1), with higher scores in higher‑tier than lower‑tier hospitals (40.6% vs. 21.9%; P < 0.001). Hospitals offering arthroscopy were more likely to be higher‑tier facilities (RR, 5.2; 95% CI, 2.6–10.4; P < 0.001). Conclusions: Arthroscopy services were uncommon among the hospitals assessed and concentrated in higher‑tier facilities, predominantly in Dar es Salaam. Planning service expansion should consider coordinated workforce development, equipment maintenance, reliable supplies, and institutional support. Phased development through selected referral centres warrants consideration, although its feasibility and effectiveness require further assessment.