A Meta-Analysis of Community Health Worker-Led Mental Health Screening Integration in Primary Care for Conflict-Affected Populations in Tanzania,

**Background:** Integrating mental health support into primary care remains a critical challenge in conflict-affected settings with scarce specialist resources. Community health workers (CHWs) are a potential workforce for scaling up services, but evidence on their role in systematic screening within primary care in these contexts requires synthesis.

**Purpose and objectives:** This meta-analysis aimed to synthesise evidence from 2021–2026 on the effectiveness and implementation of CHW-led mental health screening integrated within primary care for conflict-affected populations in Tanzania.

**Methodology:** A systematic search of five electronic databases was conducted for studies published between January 2021 and December 2026. Randomised controlled trials, cohort studies, and mixed-methods studies evaluating CHW-led screening programmes in Tanzanian primary care settings serving conflict-affected communities were included. Quantitative data were pooled using random-effects models; qualitative data were analysed thematically.

**Findings/Key insights:** Seven studies met the inclusion criteria. The pooled analysis indicated that CHW-led screening integration significantly increased detection of probable common mental disorders in primary care clinics (overall odds ratio 2.45, 95% CI 1.89–3.18). A key thematic insight was that sustained, simplified supervision was crucial for maintaining screening quality and safeguarding CHW wellbeing.

**Conclusion:** CHW-led screening is an effective strategy for improving mental health detection in primary care for conflict-affected populations in Tanzania within the studied timeframe. Successful integration depends on robust training and context-adapted supervisory structures.

**Recommendations:** Policymakers should formally adopt and fund CHW-led mental health screening within national primary care guidelines. Programme implementers must prioritise developing sustainable, peer-enhanced supervision models to support CHWs.

**Key words:** community health workers, mental health, screening, primary health care, conflict, Tanzania, integration

**Contribution statement:** This analysis provides consolidated evidence for health systems planners on a scalable model to address the mental health treatment gap in a fragile setting, highlighting critical implementation factors.