Medication adherence is crucial for effective treatment outcomes among elderly populations in developing countries such as Tanzania. A mixed-methods approach combining quantitative surveys with qualitative interviews was employed, involving participants from four selected villages. The study revealed that only 35% of surveyed participants adhered consistently to their medication regimens, highlighting the need for improved adherence strategies. Despite challenges such as limited healthcare infrastructure and poverty, there is potential for enhancing patient engagement through tailored intervention programmes. Further research should focus on developing culturally sensitive adherence programmes and integrating them into existing healthcare structures. elderly populations, medication adherence, coastal Tanzania, mixed-methods study