Low- and middle-income countries (LMICs) experience recurrent public health emergencies, including infectious disease outbreaks, climate-related shocks and humanitarian crises, which expose persistent weaknesses in health system preparedness and response. Although resilience—defined as the capacity of health systems to anticipate, absorb, adapt to and recover from shocks—has gained increasing attention, there is no comprehensive synthesis of tools specifically designed to evaluate the resilience of public health emergency preparedness and response (PHEPR), particularly in LMICs contexts.

To identify, describe and critically appraise existing tools and frameworks used to evaluate PHEPR resilience, and to assess their methodological robustness, availability and applicability to LMICs health systems.

This systematic review protocol is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) 2015 statement and will follow the PRISMA 2020 reporting guideline. A comprehensive search will be conducted in PubMed, Scopus, Web of Science, WHO Institutional Repository for Information Sharing (IRIS), Africa Centres for Disease Control and Prevention repositories and relevant governmental and organisational platforms. Eligible sources will include peer-reviewed and grey literature published in English between 2005 and 2025 that describe, develop, validate or apply PHEPR resilience assessment tools. Two reviewers will independently undertake screening, full-text review and data extraction using a piloted 24-item extraction form. Methodological quality of empirical studies will be appraised using appropriate Joanna Briggs Institute critical appraisal tools, while resilience assessment instruments will be evaluated using structured qualitative criteria examining their conceptual foundations, development methods, validation evidence and implementation characteristics

Ethical approval was not required because this review will use publicly available literature. Findings will be disseminated through peer-reviewed publication, conference presentations and policy briefs to inform future development and implementation of resilience assessment tools for public health emergency preparedness and response in LMICs.

CRD420251243633.

To evaluate the availability of mental health services and resources across a stratified multistage sample of care and treatment clinics (CTCs) delivering HIV care from eight geographical zones of Tanzania.

Cross-sectional facility-based baseline survey.

81 CTCs representing national geographical zones and service delivery tiers.

Health facility in-charges or service providers with knowledge of HIV/non-communicable disease (NCD) services (Tier 1: n=11; Tier 2: n=13; Tier 3: n=9; Tier 4: n=48).

Availability of (1) trained mental health professionals, (2) screening/assessment tools for mental health and (3) educational materials.

Mental health services were unevenly distributed across facility tiers. Over half of Tier 1 facilities reported having trained mental health professionals (6/11; 54.5%) and screening tools (6/11; 54.5%), compared with only 35.4% (17/48) and 2.1% (1/48), respectively, in Tier 4 facilities. No Tier 2 or Tier 3 facilities reported availability of trained staff or screening tools. Educational materials were present in only 18.2% (2/11) of Tier 1 facilities and 8.3% (4/48) of Tier 4 facilities. Overall, more than two-thirds of facilities lacked any mental health resource assessed.

Mental health services remain limited across all facility levels, with nearly complete absence at lower-tier facilities. Urgent investment is required to integrate mental health into HIV and NCD care, especially at primary care settings.

Tanzania carries a dual burden of communicable and non-communicable diseases while remaining vulnerable to emerging pandemics of public health concern. Since its independence in 1961, Tanzania has implemented successive health reforms aimed at expanding access and moving towards universal health coverage (UHC). Despite notable progress, inequities in access, quality and financial protection persist. This review examined how policy evolution (1961–2025) addressed or reinforced inequities and the lessons for building resilience and equity in UHC.

We conducted a scoping review of national health policies, strategies, legislation and the related literature (1961–2025), following Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Eligible sources included government reports, strategic plans, evaluation reports and peer-reviewed or grey literature. Data were analysed using the Walt and Gilson Policy Triangle and mapped against the WHO Health Systems Building Blocks.

Out of 10 435 records identified, 60 documents met the inclusion criteria. Policy evolution reflected five broad reform episodes, ranging from postindependence centralisation to primary healthcare, structural adjustment and cost-sharing, sector-wide reforms and recent UHC-focused financing strategies. Reforms shifted from politically driven, top-down policies to participatory and evidence-informed approaches. Mapping showed progressive but uneven gains across service delivery, workforce, financing, governance, medicines and information systems. Six thematic shifts towards UHC were identified: fragmented to pooled financing, routine delivery to resilient systems, paper to digital systems, workforce numbers to distribution and skills-mix, state-only to mixed providers and expansion to effective coverage.

Tanzania’s reform trajectory illustrates adaptive progress, but persistent inequities in financing, workforce distribution and service access remain. Achieving equitable and resilient UHC will require stronger domestic financing, governance and primary care, with transferable lessons for other low- and middle-income countries.