In December 2023, floods and landslides in Hanang District, Northern Tanzania, caused severe casualties, infrastructure damage, and community displacement. We describe the public health emergency response and lessons learnt during this disaster to guide future mitigations.

Retrospective data collection during the disaster was made through quantitative (description of casualties) and qualitative (interviews and focus groups) approaches to provide insights into psychosocial support, coordination, and other response pillars. Microsoft Excel (2019) was used for quantitative data analysis, and MAX Qualitative Data Analysis was used to manage qualitative data.

Soft tissue injuries, bruises, and lacerations were the most common (60.43%), with 87.77% of casualties recovering and a notable fatality rate of 12.23%. Mental health and psychosocial support reached over 3300 individuals, offering depression assessments and family reconnections. Establishing a dual-level public health response team and implementing the Incident Management System demonstrated the country’s response efficiency.

The public health emergency response to the 2023 floods and landslides in Hanang District was largely effective. This demonstrated strong coordination, capacity, and resilience of Tanzania health system; however, the fatality rate highlighted a need for further investment to improve future disaster prevention, preparedness, and response.