Accurate and complete clinical documentation is critical for delivering high-quality prostate cancer care, especially in settings with fragile health systems and a rising prevalence of non-communicable diseases. Inadequate data can compromise service efficiency, delay treatment, and negatively affect patient outcomes. This study assessed the quality of clinical notes for prostate cancer patients across five tertiary hospitals in Tanzania during 2022. A sequential mixed-methods design was applied, combining quantitative review of patient records with qualitative interviews. Data were extracted from both electronic and paper-based clinical notes, and in-depth interviews were conducted with 25 healthcare providers to understand the barriers to maintaining high-quality records. Quantitative analyses, performed using SPSS 27, focused on evaluating completeness and accuracy of documentation, while qualitative data were analyzed thematically using a hybrid inductive and deductive approach in NVivo 14. Results indicated significant gaps in the quality of clinical documentation. Although the overall accuracy of recorded variables was high (99.4%, n=1,494), key clinical information was often missing. Clinical stage was recorded in 70% (n=1,052) of cases, and Gleason score in 61.4% (n=923), whereas age, clinical presentation, and treatment type were consistently documented. Interviews revealed several factors contributing to poor data quality, including limited knowledge of documentation standards, fragmented data systems, staff shortages, lack of supervision, and the concurrent use of electronic and paper records. Integration between hospital-based cancer registries and the national Health Information Management System was notably absent. The findings underscore the need for targeted interventions to improve clinical note quality in Tanzanian prostate cancer care. Strengthening personnel capacity, improving system integration, and implementing structural reforms are critical steps toward ensuring comprehensive and reliable documentation, which is essential for effective patient management and improved health outcomes.
