AbstractThis article presents the results of an assessment of prescribing practice, undertaken in the Morogoro region of Tanzania. As part of a wider evaluation of performance in primary level health units, retrospective data from patient registers and prospective data from observations of consultation practice were assessed using indicators proposed by the International Network of Rational Use of Drugs. Tanzanian prescribing practices compared favourably with other countries where studies using the same indicators have been undertaken. However, relatively high proportions of incorrect prescriptions were identified, with particular problems of under‐prescribing. Church units were also found to perform less well than government units against the indicators used; differences between the dispensary and health centre level were few. Actions to address the problems highlighted by this study include more careful monitoring and regulation of non‐government health care and identification of the root causes of under‐prescribing in government units. Review of prescribing practice using appropriate indicators is important in both cases, although also requiring wider regulatory action, health provider and patient education, and action to tackle the low morale of health wo