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This paper examines children's potential access to school health services by analysing data on the demographic structure, enrolment patterns and reported causes of early school-leaving in 347 schools in Tanga Region, Tanzania served by a school-based health programme. The analysis indicates that net enrolment ratios have risen over the previous 6 years, particularly among children under 10 years. However, in 1994 children were still much older than expected for a basic school population: 81% were adolescents (≥10 years) and the mean age was 12 years. These data suggest that schools can provide equitable access to health education and school-based health services for a majority of children, even in a low-income country, and that the primary school population is predominantly adolescent and would benefit from health programmes targeted at that age group.