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Tanzanian women spend more time overall than men on unpaid care work activities, and less on cash-earning work. This report presents the findings of research conducted in Tanzania as part of the ‘Balancing unpaid care work and paid work: successes, challenges and lessons for women’s economic empowerment programmes and policies’ research project. In particular, it reflects the voices and experiences of women and their household members who live across four rural districts in the Tanga region. The study finds that women in the region shoulder the majority of unpaid care work responsibilities, and struggle to balance these with paid work. Women therefore suffer the drudgery and physical and psychosocial stress of juggling paid work with unpaid work. Reasons for this include: the persistence of gender norms about who should do care work; the lack of public services essential to both the care and paid economies; and the low incomes earned by both women and men in these impoverished communities. The study highlights that intervention is needed to support a rebalancing of unpaid care with paid work. This could be achieved through: improved working conditions and pay; provision of childcare; public water or fuel services; gender-sensitive infrastructural development; and efforts to address gender-unequal social norms and values that proscribe the redistribution of care.