Community Health Fund (CHF) was established in 1996 as a District Council based pre-payment health insurance scheme in Tanzania with the aim of improving health of communities working in the informal sectors. However, since its formulation, it has been performing unsatisfactorily, and hence majority of Households (HHs) are not members while other members are withdrawing from the scheme. This necessitated the need for assessing the contribution of CHF on social health security among members. Specifically, this paper examined the challenges faced by households regarding CHF membership and analysed the contributions of CHF on its member. The study area was Kalambo District Council. A cross-sectional research design was used, whereas a simple random sampling technique through lottery method was employed to select the sample size of 354 respondents. Qualitative data were collected using Focus Group Discussions (FGDs) and Key Informant Interviews (KIIs), while quantitative data were collected using a questionnaire. Quantitative data were coded and analysed using IBM-SPSS. Qualitative data were analysed through content analysis. The results show that CHF contributed to social health security among its members in the study area, through provision of health services to its members once they fall sick. On other hand, CHF had few members as only 24.3% of HHs had membership to CHF. One of the barriers for CHF was lack of awareness among communities about the existence of CHF, while other cited lack of money for contributing to CHF. Thus, the study concludes that CHF has not contributed significantly to the health security among targeted members. The study recommends that, CHF officials should widely sensitize communities through seminars and meetings about CHF and its benefits to them. Furthermore, CHF stakeholders should coordinate communities in the area to establish financial institutions such as Village Community Banks (VICOBA) where they can save and borrow money for registration cards.

Community Health Fund (CHF) is one among health insurance schemes found in Tanzania. It was established in 1996 with the aim of improving the health of people who work in informal sectors. However, since its formulation, it has not performed well; the majority of HHs are not members, and some members are withdrawing from the scheme. The overall objective was to assess the attitude of community members towards the importance of CHF for health security. Specifically, the paper assesses the attitude towards CHF interventions among members and non-members of CHF and compares the attitude between members and non-members of CHF on health security. Cross sectional research design was used in this study. Simple random sampling technique using the lottery method was employed to select 354 respondents. Data were collected using a household questionnaire survey, Focus Group Discussions guide, Key Informant Interviews checklist and documents’ reviews. Descriptive statistics, inferential statistics and content analysis were used to analyze the data. The findings show that CHF has inclusive benefits to its members as it covers costs of health treatment rather than paying money every time they attend medical treatments. Furthermore, the attitude towards CHF among members and non-members was accounted for 9.3% and 51.9 negative, 2.3% and 4.1 neutral and 88.4 and 44.0 positive. This indicates that the majority of people in the study area had a positive attitude towards CHF services. Thus, the study concludes that a great proportion of members of CHF in Kalambo District have positive attitude towards CHF intervention while the majority of non-members have negative attitude towards CHF intervention because they were not aware of it due to lack of knowledge. It is recommended that the government should mainstream CHF intervention to all communities so that non-members can join the scheme and hence get better health services.  Also, the study recommends that the CHF service providers should put more emphasis on sensitising communities against negative attitudes from non-members of CHF.