Introduction and background: The Community Health Fund (CHF) scheme was initiated in 1996 by the Government of Tanzania to make health care services accessible to people engaged in informal sector. Objective: The aim of this study was to determine the effects and challenges of CHF on accessibility to health care services in Songea District Council. Methods: A cross sectional study design which involved 88 respondents was adopted. In order to obtain the required data the study respondents included CHF managers, and members and non-members of CHF. Questionnaires, interviews and documentary reviews were employed as data collection tools in this study. SPSS version 20 computer programme was used to analyse quantitative data. The analysis of qualitative data involved content analysis approach. Results: After joining CHF 64.3% of all respondents have been attending to the health facility whenever they fall sick. The respondents given prescribed drug whenever they went to the health facilities constituted 30%. The challenges of CHF on accessibility to health care services included lack of comprehensive benefits package, inadequate medical supplies and equipment at the health facilities, inadequate skilled and motivated health providers, lack of local health facilities, lack of choice of providers and existence of out-of-pocket expenditure. Efforts made by the District to address identified challenges were ensuring adequate medical supplies and equipment at the health facilities; and ensuring adequate skilled and motivated health providers. Another effort was initiation of the process of introducing Compulsory Community Health Fund (CCHF). Conclusion: The study concludes that the effects of CHF on accessibility to health care services can be more realised if all stakeholders collaborate to address observed challenges. Moreover, this will encourage more people to join CHF since awareness among non-members is very high and they perceive it as a good system