Journal ArticleThere are a number of efforts by the Tanzanian Government to promote accessible and equitable health services to deprived rural communities throughout the country. The government, among other things, has been mobilizing various stakeholders to contribute to the provision of health services to poor rural communities through community based health insurance schemes. However, the provision of health services, through health insurance schemes, continues to face poor response from the intended beneficiaries. Using a case of Monduli Juu Ward, this study explored rural communities‟ response towards Joining the improved Community Health Fund (iCHF). The study adopted a mixture of cross- sectional research design and Participatory Action Research (PAR). The collected data were analyzed by using SPSS and content analysis. Overall, the findings show that there are several issues that affect the extent of rural communities‟ response to joining the schemes. Lack of awareness and the prevalence of poverty among households have been proven to gravely block a number of households from joining the scheme. It is recommended that the government and other stakeholders should work closely with poor rural communities to create economic empowerment programs and massive awareness campaigns. The measures will enable the local communities to improve their socio - economic wellbeing as well as to awake them on the benefits they would have obtained by joining the iCHF. Finally, PAR is instrumental in the mobilization of communities for them to own the process.