Journal articleLower and Middle-Income Countries (LMICs) implement fiscal decentralization through Direct Health Facility Financing (DHFF) to empower Health Facility Governing Committees (HFGCs). The measure is designed to enable HFGCs to effectively participate in the planning, implementing and controlling health service delivery at primary health facilities. However, it is not empirically known what HFGCs members perceive to be determinants of the performance of these HFGCs under DHFF context. Drawing from community participation and decentralization literature, this study was conducted to assess the determinants of the HFGCs performance under DHFF as perceived by the HFGC members in four selected regions in Tanzania. A cross-sectional research design was employed to collect both qualitative and quantitative data from the four regions. The study has found that availability of finance to the health facility has RII 0.8964 score is ranked 1st important determinant of HFGC performance, followed by clarity of powers and functions with RII 0.8928 score (2nd) and communication between the HFGCs and community has RII 0.8792 score ranked third (3rd). This study concludes that contextual factors significantly influence the performance of HFGCs than HFGC members' characteristics in carrying out their devolved functions. The study recommends working environment for HFGCs to be improved for strengthening HFGCs performance.