Dissertation (MA Public Administration)This study portrays about “The Role of Citizens in Determining Quality Health Services in Tanzania: A case of Kilosa District”. The intention of the study was to examine the extent to which the grassroots level through local government authorities were free to make their own operational decisions in planning and supervising their social services as provided through local government without much depending and intervention from the central government. The methodology for the study applied cross-sectional design, survey and participatory observation methods that involved administering questionnaires to the target group of the respondents. Interviews were also applied to various resourceful persons. There was also documentary search. All the remarks from the respondents have been incorporated in writing up this study. The results show that, majority of the respondents give the opinion that grass root citizens were free to determine the quality of social services with respect to health services at a little extent. This posses some challenges to improve the sector. This study recommends that there is a need to give more autonomy to the LGAs in terms of decision making and resource mobilization. The citizens fail to get supportive services on time and lack the ability to decide on the quality of services they need so that they can easily provided quality services from the service providers they depend on.