Dissertation (MA Development Studies)This study aimed at assessing roles and challenges of decentralization by devolution on health service delivery at Dodoma Urban District. The specific objectives were, to examine the role of Decentralization by Devolution in health service delivery in Dodoma urban district, to examine challenges of decentralization by devolution in health service delivery in Dodoma rural district, to examine the reasons of the identified challenges of decentralization by devolution on health service delivery in Dodoma urban District. Cross-sectional survey design employed to undertake the research. The sample of 100 respondents was being selected purposively. Data were collected using questionnaires; interview and participatory observation and SPSS version 16 were used in the course of data analysis. The findings show that more than 60% of respondents were not aware on roles of decentralization by devolution on health service delivery this is due to top down approach during policy formulation. Decentralization by devolution faced several challenges such as massive poverty, burden of diseases, politicization of the process and lack of clear fiscal autonomy between the LGAs and CG. These challenges curtailed the provisions of health services in terms of affordability and accessibility. Poverty eradication strategy, education, participation, and commitment once instrumented the policy of decentralization by devolution will bare a positive result towards addressing the provisional of health service to majority of people at Dodoma rural District in timeless manner and quality manner.