Dissertation (MSc Public Health)Background: Community Health Fund (CHF) is the promising means for enhancing access to and utilization of the health services to the low social economic status societies in Tanzania. Little is known on the influence of Health care services utilization and perceived satisfaction on enrollment status to the Improved Community Health Fund (ICHF) among household. The government goal for 2015 was a 30% CHF enrolment among Tanzania HH. Only16.4% was achieved. The aim of this study was to explore the influence of Health care services utilization and perceived satisfaction on enrolment status to the Improved Community Health Fund among household. Methods: A cross sectional study design of randomly selected of 424 head of the household in three district council in Dodoma region. A self-administered questionnaire were used which was standardized tool adopted from previous studies. Descriptive analysis was used to establish status of enrollment, bivariate and multivariate logistic regression was used to establish determinant of enrollment status to the ICHF and the data analyzed by SPSS version 25.0 (chi-square and AOR at p< 0.05 was used as significance level). Results: Out of 424 of the respondents only 19.1% were enrolled to the ICHF. The high income households were 2.224 (AOR); p-value (0.034) at CI of 95% (1.063, 4.657) more likely to be enrolled to the ICHF as compared to very poor households. Regarding elderly, the households with more than two elderly aged 60 years and above were 2.986 (AOR); p-value 0.006 at the CI of 95% (1.373, 6.496) more likely to be enrolled to the ICHF as compared to the households with no elderly. Conclusion: The current study shows that there is low level of household enrollment to the ICHF and the strongest determinants were; wealth status, presence of elderly above 60 years, motivational benefits and availability of the HCs. Also there is significant difference on the level of perceived satisfaction among enrolled and unenrolled