Objectives: The objectives of this study were to assess community awareness and preferences on the alternative health financing mechanisms that have been introduced in the district. Design: A cross sectional, household survey Setting: Songea Rural District, Ruvuma Region South Western Tanzania Methods: Multistage random sampling procedure was used to select 6 villages that were included in the study. A total of 622 heads of households or their representatives were interviewed using an interviewer administered questionnaire. Computer data entry and analysis were done using EPI Info version 6.0 software programme. Results: Community awareness on the Community Health Fund (CHF) and User Fees were high i.e. 94.9% and 93.2% respectively, while awareness on National Health Insurance Scheme (NHIS) was relatively low at 34.6%. Most of the respondents used User Fees (81.4%) in financing their health care consumption and it was also the most preferred health financing mechanism (38.4%) followed by CHF (30.5%), however almost a fifth of the respondents, the majority of whom were peasants (95.0%) preferred getting "free care". Recommendations: Study recommendations include increasing community awareness on NHIS and ensuring proper identification of individuals who should be given fee waivers/ exemptions.
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