In Tanzania, the majority of the population is located in rural area. National Health Policy in the country clearly advocating health for all, this is basically focused on ensuring no one is left behind regardless of any kind of marginalization, including; gender, disability and location (rural-urban). However, shortage and inadequate distribution of skilled human resources remained unfinished agenda that needed to be addressed. So, this chapter presents health system operations and improvement actions in Tanzania, highlights the current health outcomes, as well as discusses status of health care provision in rural communities in relation to the availability health professional in the areas. This chapter concludes that improving quality of health for majority requires provision of a fair balance of health services between rural and urban communities. As of now, the main bottleneck that President Samia Suluhu Hassan has to remove so as to improve the quality of health for majority is to; continue offering financial incentives and increasing health budgets to hire more health professionals in the areas; re-thinking about redistribution of these health professionals to overcome shortage in rural areas; changing the referral system so that all clinicians, including assistant medical officers, who make up the majority of clinical staff at rural health care facilities, to make referrals; as well as ensuring good communication between the referral facility and the tertiary care hospital in the districts.