Effective implementation of health interventions is critical for maximum adoption and optimal health outcomes. This qualitative study assessed the differences in Community Health Club (CHC) implementation in villages using qualitative research methods. Villages in Rusizi district in Rwanda were purposively selected with high, medium, and low adoption rates. The results revealed that the traits and skills of intervention facilitators (providers or implementers) at the village level, the involvement of the head of the village in the CHC intervention activities, and the support supervision by the Community Environmental Health Officer from the health center may have contributed to high rates of adoption of the intervention. Poor community organization, mistrust, lack of equal consideration among intervention beneficiaries, and lack of skills and capacity for intervention facilitators may have contributed to the low rates of intervention adoption. The results of this study suggest the need for capacity building of implementers, local leaders, and supervisors for improved (1) skills to adapt to local contexts and maximize the intervention adoption, (2) involvement and participation of local leadership, and (3) support supervision, guidance, and close monitoring, respectively. for effective implementation and maximum adoption of CHC intervention.