Internal controls and service delivery in the health service sector of Uganda: A case of Masaka district local government
Abstract
This study looked at internal controls and service delivery in the health service sector of Uganda
with a case of Masaka District Local Government. Specifically the study reviewed control
environment, control activities, monitoring and evaluation and how they affected health service
delivery in District Local Governments.
The study adopted a case study design and had a study population of 202 and a sample size of
133 which was derived from the Krejcie and Morgan sampling table (1970). Stratified random
sampling method was used by the researcher in data collection.
The empirical data was analyzed both quantitatively and qualitatively to examine the relationship
between internal controls and health service delivery.
The key findings of the study indicated that internal controls i.e. control environment, control
activities, monitoring & evaluation have a positive and significant effect on health service
delivery. Therefore, it was concluded that control environment has positive effect on health
service delivery; control activities have a very strong positive relationship on health service
delivery; and monitoring & evaluation has a positive effect on health service delivery.
From the study, it was recommended that the existing internal controls be revised and
strengthened to further improve health service delivery; the controls be thoroughly reviewed and
adherence enforced; while monitoring & evaluation be carried out. It was recommended that
more investment should be devoted on control environment; keen attention should be employed
in improving activities like proper segregation of duties, performance reviews, physical controls,
risk mitigations, approvals, authorizations, proper management of human capital, budget
reviews, authorization lines, strict logins which would in turn enhance the health service sector,
and proper monitoring and evaluation in terms of risk identification, putting up measures to
control risk, carrying out periodic evaluations, audit reviews, availing more resources to
monitoring and evaluation activities, data quality assurance, continuous quality improvement
would enhance the health service sector of Uganda