Influence of efficient internal financial controls on effective health service delivery systems in public hospitals in Uganda; case study: Jinja and Mbale Regional Referral Hospitals

Abstract

The study investigated the influence of internal efficient financial controls on effective health service delivery systems in public hospitals in Uganda.Specifically, the study examined the influence of implementation of financial policies (in terms of policy relevancy, policy support from management, policy penalties, and policy awareness), financial audit gaps (in terms of audit purpose, audit transparency, and audit recommendation action), and financial reports (in terms of report quality, report timeliness, report accessibility) on effective delivery of health services in two major referral hospitals in eastern Uganda.This study used a descriptive research design. To cater for both the qualitative and quantitative data, the study collected opinions/perceptions/viewpointsas well as figures, statistics, and numbers, respectively. Data was analysed using frequencies, Pearson’s product moment correlation coefficient and regression analysis.Frequencies are presented as both absolute numbers and percentages. A standard deviation approximately equal to zero means that the respondents did not vary in their opinions, while a standard deviation approximately equal to 1 means that respondents moderately varied in their opinions and a standard deviation much larger than 1 means that the respondents highly varied in their opinions.The majority of respondents were female and overall most of the respondents were between the age of 18 and 30 years. The majority of respondents had worked at the hospitals between 1 to 3 years, and most of the respondents were educated up to diploma level. The findings indicated that implementation of financial policies has a moderate positive influence on effective health service delivery in Uganda. The p-value for implementation of financial policies and effective health service delivery was less than 0.050 (=0.0001), given r=0.607, the study therefore, accepted the influence as statistically significant.Implementation of financial policies has significant influence on effective health service delivery (F=32.706, df = 1, p<0.05 (=0.000)). The findings indicated that financial audit gaps had a moderate positive influence on effective health service delivery in regional referral hospitals in Uganda. The p-value for implementation of financial audit gaps and effective health service delivery was less than 0.050 (=0.0001), given r=0.725, the study accepted the influence as statistically significant.Implementation of financial audit gaps had significant influence on effective health service delivery (F=61.977, df = 1, p<0.05 (=0.0001)). Financial reports have a positive influence on effective heath service delivery referral hospitals in Uganda at 0.050, P=0.0001), given r=0.422, the study therefore accepted the influence as statistically significant. Further findings from regression analysis revealed that financial reports had significant influence on effective health service delivery (F=12.104, df = 1, p<0.05 (=0.001)). The study concluded that implementation of financial policies, financial audit gaps and financial reporting have a significant influence on effectiveness of healthcare service delivery in the selected hospitals in Uganda. Therefore, the study recommends that referral hospitals in Uganda should invest more money in mechanisms to enforce financial policies, internal and external audit processes and train officers on financial management in order to ensure thorough and timely financial reporting.