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