Internal Auditing Quality and Accountability for Maternal Health in Government Hospitals in Uganda: A Case of Kalisizo General Hospital in Kyotera District

Abstract

This study investigated the contribution of internal audit quality to accountability practices in maternal health service delivery at Kalisizo General Hospital, Uganda. The study focused on three dimensions of internal audit quality: competence, independence, and management support. A descriptive cross-sectional survey design was employed, targeting a sample of 82 hospital staff, with data collected using structured questionnaires and analyzed using inferential statistics, specifically Pearson correlation analysis. The findings revealed statistically significant positive relationships between internal audit quality dimensions and accountability. Internal audit competence was significantly correlated with accountability (r = .642, p < .01), suggesting that higher qualifications, certification, and professional experience among auditors are associated with improved accountability practices. Internal audit independence also showed a significant positive correlation with accountability (r = .598, p < .01), indicating that unrestricted access, unbiased conduct, and freedom from management interference contribute to better oversight and transparency. Similarly, management support for internal audit was positively and significantly related to accountability (r = .675, p < .01), reflecting the critical role of funding, staffing, and implementation of audit recommendations. The study concludes that internal audit quality significantly influences accountability in maternal health service delivery. Strengthening auditor competence, safeguarding independence, and enhancing management support are essential strategies for improving governance and accountability in public health institutions.