Conceptual paper

Abstract

The healthcare sector in developing countries is bedeviled with many problems, healthcare expenditure is rising in developing countries, but the corresponding increase in the efficiency of healthcare providers is disappointing. The reasons for these failures are multifaceted rangingfrom corruption, implementation problems of healhcare projects, lack of effective monitoring etc. Dissatisfaction with healthcare delivery systems in developing countries has heightened the call for strengthened accountability. Improved accountability in healthcare delivery systems in developing countries will ultimately lead to; improved healthcare service delivery, reduced corruption and increased efficiency in the use of resources. Internal and external audit reveiws of control procedures aredone in isolation.This paper argues that existing methods of assessing and enhancing accountability are ineffective and proposes Risk Based Internal auditing as a tool to improve financial and performance accountability in healthcare delivery systems in developing countries. A risk-based internal audit approach,will align a healthcare service provider’s risk profile with the strategic objectives of the provider and ensure only high risk areas are focused on. This approach as proposed in this paper, is intended to offer to the international community, donor agencies and governments of developing countries, an alternative way of enhancing accountability and an improved version of social accountability that is initiated by the development partners in developing countries.