Abstract:
The effectiveness of internal audits is critical for ensuring accountability, transparency,
and resource management within healthcare Faith-Based Organizations (HFBOs),
especially those operating in resource-limited contexts. In Tanzania, HFBOs play an
essential role in healthcare delivery, managing significant resources and public funding.
Despite their importance, limited research addresses the effectiveness of internal audits
in these organizations, particularly in terms of professional competence, auditor
independence, and adherence to standards. This study investigates the effectiveness of
internal audits within selected HFBOs in Arusha City, Tanzania, using qualitative
methods to explore perceptions among auditors, management, and board members.
Employing a descriptive research design, data were collected from 80 respondents across
28 HFBOs through focus group discussions (FGDs). The study applied thematic analysis
to evaluate responses regarding professional competence, independence, and standards
adherence. Findings reveal key challenges, including limited ongoing training and
professional development, significant management influence on audit processes, and
inconsistent adherence to the International Standards for the Professional Practice of
Internal Auditing (ISPPIA). These issues are exacerbated by resource constraints and
outdated auditing procedures, which compromise the effectiveness of internal audits.
The study concludes that enhancing auditor training, establishing policies to safeguard
auditor independence, and implementing systematic standards compliance are essential
for improving audit quality in HFBOs. Recommendations include increasing investment
in auditor capacity-building, adopting updated audit software, and developing regulatory
frameworks to protect auditor autonomy. This study contributes to the limited body of
knowledge on internal auditing within HFBOs, offering insights to strengthen
governance, transparency, and accountability in faith-based healthcare organization
