The main aim of this study was to examine the extent to which internal control practices affected health service delivery in Rukungiri District. The research adopted a case study design using both quantitative and qualitative approaches. The target population was 140 key stakeholders that lived and worked in Rukungiri District and a sample size of 104 was drawn from the target population. Our findings from the descriptive statistics, interviews conducted from key stakeholders and documentary reviews revealed a positive and significant relationship between internal control practices and health service delivery in Rukingiri District. The regression analysis results also indicated a modest model fit with adjusted r square of 0.137 which implies that about 14% variation in health service delivery was predictable by internal control practices while the remaining 86 % is explainable by other factors.

Keywords: Internal Control Practices, Health services, Local government.