Lauwo, Tumaini.2026-02-252026-02-252023-11https://repository.tia.ac.tz/handle/123456789/279ABSTRACT The focus of the study was to examine the effect of internal control system on financial performance of the health institutions in Tanzania. Specifically, the study aimed to examine the effect of internal control environments on financial performance of the health institutions, analyze the relationship between internal control activities and financial performance of the health institutions and examine the effect of risk management strategies on financial performance of the health institutions. The study was conducted at CCBRT Hospital in Dar es Salaam. The study used a descriptive survey research design and quantitative research approach. Using convenience sampling a sample of 122 respondents were selected. Data were collected by using structured questionnaire and multiple regression analysis was used to analyze data through Statistical Package for Social Science (SPSS) as data analysis tool. The results show that there is positive and significant relationship between control environment, control activities, risk management strategies, and financial performance in healthcare institutions. This imply that health institutions with a stronger control environment, characterized by ethical values and commitment to competence, tend to achieve higher financial performance. The study concludes that control environment, control activities, and risk management strategies have positive effect on the financial performance of healthcare institutions. The study recommends that the management of CCBRT Hospital should focus on further enhancing its control environment by fostering ethical values and promoting a culture of competence among its workforce. Also the hospital should continue to invest in and strengthen its control activities, ensuring that policies and procedures are effectively implemented to improve internal processesenRisk ManagementFinancial PerformanceInternal ProcessesThesis