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This research work concentrates upon Effective Internal Control System as a Means of Fraud Prevention and Detection in Hospital Management.  It will also review the usefulness of internal control in the prevention and detection of fraud and irregularities in business organizations like Hospital.  Chapter one deals with the background of the study, statement of the study, objective of the study, research questions, significance of the study, scope of the study, as well as the limitation of the study.  Chapter two entails the literature review on the internal control system, audit supervision and control, internal control that should be put in place in internal audit, weakness of internal control system, qualification of an internal auditor, types and essentials of internal control and limitation of internal control.  Chapter three is the research methodology which contains the source of data collection, population of the study, sample of the study, design of the study, validation of instrument, reliability of instrument, instrument for data collection and method of data analysis.  The chapter four deals with the presentation and analysis of data, while chapter five contains summary of findings, conclusion and recommendations.



Title                                                                                                           i

Approval                                                                                                     ii

Dedication                                                                                                  iii

Acknowledgement                                                                                    iv

Abstract                                                                                                      vi

Table of contents                                                                                                vii

Chapter One – Introduction

1.1    Background of the study                                                               1

1.2    Statement of problem                                                                     2

1.3    Objective of the study                                                                             2

1.4    Research Question                                                                        3

1.5    Significance of the study                                                               3

1.6    Scope of the Study                                                                         4

1.7    Limitation of the Study                                                                             4

1.8    Brief History of Aluta Hospital                                                       4

1.9    Definition of Terms                                                                         5


Chapter Two – Literature Review                                                                 

2.1    Introduction                                                                                     7

2.2    Internal Control System                                                                 7

2.3    Audit Supervision and Control                                                      9

2.4    Internal Controls that should be put in Place in Internal Audit   10

2.5    Weakness of Internal Control System                                          11

2.6    Qualification of an Internal Auditor                                                         11

2.7    Types and Essential of Internal Control                                       11

2.8    Limitation of Internal Control                                                                   13

2.9    Summary of Literature Reviewed                                                 13

2.10  Nature of Fraud                                                                              14

2.11  Purpose of Fraud Investigation                                                     14

2.12  Duties to Prevent and Control Fraud (The Role of Auditor)                 16


Chapter Three – Research methodology

3.1    Introduction                                                                                     18

3.2    Research design                                                                            18

3.3    Population of the Study                                                                 18

3.4    Sample Size                                                                                    19

3.5    Sources of Data Collection                                                            19

3.6    Validity of the Instrument                                                               19

3.7    Reliability of the Instrument                                                           20

3.8    Method of Data Collection                                                             20

3.9    Method of Data Analysis                                                               20

Chapter Four – Data Analysis and Presentation

4.1    Introduction                                                                                      21

4.2    Questionnaire Administered                                                                   21

Chapter Five – Summary Conclusion and Recommendations

5.1    Introduction                                                                                     33

5.2    Summary of the Study                                                                             33

5.3    Conclusion                                                                                      33

5.4    Recommendation                                                                           34

5.5    Suggestions for Further Studies                                                   34

Bibliography                                                                                    36

Appendix                                                                                          37

          Questionnaire                                                                                 38




1.1       Background of the Study

No economic entity can progress when there is fraud in the operations of its management. Fraudulent activities in business organizations are traceable to lapses in the internal control system operating in their respective department. Internal control is an essential function of management that deals with measurement and correction of the performance of the subordinate with a view to achieving organizational goals with maximum efficiency and at minimum cost. Internal audit is an independent, objective assurance and consulting activity designed to add value and improve an organizations operations.

 Millichamp (2000) said that the use of criminal deception to obtain an unjust or illegal advantage is known as fraud. There could be fraudulent manipulation of figures in accounting information and forgoing of cheque and other document and using ones approval more than once, which is not done by the auditor but by the employees of the organization. Effective internal control system can be said to exist hand in hand with fraud as the controlling tool in a business in regards to fraudulent act. A weak internal control system could be a fertile channel for fraud perpetration in any organization. The importance of solid internal control system in manage of an organization cannot therefore be over emphasized.

1.2       Statement of the Problem

A good quality internal control services will make positive contribution to the hospital management. Some of the problems that actually hinder internal control are problems of incompetent persons that are engaged by the organization, poor management and uncooperative attitude of non-audit staff due to ignorance of internal control objectives. That is lack of skill in the discharge of duties

1.3       Objectives of the Study

Many public organizations of different sizes have seen the need of internal control as the means for fraud prevention and detection in hospital management for ensuring effective working and internal control system.

 Some of the objectives of the study includes;

·                    To check the internal audit work of the department of hospital management.

·                    To renew the function of internal control generally in the hospital management

·                                            To detect and prevent fraud and irregularities in Aluta Hospital, Oleh

·                    To determine the degree of reliance placed on internal control report and corrective measures taken in the past.

1.4       Research Questions

1.           What is the control measure your hospital put in place to prevent fraudulent practices?

2.                           How does your hospital guide against fraudulent practices?

3.           To what extent does management actually rely on internal control in hospital management?

4.           What factor limits internal control function in fraud detection and prevention in hospital management.

5.                           What do you understand as internal control?

1.5       Significance of the Study

This research work will be of great significance to benefit a lot of persons which have been having problems with internal control system and its accounting meaning in general. It will enable management of hospitals and other business organizations to detect and prevent fraud among the employees.

    The study will also serve as a guide line to students and researchers who may which to carry out research work in this area in the future.


1.6       Scope of the Study

This research study is mainly on the effective internal control system as a means of fraud prevention and detection in hospital management with special reference to Aluta Hospital, Oleh in Isoko South Local Government area delta state.

This research will be on descriptive research therefore, hypothesis testing will not be required.

1.7       Limitation of the Study

In the cause of this study, the researcher was faced with a number of problems. Among the short comings includes, financial constraint, which prevented the researcher from carrying out his study in details.

    Unwillingness to release information required for the research which were considered confidential to the organization by the officers concerned. Time factor had also been one of the greatest constraint.

1.8       Brief History of Aluta Hospital

Aluta Hospital was established in the year 1993. The owner was Doctor Aluta, the Hospital was later approved and commissioned by the Delta State Government on July 1996.

This hospital was owned and directed by Doctor Aluta.  It is a private hospital which is located at Oleh/Emede expressway in Isoko South Local Government Area, Delta State.

1.9       Definition of Terms

·                 Fraud: it is a deliberate act and may require specific procedures in order to detect. It involves the use of deception to obtain an unjust or illegal financial advantage

·                    Internal Control: this is a whole system of control, financial or otherwise established by management in other to carry on the business of the enterprise in an orderly and efficient manner ensure adherence to management policies, safeguard the asset and secure as far as possible the completeness and accuracy of the records.

·                 Internal audit: this is an independent, objective assurance and consulting activity designed to add value and improve an organizations operations.

·                    Auditing: it is independent examination of books of account and record of the company with a view to expressing an opinion on the true and fairness of financial statement by an auditor.

·                 Control: this is the monitoring of activities to ensure their conformity to laid down plans and procedure.




2.1    Introduction

The establishment and maintenance of an adequate system of internal control in an organization is one of the responsibilities. A good internal control system will help management of organization to reduce the cases of fraud. No system of internal control, not withstanding how elaborate it may be, can by itself guarantee efficient administration of the establishment and cannot totally provide a tool against fraudulent acts, but if properly installed, implemented, and reviewed it will ensure that fraud in the organization can be reduced to minimum effect.


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