The Public sector plays a critical role in the effective delivery of public services that are essential to the functioning of a state economy. The service delivery in the public sector has been noted to be ineffective due to self-interest service from the public sector officers, unlike the private sector, where focus is primarily on shareholder value. The study examined the effect of the balanced scorecard and service delivery at the national health insurance fund in Mombasa County, Kenya. The specific objectives of the study were to determine the effect of the financial perspective of the balanced scorecard, the effect of customer perspective of the balanced scorecard, the internal business perspective of balanced and examine the effect of innovation and learning perspective of balanced scorecard on service delivery at national health insurance fund in Mombasa County. The study is anchored on Balanced score card model and agency theory. The study adopted a descriptive survey research design that depicts the attributes of a specific circumstance, occasion, or case. The targeted population of the study was 158 and the respondents were senior managers, middle level managers, lower level managers and the support staff working at national health insurance fund in Mombasa County. The study finds that the balanced scorecard improves systems of the cost structure, the organization creates more revenue opportunities, net shareholder value is maintained and the asset is well utilized. Additionally, it can be concluded that most employees are delighted with the financial evaluation process by use of the balanced scorecard. The study found a positive relationship between the balanced scorecard components namely customer focus, financial perspective, customer perspective, internal business perspective, innovation, learning aspect and service delivery. The study concluded that customer focus to enhance the service delivery could be through implementing customer satisfaction measures, implementing customer service charter, maintaining product functionality, maintaining customer relationship management and maintaining customer loyalty. The study recommended that the need for NHIF to achieve the balanced scorecard to be able to track financial results while simultaneously monitoring progress through building the capabilities and as well acquiring the intangible assets they would need future growth. Also, the study recommended the organization to consider the issue cost minimization strategy to enhance the service delivery to the customers. In addition to that, there is a need to have a permanent solution to steady funds to be able to meet its obligations. The study further recommended that the organization to embrace the balanced scorecard and will help improve communication between the management and customers thus improve on the quality service hence satisfy the needs of the customers.
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