Abstract
<title>Abstract</title> <p>Non-Governmental Health Organizations (NGHOs) play a critical role in complementing public health systems and advancing community development; however, their financial sustainability remains constrained by donor dependence, increasing operational costs, and institutional weaknesses. This study aimed to identify the internal and external factors influencing the financial sustainability of NGHOs in Dar es Salaam, Tanzania, with particular emphasis on factors that significantly determine long-term financial resilience. From the Resource-Based View (RBV) perspective, the study employed a descriptive research design using a quantitative approach. Data were collected through a structured questionnaire administered to 243 NGHO stakeholders. Data analysis involved descriptive statistics by including the frequency and percentage distribution, mean, and standard deviation using SPSS version 26. The findings indicated that staff fundraising and financial planning skills (M = 3.78) and effective internal control mechanisms (M = 3.72) were the most influential internal factors, while macroeconomic conditions (M = 3.75), government policies (M = 3.72), and donor reliability (M = 3.62) emerged as key external determinants. Regression results showed that these factors collectively explained 22.3% of the variance in financial sustainability (R² = 0.223, p < .001). The study concludes that sustainable NGHO financing requires strengthening internal organizational capabilities alongside improving responsiveness to external institutional conditions. The findings highlight the need for targeted capacity development, robust financial controls, and strategic engagement with policy environments to enhance long-term sustainability.</p>