A Research Report Submitted to the School of Business in partial fulfillment of the requirement for the Award of the Bachelor Degree of Business Administration in Procurement and Logistics Management(BBA-PLM) of Mzumbe University.The main objective of this research was to assess the factors affecting procurement performance in public institution. The study had three specific objectives the first was to determine the effects of procurement ethics to performance of procurement at Mbeya Referral Regional Hospital, to assess the effect of suppliers to procurement performance at Mbeya referral regional hospital and to determine the effects of staffs competence to the performance of procurement at Mbeya Referral Regional Hospital .The researcher applied a case study research design. The researcher collected Primary data and secondary data. Primary data collected through questionnaire and interview and secondary data was collected from documentary reviews. The targeted population was 100 employees where from them the Sample size used was 50 respondents. The sampling procedures were purposive and simple random sampling. Data collected from the respondents were analyzed with aid of SPSS and the findings of the study presented in the tables and inferential analysis which included correlation and multiple regressions .After collection of data the findings showed that there was strong positive relationship between independent variable and dependent variable where by regression indicated that ethics contributes 23% of procurement performance followed by staff competency which contributed up to 36.7% of procurement performance and supplier related issues which contributed 40.7% of procurement performance at MRRH. In consideration with findings researcher conclude that ethical factor, staff competence and supplier related issues affect the procurement performance at MRRH .Researcher recommends that training and workshops to be provided to the procurement personnel and users so as to build the capacity in procurement arena, the PMU to work according to the act PPA 2011 and its regulations 2013 and PMU should have an effective public procurement system which will allow suppliers to provide satisfactory quality, services and price within a timely delivery schedule.