Successful execution of projects is critical to the development and strategic variations within an institution. However, there have been setbacks due to the deficiencies in monitoring and evaluation (M&E) practices. M&E is an important part of any project’s success story because they oversee project effectiveness, efficiency, transparency, and accountability, among other things. A background review discloses the insufficiency of M&E practices within the institution. The purpose of the study was to examine how M&E budgetary practices affect project service delivery. The study’s theoretical foundation was based on resource-based theory. A descriptive study design was employed targeting administrators, project managers, nurses, chief of centers, and data collection staff. The study focused on a target population of 140 people. The study employed a sample size of 103 respondents using Fisher’s exact formula. The researcher exploited the purposive sampling technique during the study. Data collection instruments administered were questionnaires and key informant interviews. Reliability of instruments was through internal consistency using Cronbach’s Alpha Coefficient of 0.70 or greater while the validity of these instruments was done using content, face, and constructs validity. Quantitative data from questionnaires were analyzed using descriptive statistics used including frequencies, standard deviation, mean, and percentages with the aid of a statistical package for social science (SPSS). Pearson Coefficient Correlation and Multiple regression models were used to make inferences and generalizations. The hypotheses test was graded at the 0.05 level of significance. The study findings indicated that there was a statistically strong significant positive effect of M&E budgetary practices on project service delivery (r=0.622; p<0.05). These findings indicated the alternate hypotheses was accepted and the null hypotheses was rejected. M&E budget serves as a cost and revenue indicator for project managers’ daily operational activities. M&E budget is used to provide information and support management decisions, as well as monitor and control the organization throughout the year. This study recommends that the CBCHS institute budgetary adjustments in the budgetary processes and practices. This will help to predict the future expenses, and costs and accordingly work towards the expected revenues as well as cater adequately on the allocated resources.