The Ministry of Health (MoH) has been tasked to pay close attention to the Auditor General’s (AG) recommendations despite the fact that it got a qualified opinion on realizing value for money in the utilization of public funds for compliance audits in the financial year ended June 2021.
At a Parliament Accounts Committee (PAC) hearing Tuesday, parliamentarians showed that the ministry has weakness in complying with some recommendations of the AG resulting in similar issues resurfacing through the audit reports.
For example, the AG showed that the ministry had persistent gaps in utilization reports of funds transferred to Ruhengeri Hospital for ophthalmic consultation and the ocular surgery campaign.
As highlighted in the previous year’s audit reports, on 17 September 2015, MoH transferred Rwf46.5Million to Ruhengeri Hospital for ophthalmic consultation and ocular surgery campaign.
The review of the accountability report provided by Ruhengeri Hospital to MoH on the utilization of these funds revealed that 74% of the expenditure amounting to Rwf 34.2 million was partially supported and lacked some important support documents.
MoH management indicated that the involved finance staff of Ruhengeri Hospital were jailed for misappropriation and misuse of the hospital’s funds and that the supporting documents could not be retrieved but asked Rwanda Investigation Bureau (RIB) to do further follow-up to ensure that these transfers are accounted for and recovered.
However, at the time of the current audit in January 2022 (9 months later), there was no evidence of any further follow-up made by MoH management thus the inadequate ascertainment of misappropriation or fraudulent use of public funds in the case and risk resulting in failure to recover any funds.
The AG also showed a lack of utilization reports for transfers made to non-reporting government entities in which previous audit reports for the years ended 30 June 2015, 2016, 2017, 2018 and June 2019, transfers of Rwf139.4 million were not sufficiently supported.
However, at the time of the current audit in January 2022, Rwf77. 1 million representing 55% of the above expenditure was not yet supported. MoH Management indicated that these cases were taken to RIB for follow up but there was no evidence of response from RIB showing the status of these cases.
PAC Chairman Valens Muhakwa asked why the ministry doesn’t heed the AG’s recommendations to solve some of these issues.
“Why don’t you deal with this issue since it keeps coming back every year? And we know that even RIB is involved in most cases and some in court. This issue should be dealt with immediately,” Muhakwa said.
The ministry of health plans to improve services provided by Community Health Workers (CHWs); the Community Based Health Insurance Scheme (CBHI) however the AG cited weakness in the management of CHWs’-HIV Performance Based Financing (PBF) and serious delays in dispatching funds meant to enable both services to improve the healthcare system
During the year under audit, MoH transferred Rwf965.6Million to 475 CHWs cooperatives relating to PBF for quarter 4 (for 2018-2019) and three quarters (for 2019-2020). However, a review of the PBF-HIV payment process at MoH revealed the following weaknesses:
However, the following weaknesses were found- The list of individual CHWs indicating the HIV indicators reported and the corresponding PBF to be paid to an individual CHW was not attached to the transfers.
It was noted that only 19 out of 475 CHWs cooperatives, representing 4% of all cooperatives provided feedback on the distribution of PBF received, and the remaining unused balances.
Furthermore, a review of those 19 feedback reports indicated that transfers made by MoH were not fully distributed to individual CHWs and Rwf40,000 were still remaining in the cooperatives’ bank accounts. This amount may be significantly increased if all cooperatives provided their feedback.
For the CBHI program, with Rwf6Billion annual government budget allocation disbursed in installments, suffered the first quarter of Rwf 813.7M was transferred with a delay of 22 days, and the seventh installment of Rwf 196.4M for each needy person in category one of Ubudehe was delayed 140 days.
MPs were not impressed with these findings and tasked the ministry to sort out the issues which don’t need rocket science to implement.
Ministry of Health officials committed to resolve the above concerns and especially follow up on the cases where funds need to be recovered and transferred on time.
