reports/chunks/Gulu Regional Referral Hospital Report of the Auditor General, 2023.chunks.json

{"paragraphs": [{"content": "THE REPUBLIC OF UGANDA", "metadata": {"headings": [{"headings_0": {"content": "THE REPUBLIC OF UGANDA", "page": 1, "level": 1}}], "page": 1, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "REPORT OF THE AUDITOR GENERAL ON THE FINANCIAL STATEMENTS OF GULU REGIONAL REFERRAL HOSPITAL", "metadata": {"headings": [{"headings_0": {"content": "REPORT OF THE AUDITOR GENERAL ON THE FINANCIAL STATEMENTS OF GULU REGIONAL REFERRAL HOSPITAL", "page": 1, "level": 1}}, {"headings_1": {"content": "THE REPUBLIC OF UGANDA", "page": 1, "level": 1}}], "page": 1, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "FOR THE YEAR ENDED 30 TH JUNE 2023 \nList of Acronyms", "metadata": {"headings": [{"headings_0": {"content": "REPORT OF THE AUDITOR GENERAL ON THE FINANCIAL STATEMENTS OF GULU REGIONAL REFERRAL HOSPITAL", "page": 1, "level": 1}}, {"headings_1": {"content": "THE REPUBLIC OF UGANDA", "page": 1, "level": 1}}, [{"headings_0": {"content": "REPORT OF THE AUDITOR GENERAL ON THE FINANCIAL STATEMENTS OF GULU REGIONAL REFERRAL HOSPITAL", "page": 1, "level": 1}}, {"headings_1": {"content": "THE REPUBLIC OF UGANDA", "page": 1, "level": 1}}]], "page": 1, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": [["CGV", "Chief Government Valuer"], ["CIL", "Consolidated Implementation Letter"], ["G2G", "Government to Government"], ["GoU", "Government of Uganda"], ["HCMS", "Human Capital Management System"], ["ICT", "Information and Communication Technology"], ["INTOSAI", "International Organization of Supreme Audit Institutions"], ["IPPS", "Integrated Personnel and Payroll system"], ["ISSAIs", "International Standards of Supreme Audit Institutions"], ["LGPPDA", "Local Government Public Procurement and Disposal Authority"], ["MoFPED", "Ministry of Finance, Planning and Economic Development"], ["MoGLSD", "Ministry of Gender, Labour and Social Development"], ["MoPS", "Ministry of Public Sevice"], ["NAA", "National Audit Act"], ["NTR", "Non-Tax Revenue"], ["OAG", "Office of the Auditor General"], ["PFMA", "Public Finance Management Act"], ["PPDA", "Public Procurement & Disposal of Public Assets"], ["RRH", "Regional Referral Hospital"], ["RRH", "Regional Referral Hospital"], ["UGX", "Uganda Shilling"]], "metadata": {"headings": [{"headings_0": {"content": "REPORT OF THE AUDITOR GENERAL ON THE FINANCIAL STATEMENTS OF GULU REGIONAL REFERRAL HOSPITAL", "page": 1, "level": 1}}, {"headings_1": {"content": "THE REPUBLIC OF UGANDA", "page": 1, "level": 1}}], "page": 3, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "columns": ["Acronym", "Meaning"], "type": "table"}}, {"content": "REPORT OF THE AUDITOR GENERAL ON THE FINANCIAL STATEMENTS OF GULU REGIONAL REFERRAL HOSPITAL", "metadata": {"headings": [{"headings_0": {"content": "REPORT OF THE AUDITOR GENERAL ON THE FINANCIAL STATEMENTS OF GULU REGIONAL REFERRAL HOSPITAL", "page": 4, "level": 1}}, {"headings_1": {"content": "REPORT OF THE AUDITOR GENERAL ON THE FINANCIAL STATEMENTS OF GULU REGIONAL REFERRAL HOSPITAL", "page": 1, "level": 1}}], "page": 4, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "FOR THE YEAR ENDED 30 TH JUNE 2023", "metadata": {"headings": [{"headings_0": {"content": "REPORT OF THE AUDITOR GENERAL ON THE FINANCIAL STATEMENTS OF GULU REGIONAL REFERRAL HOSPITAL", "page": 4, "level": 1}}, {"headings_1": {"content": "REPORT OF THE AUDITOR GENERAL ON THE FINANCIAL STATEMENTS OF GULU REGIONAL REFERRAL HOSPITAL", "page": 1, "level": 1}}], "page": 4, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "THE RT. HON. SPEAKER OF PARLIAMENT", "metadata": {"headings": [{"headings_0": {"content": "THE RT. HON. SPEAKER OF PARLIAMENT", "page": 4, "level": 1}}, {"headings_1": {"content": "REPORT OF THE AUDITOR GENERAL ON THE FINANCIAL STATEMENTS OF GULU REGIONAL REFERRAL HOSPITAL", "page": 4, "level": 1}}], "page": 4, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "OPINION", "metadata": {"headings": [{"headings_0": {"content": "OPINION", "page": 4, "level": 1}}, {"headings_1": {"content": "THE RT. HON. SPEAKER OF PARLIAMENT", "page": 4, "level": 1}}], "page": 4, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "I have audited the accompanying financial statements of Gulu Regional Referral Hospital, which comprise the Statement of Financial Position as at 30 th June 2023, the Statement of Financial Performance, Statement of Changes in Equity, Statement of Cash Flows, together with other accompanying statements for the year then ended, and notes to the financial statements, including a summary of significant accounting policies. \nIn my opinion, the financial statements of Gulu Regional Referral Hospital for the year ended 30 th June 2023 are prepared, in all material respects, in accordance with section 51 of the Public Finance Management Act (PFMA), 2015 (as amended), the Financial Reporting Guide, 2018 and as guided by the Accountant General.", "metadata": {"headings": [{"headings_0": {"content": "OPINION", "page": 4, "level": 1}}, {"headings_1": {"content": "THE RT. HON. SPEAKER OF PARLIAMENT", "page": 4, "level": 1}}, [{"headings_0": {"content": "OPINION", "page": 4, "level": 1}}, {"headings_1": {"content": "THE RT. HON. SPEAKER OF PARLIAMENT", "page": 4, "level": 1}}]], "page": 4, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "BASIS FOR OPINION  \nI conducted my audit in accordance with International Standards of Supreme Audit Institutions (ISSAIs). My responsibilities under those standards are further described in the Auditor\u2019s Responsibilities for the audit of the Financial Statements section of my report. I am independent of the Gulu Regional Referral Hospital in accordance with the Constitution of the Republic of Uganda (1995) as amended, the National Audit Act, 2008, the International Organisation of Supreme Audit Institutions (INTOSAI) Code of Ethics, the International Ethics Standards Board for Accountants\u2019 Code of Ethics for Professional Accountants (IESBA Code) and other independence requirements applicable to performing audits of Financial Statements in Uganda. \nI have fulfilled my ethical responsibilities in accordance with the other requirements and the IESBA Code. I believe that the audit evidence I have obtained is sufficient and appropriate to provide a basis for my opinion. \nKEY AUDIT MATTERS  \nKey audit matters are those matters that, in my professional judgment, were of most significance in my audit of the financial statements of the current period. These matters were addressed in the context of my audit of the financial statements as a whole, and in forming my opinion thereon, and I do not provide a separate opinion on these matters. \nThe mandate of the Gulu Regional Referral Hospital is to implement the National Health Policy Guidelines and improve the quality of life of the people in the region, to provide and make the essential drugs accessible to patients and to provide specialized and general health services in line with its referral status to the population within its area and even beyond. \nI reviewed documents such as work plans, budgets, performance reports and payment records. I also conducted interviews and physical inspections to corroborate my findings from the review of the documents. \nDuring the financial year 2022/2023, Gulu Regional Referral Hospital (RRH) had an approved budget of UGX. 17,677,764,198 out of which UGX. 17,672,332,191 was warranted as shown below;", "metadata": {"headings": [{"headings_0": {"content": "OPINION", "page": 4, "level": 1}}, {"headings_1": {"content": "THE RT. HON. SPEAKER OF PARLIAMENT", "page": 4, "level": 1}}, [{"headings_0": {"content": "OPINION", "page": 4, "level": 1}}, {"headings_1": {"content": "THE RT. HON. SPEAKER OF PARLIAMENT", "page": 4, "level": 1}}], [{"headings_0": {"content": "OPINION", "page": 4, "level": 1}}, {"headings_1": {"content": "THE RT. HON. SPEAKER OF PARLIAMENT", "page": 4, "level": 1}}], [{"headings_0": {"content": "OPINION", "page": 4, "level": 1}}, {"headings_1": {"content": "THE RT. HON. SPEAKER OF PARLIAMENT", "page": 4, "level": 1}}], [{"headings_0": {"content": "OPINION", "page": 4, "level": 1}}, {"headings_1": {"content": "THE RT. HON. SPEAKER OF PARLIAMENT", "page": 4, "level": 1}}], [{"headings_0": {"content": "OPINION", "page": 4, "level": 1}}, {"headings_1": {"content": "THE RT. HON. SPEAKER OF PARLIAMENT", "page": 4, "level": 1}}]], "page": 4, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": [["1.", "Recurrent (Wage)", "11,518,040,294", "11,512,608,291", "99.95"], ["2.", "Recurrent (Non-wage)", "5,169,723,904", "5,169,723,900", "100"], ["3.", "Development", "990,000,000", "990,000,000", "100"], ["", "**Total**", "**17,677,764,198**", "**17,672,332,191**", "99.97"]], "metadata": {"headings": [{"headings_0": {"content": "OPINION", "page": 4, "level": 1}}, {"headings_1": {"content": "THE RT. HON. SPEAKER OF PARLIAMENT", "page": 4, "level": 1}}], "page": 5, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "columns": ["Sn", "Details", "Budget UGX", "Warrants UGX", "% age"], "type": "table"}}, {"content": "Out of the total warrants of UGX. 17,672,332,191, I reviewed expenditure on activities/outputs worth UGX. 11,532,766,831 (65%) as summarised in the table below;", "metadata": {"headings": [{"headings_0": {"content": "OPINION", "page": 4, "level": 1}}, {"headings_1": {"content": "THE RT. HON. SPEAKER OF PARLIAMENT", "page": 4, "level": 1}}], "page": 5, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": [["1", "Wage Expenditure", "10,102,931,391", "10,102,931,391", "57%"], ["2", "Retooling of the Regional Referral Hospital", "275,016,878", "10,377,948,269", "59%"], ["3", "Outputs/activities performance review under budget", "1,154,818,562", "11,532,766,831", "65%"], ["", "**Total of the expenditure audited**", "11,532,766,831", "", ""]], "metadata": {"headings": [{"headings_0": {"content": "OPINION", "page": 4, "level": 1}}, {"headings_1": {"content": "THE RT. HON. SPEAKER OF PARLIAMENT", "page": 4, "level": 1}}], "page": 5, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "columns": ["Sn", "Details", "Actual Expenditure (UGX)", "Cumulative Actual expenditure (UGX)", "Cumulative %age out of total warrants"], "type": "table"}}, {"content": "Out of the hospital budget of UGX. 17,677,764,198 in the financial year 2022/2023, UGX. 10,102,931,391 (57%) was spent on employee costs which has been reported in the section on findings from the payroll special audit and the balance was utilized on major interventions. \nBelow are my findings from the performance of revenues/warrants, absorption of warrants and implementation of out-puts and activities under the budget performance review.", "metadata": {"headings": [{"headings_0": {"content": "OPINION", "page": 4, "level": 1}}, {"headings_1": {"content": "THE RT. HON. SPEAKER OF PARLIAMENT", "page": 4, "level": 1}}, [{"headings_0": {"content": "OPINION", "page": 4, "level": 1}}, {"headings_1": {"content": "THE RT. HON. SPEAKER OF PARLIAMENT", "page": 4, "level": 1}}]], "page": 5, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": [["**No** Observation**", "**Recommendation**"], ["**Revenue Performance**  **Performance of Non Tax Revenue**  According to the approved budget, the Gulu RRH was supposed to collect revenue to the tune of UGX.340,000,000 however, by the end of the year only UGX.66,767,550 had been collected representing 20% performance as shown in the table below,  No Source Approved Variance budget Actual Collections Tax Revenues Non-Tax Revenues 0  340,000,000 0 66,767,550 0  273,232,450 Total Revenue 340,000,000 66,767,550 273,232,450 **1 2** **3** 1.1", "advised that Accounting Officer to initiate strategies to raise funds to improve Hospital infrastructures  and acquisition of dedicated Laboratory equipment and engage the relevant Ministries for wage and authority to recruit more staff to to I"]], "metadata": {"headings": [{"headings_0": {"content": "OPINION", "page": 4, "level": 1}}, {"headings_1": {"content": "THE RT. HON. SPEAKER OF PARLIAMENT", "page": 4, "level": 1}}], "page": 5, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "columns": ["column_0", "column_6"], "type": "table"}}, {"content": "U nder collection of revenue at vote level negatively affects collections at Treasury level thereby denying government resources for implementation of budget activities.  \nThe Accounting Officer explained that the under collections was due to poor/ dilapidation infrastructure which was non- attractive, human resource gaps affecting services and lack of functional equipment such as dedicated Laboratory equipment. 1.2", "metadata": {"headings": [{"headings_0": {"content": "OPINION", "page": 4, "level": 1}}, {"headings_1": {"content": "THE RT. HON. SPEAKER OF PARLIAMENT", "page": 4, "level": 1}}], "page": 6, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "Performance of GOU warrants", "metadata": {"headings": [{"headings_0": {"content": "Performance of GOU warrants", "page": 6, "level": 2}}, {"headings_1": {"content": "OPINION", "page": 4, "level": 1}}], "page": 6, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "The hospital had an approved budget of UGX.17,677,764,198 from the various programs out of which UGX.17,672,332,191 was warranted resulting in a shortfall of UGX.5,432,007 representing a 99.9% performance.  \nThe performance of the warrants from each of the programs from which the hospital was allocated funds is shown in the table below;  \nProgramme Approved Warrants Variance %age Budget (UGX.Bn) (UGX.Bn) performance (UGX.Bn)  \nHuman Capital 17.678 17,672 0.0054 99.9 Development", "metadata": {"headings": [{"headings_0": {"content": "Performance of GOU warrants", "page": 6, "level": 2}}, {"headings_1": {"content": "OPINION", "page": 4, "level": 1}}], "page": 6, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "Total 17.678 12.672 0.0054 99.9", "metadata": {"headings": [{"headings_0": {"content": "Total 17.678 12.672 0.0054 99.9", "page": 6, "level": 5}}, {"headings_1": {"content": "Performance of GOU warrants", "page": 6, "level": 2}}], "page": 6, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "The UGX.5,068,314,344 that was not warranted was meant for the p activities which were either partially or not implemented at all;", "metadata": {"headings": [{"headings_0": {"content": "Total 17.678 12.672 0.0054 99.9", "page": 6, "level": 5}}, {"headings_1": {"content": "Performance of GOU warrants", "page": 6, "level": 2}}], "page": 6, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "No Programm Amount Activities Purpose of the", "metadata": {"headings": [{"headings_0": {"content": "No Programm Amount Activities Purpose of the", "page": 6, "level": 5}}, {"headings_1": {"content": "Total 17.678 12.672 0.0054 99.9", "page": 6, "level": 5}}], "page": 6, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": ". e not not unimplemented", "metadata": {"headings": [{"headings_0": {"content": ". e not not unimplemented", "page": 6, "level": 5}}, {"headings_1": {"content": "No Programm Amount Activities Purpose of the", "page": 6, "level": 5}}], "page": 6, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "warranted implement activity ed", "metadata": {"headings": [{"headings_0": {"content": "warranted implement activity ed", "page": 6, "level": 5}}, {"headings_1": {"content": ". e not not unimplemented", "page": 6, "level": 5}}], "page": 6, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "1 Human 5,432,007 Pension To effect payments to Capital the retired Public Managemen Officers within the t  \nHospital.", "metadata": {"headings": [{"headings_0": {"content": "warranted implement activity ed", "page": 6, "level": 5}}, {"headings_1": {"content": ". e not not unimplemented", "page": 6, "level": 5}}], "page": 6, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "Total 5,432,007", "metadata": {"headings": [{"headings_0": {"content": "Total 5,432,007", "page": 6, "level": 5}}, {"headings_1": {"content": "warranted implement activity ed", "page": 6, "level": 5}}], "page": 6, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "closed the staffing gaps.", "metadata": {"headings": [{"headings_0": {"content": "Total 5,432,007", "page": 6, "level": 5}}, {"headings_1": {"content": "warranted implement activity ed", "page": 6, "level": 5}}], "page": 6, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "The warrants that were not utilized were meant for the I also advised the following activities that were partially or not implemented at all Accounting Officer to as shown in Appendix 1 (a). Failure to absorb funds always engage with negatively affected Health service delivery to citizens.  \nthe MoH and MoFPED to ensure timely The Accounting Officer explained that the unutilized warrants release of CIL and to were mainly Government-to-Government (G2G) funds, which ensure G2G staff are were not absorbed because of lack of staff and late release of recruited.  \nthe Consolidated Implementation Letter (CIL) by Ministry of  \nHealth (MoH) and MoFPED. He further explained that the  \nDevelopment funds of UGX.870m was not utilized due to lack  \nof contract renewal for the construction of a staff houses. \n1.4", "metadata": {"headings": [{"headings_0": {"content": "Total 5,432,007", "page": 6, "level": 5}}, {"headings_1": {"content": "warranted implement activity ed", "page": 6, "level": 5}}, [{"headings_0": {"content": "Total 5,432,007", "page": 6, "level": 5}}, {"headings_1": {"content": "warranted implement activity ed", "page": 6, "level": 5}}]], "page": 7, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "Appropriateness of performance indicators and targets", "metadata": {"headings": [{"headings_0": {"content": "Appropriateness of performance indicators and targets", "page": 7, "level": 2}}, {"headings_1": {"content": "Total 5,432,007", "page": 6, "level": 5}}], "page": 7, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "in the work plans  \nRegulation 11 (2) b of the Public Finance Management Regulations, 2016 states that the work plan of a vote shall indicate the key performance indicators to be used to gauge the out-puts.  \nPart A of the performance contract for Accounting Officers outlines the core performance requirements against which their performance should be assessed in regard to achievement of planned results. This requires the Accounting Officer to be assessed on the extent to which annual key performance indicators and targets are achieved for key projects and/or programs. \nI observed that the budgets for all five (5) outputs assessed were supported by individual activity costing and budgets. \n1.5", "metadata": {"headings": [{"headings_0": {"content": "Appropriateness of performance indicators and targets", "page": 7, "level": 2}}, {"headings_1": {"content": "Total 5,432,007", "page": 6, "level": 5}}, [{"headings_0": {"content": "Appropriateness of performance indicators and targets", "page": 7, "level": 2}}, {"headings_1": {"content": "Total 5,432,007", "page": 6, "level": 5}}], [{"headings_0": {"content": "Appropriateness of performance indicators and targets", "page": 7, "level": 2}}, {"headings_1": {"content": "Total 5,432,007", "page": 6, "level": 5}}]], "page": 7, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "Implementation of outputs", "metadata": {"headings": [{"headings_0": {"content": "Implementation of outputs", "page": 7, "level": 2}}, {"headings_1": {"content": "Appropriateness of performance indicators and targets", "page": 7, "level": 2}}], "page": 7, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "I assessed the implementation of four (4) outputs that had I  \nadvised the been fully quantified with a total of thirty-seven (37) activities Accounting  \nOfficer worth UGX.1,154,818,562 and noted that;  \nensure unimplemented activities are rolled", "metadata": {"headings": [{"headings_0": {"content": "Implementation of outputs", "page": 7, "level": 2}}, {"headings_1": {"content": "Appropriateness of performance indicators and targets", "page": 7, "level": 2}}], "page": 7, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "- Four (4) outputs with Thirty-seven (37) activities and over and given expenditure worth UGX.1,154,818,562 were fully priorities for implemented. Out of the thirty-seven (37) activities, the implementation in the hospital fully implemented twenty-eight (28) activities; and subsequent period. nine (9) activities were partially implemented", "metadata": {"headings": [{"headings_0": {"content": "Implementation of outputs", "page": 7, "level": 2}}, {"headings_1": {"content": "Appropriateness of performance indicators and targets", "page": 7, "level": 2}}], "page": 7, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "list"}}, {"content": "i.  \nUndertook only nine (09) trainings of health workers to deliver KP friendly services out of the planned 14.  \nii. Conducted only seven (07) engagements with stakeholders in the HIV prevention out of the planned 11 engagements. \nRefer to Appendix 1(b) (i & ii) for details. \nAccounting Officer explained that the non-implementation of the planned activities was majorly associated with the G2G activities. The G2G activities were not implemented due to delayed release of the CIL; which was issued in October 2022, hence delayed recruitment of project staff. \n2.0", "metadata": {"headings": [{"headings_0": {"content": "Implementation of outputs", "page": 7, "level": 2}}, {"headings_1": {"content": "Appropriateness of performance indicators and targets", "page": 7, "level": 2}}, [{"headings_0": {"content": "Implementation of outputs", "page": 7, "level": 2}}, {"headings_1": {"content": "Appropriateness of performance indicators and targets", "page": 7, "level": 2}}], [{"headings_0": {"content": "Implementation of outputs", "page": 7, "level": 2}}, {"headings_1": {"content": "Appropriateness of performance indicators and targets", "page": 7, "level": 2}}], [{"headings_0": {"content": "Implementation of outputs", "page": 7, "level": 2}}, {"headings_1": {"content": "Appropriateness of performance indicators and targets", "page": 7, "level": 2}}]], "page": 8, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "Management of the Government Salary Payroll", "metadata": {"headings": [{"headings_0": {"content": "Management of the Government Salary Payroll", "page": 8, "level": 1}}, {"headings_1": {"content": "Implementation of outputs", "page": 7, "level": 2}}], "page": 8, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "In a letter to the Auditor General dated 29 th November 2022 referenced HRM 155/222/02, the Minister of Finance, Planning and Economic Development (MoFPED) highlighted that, despite the reforms introduced by Government to mitigate against persistent supplementary requests for additional funds to cater for wage shortfalls, there has not been significant results and yet expenditure on wage is a substantial percentage of all RRH budgets. Other anomalies highlighted included: payments for non-existent employees, underpayments to staff and irregular overpayments to staff, among others. \nAccordingly, I carried out a special audit on wage payroll in the Regional Referral Hospital to establish the root causes of the identified challenges and propose remedial measures. The audit covered four (4) FYs from 2019/2020 to 2022/2023 to which I issued a separate detailed audit report and below is a summary of the key findings from the special audit; \nGulu Regional Referral Hospital had a wage budget of UGX.11,518,040,294, out of which UGX. 10,102,931,391 was utilised for the period under review. Below is a summary of the key findings from the special audit;", "metadata": {"headings": [{"headings_0": {"content": "Management of the Government Salary Payroll", "page": 8, "level": 1}}, {"headings_1": {"content": "Implementation of outputs", "page": 7, "level": 2}}, [{"headings_0": {"content": "Management of the Government Salary Payroll", "page": 8, "level": 1}}, {"headings_1": {"content": "Implementation of outputs", "page": 7, "level": 2}}], [{"headings_0": {"content": "Management of the Government Salary Payroll", "page": 8, "level": 1}}, {"headings_1": {"content": "Implementation of outputs", "page": 7, "level": 2}}]], "page": 8, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": [["**No**", "**Observation**", "**Recommendation**"], ["**2.1**", "**Utilization of the Wage Budget**  The Gulu RRH had an approved wage budget of UGX.8,110,353,682, and obtained supplementary funding of UGX.825,600,000 resulting into a revised wage budget of UGX.8,935,953,682 of which UGX.8,935,953,682 (100%) was warranted. Out of the total warrants, UGX.8,816,353,872 was utilized by the Gulu RRH resulting in un-utilized warrants of UGX.119,599,810 representing utilization of 98.7% as summarized in the table below. **Approv ed Budget UGX. Bn** 8.110 **Supple mentar y UGX. Bn** **Revised Budget** **UGX.** Bn** **Warrants UGX. Bn** **Payment** **s** Bn** **UGX.** **Unspent Balance UGX. Bn** 0.826 8.936 8.936 8.816 0.120", ""]], "metadata": {"headings": [{"headings_0": {"content": "Management of the Government Salary Payroll", "page": 8, "level": 1}}, {"headings_1": {"content": "Implementation of outputs", "page": 7, "level": 2}}], "page": 8, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "columns": ["column_0", "column_1", "column_9"], "type": "table"}}, {"content": [["", "Accounting Officer noted the observation. the analysis, I noted that; \uf0b7 There was an under absorption of UGX.119,599,810 From The", ""], ["**2.2**", "**Validation of employees on the RRH Payroll**  Gulu RRH had 352 employees on the IPPS payroll of which 345 (98%) were fully verified and 7 (2%) did not show up. addition, all individuals had accessed the payroll by end of June, 2023; therefore, none was captured as new records in my determination of the Gulu RRH wage bill. Officer explained that one person had died, two were drivers on interdictions, one individual was on sick leave and two individuals had retired from service. In Accounting", "advised the Accounting Officer to use the verified payroll  the Hospital payroll. to update I"], ["**2.3**", "**Inconsistencies in Employee Details**  A total of 50 employees on the payroll had inconsistencies in their dates of birth, captured in the payroll and data captured by NIRA on the National IDs. The information is critical in the identification of an individual. information undermines the integrity of the Gulu RRH \u2019s records and may complicate the employee service history and retirement procedures. Where the errors in dates of birth increase the length of service, it may lead to the irregular extension of employee service. Accounting Officer explained that action to correct employee details was being undertaken on the Human Capital Management System (HCMS) to address the gaps. Inconsistent The", "and ensure Accounting Officer should engage the affected staff  that employee records are duly updated and brought to the attention of the Ministry of Public Service. The"], ["a)", "**Review of the Gulu RRH Staff Establishment** Review of the establishment revealed; i) Out of 485 approved positions, a total of 339 positions were filled leaving a gap of 146 vacant positions. The Accounting Officer explained that efforts were being made with Ministry of Public Service and Ministry of Finance to have budget for wage increase, to enable recruitment of staff to fill the vacant posts. This has not been possible in the last three years.", "I  to advised the Accounting Officer re-assess the Hospital\u2019s  establishment and liaise with the MoPS and MoFPED with a view to mobilizing resources to fill critical positions to enhance service delivery."]], "metadata": {"headings": [{"headings_0": {"content": "Management of the Government Salary Payroll", "page": 8, "level": 1}}, {"headings_1": {"content": "Implementation of outputs", "page": 7, "level": 2}}], "page": 9, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "columns": ["column_0", "column_1", "column_2"], "type": "table"}}, {"content": "Government Non-current assets. The votes are now required to show the fixed assets in the Statement of Financial position and apply depreciation rates as per policy under Note 1(x) to the financial statements, to recognize the consumption of the asset values over the useful life of the non-current assets. \nIt was further guided that assets at the end of the previous financial year 2021/22 for all votes, should be compiled and validated before migration to the new IFMS fixed assets Module in the adjustment period. \nTo aid comparability, the adoption of a new accounting policy would require a restatement of comparative figures and the opening balances for applicable assets. However, as stated in Note 25 of the financial statements, neither the comparative figures nor the opening balances were restated. This makes comparison limited. \nMy opinion is not modified with respect to this matter.", "metadata": {"headings": [{"headings_0": {"content": "Management of the Government Salary Payroll", "page": 8, "level": 1}}, {"headings_1": {"content": "Implementation of outputs", "page": 7, "level": 2}}, [{"headings_0": {"content": "Management of the Government Salary Payroll", "page": 8, "level": 1}}, {"headings_1": {"content": "Implementation of outputs", "page": 7, "level": 2}}], [{"headings_0": {"content": "Management of the Government Salary Payroll", "page": 8, "level": 1}}, {"headings_1": {"content": "Implementation of outputs", "page": 7, "level": 2}}], [{"headings_0": {"content": "Management of the Government Salary Payroll", "page": 8, "level": 1}}, {"headings_1": {"content": "Implementation of outputs", "page": 7, "level": 2}}]], "page": 10, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "OTHER MATTER", "metadata": {"headings": [{"headings_0": {"content": "OTHER MATTER", "page": 10, "level": 1}}, {"headings_1": {"content": "Management of the Government Salary Payroll", "page": 8, "level": 1}}], "page": 10, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "In addition to the matter raised above, I consider it necessary to communicate the following matters other than those presented or disclosed in the financial statements;", "metadata": {"headings": [{"headings_0": {"content": "OTHER MATTER", "page": 10, "level": 1}}, {"headings_1": {"content": "Management of the Government Salary Payroll", "page": 8, "level": 1}}], "page": 10, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "4.0 Long Outstanding Payables", "metadata": {"headings": [{"headings_0": {"content": "4.0 Long Outstanding Payables", "page": 10, "level": 1}}, {"headings_1": {"content": "OTHER MATTER", "page": 10, "level": 1}}], "page": 10, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "Section 41, 1 (a-c) of the Public finance management act 2015 states that (a) an Accounting Officer shall control the regularity and proper use of money appropriated to a vote, (b) be responsible for authorising any commitment made by a vote, and (c) control the resources received, held or disposed of by or on account of a vote \nA review of the statement of financial position on page 10 of the financial statements revealed that the Hospital had outstanding payables of UGX.267,286,364 (Trade creditors) by the end of the year. A review of the categorization and aging of the payables in note 26 on page 31 of the financial statements revealed amount relate to the previous financial years. \nThese long outstanding payables could lead to loss of funds due to litigation arising from delayed settlement.", "metadata": {"headings": [{"headings_0": {"content": "4.0 Long Outstanding Payables", "page": 10, "level": 1}}, {"headings_1": {"content": "OTHER MATTER", "page": 10, "level": 1}}, [{"headings_0": {"content": "4.0 Long Outstanding Payables", "page": 10, "level": 1}}, {"headings_1": {"content": "OTHER MATTER", "page": 10, "level": 1}}], [{"headings_0": {"content": "4.0 Long Outstanding Payables", "page": 10, "level": 1}}, {"headings_1": {"content": "OTHER MATTER", "page": 10, "level": 1}}]], "page": 10, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "Recommendation", "metadata": {"headings": [{"headings_0": {"content": "Recommendation", "page": 10, "level": 1}}, {"headings_1": {"content": "4.0 Long Outstanding Payables", "page": 10, "level": 1}}], "page": 10, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "A review of the supply, storage, administration and distribution of EMHS in the Hospitals revealed the following; \n5.1", "metadata": {"headings": [{"headings_0": {"content": "Recommendation", "page": 10, "level": 1}}, {"headings_1": {"content": "4.0 Long Outstanding Payables", "page": 10, "level": 1}}, [{"headings_0": {"content": "Recommendation", "page": 10, "level": 1}}, {"headings_1": {"content": "4.0 Long Outstanding Payables", "page": 10, "level": 1}}]], "page": 11, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "Deliveries not Verified/Witnessed by an Independent and Competent Party", "metadata": {"headings": [{"headings_0": {"content": "Deliveries not Verified/Witnessed by an Independent and Competent Party", "page": 11, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 10, "level": 1}}], "page": 11, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "Instruction 15.2.2 of Treasury Instruction 2017 states that so far as is possible the task of receiving and checking inventories shall be carried out by a public officer other than the one who places the orders and authorizes payment for the supplies, and the documentation should permit the various elements of the transaction, including ordering, receipt and payment, to be identified with and checked against each other. \nI noted that although the Resident City Commissioner was verifying/witnessing deliveries, five deliveries were not witnessed by an independent party as shown in the table below.", "metadata": {"headings": [{"headings_0": {"content": "Deliveries not Verified/Witnessed by an Independent and Competent Party", "page": 11, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 10, "level": 1}}, [{"headings_0": {"content": "Deliveries not Verified/Witnessed by an Independent and Competent Party", "page": 11, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 10, "level": 1}}]], "page": 11, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": [["1.", "25/11/2022", "6,461,824", "Not Witnessed"], ["2.", "04/10/2022", "440,838", "Not Witnessed"], ["3.", "21/07/2023", "14,290,920", "Not Witnessed"], ["4.", "20/07/2023", "43,635,836", "Not Witnessed"], ["5.", "28/11/2022", "72,487,861", "Not Witnessed"], ["", "**Total**", "**137,317,279**", ""]], "metadata": {"headings": [{"headings_0": {"content": "Deliveries not Verified/Witnessed by an Independent and Competent Party", "page": 11, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 10, "level": 1}}], "page": 11, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "columns": ["Cycle", "Delivery Date", "Value", "Remarks (witnessed or not witnessed)"], "type": "table"}}, {"content": "Failure to verify or witness deliveries by an independent and competent party creates vulnerabilities in the procurement process and posses a risk of loss of essential deliveries. \nThe Accounting Officer acknowledged the shortcoming and explained that although the Hospital always invited independent witnesses for NMS deliveries, other deliveries were not. He pledged to ensure that verification by independent witnesses would be for all deliveries.", "metadata": {"headings": [{"headings_0": {"content": "Deliveries not Verified/Witnessed by an Independent and Competent Party", "page": 11, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 10, "level": 1}}, [{"headings_0": {"content": "Deliveries not Verified/Witnessed by an Independent and Competent Party", "page": 11, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 10, "level": 1}}]], "page": 11, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "Recommendation", "metadata": {"headings": [{"headings_0": {"content": "Recommendation", "page": 11, "level": 1}}, {"headings_1": {"content": "Deliveries not Verified/Witnessed by an Independent and Competent Party", "page": 11, "level": 1}}], "page": 11, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "I advised the Accounting Officer to ensure that all deliveries are witnessed and verified by an independent and competent Party to mitigate possible loss.", "metadata": {"headings": [{"headings_0": {"content": "Recommendation", "page": 11, "level": 1}}, {"headings_1": {"content": "Deliveries not Verified/Witnessed by an Independent and Competent Party", "page": 11, "level": 1}}], "page": 11, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": [["", ""], ["Leaking ceiling", "Wall with cracks"]], "metadata": {"headings": [{"headings_0": {"content": "Recommendation", "page": 11, "level": 1}}, {"headings_1": {"content": "Deliveries not Verified/Witnessed by an Independent and Competent Party", "page": 11, "level": 1}}], "page": 12, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "columns": ["column_0", "column_1"], "type": "table"}}, {"content": "Poor storage can result in deterioration or the development of poisonous degradation products that can be hazardous to the patient. \nThe Accounting Officer explained acknowledged the shortcoming and attributed it to inadequate funding of the Hospital. He explained that management had started the process of prioritizing and looking for funds to address the poor storage facilities.", "metadata": {"headings": [{"headings_0": {"content": "Recommendation", "page": 11, "level": 1}}, {"headings_1": {"content": "Deliveries not Verified/Witnessed by an Independent and Competent Party", "page": 11, "level": 1}}, [{"headings_0": {"content": "Recommendation", "page": 11, "level": 1}}, {"headings_1": {"content": "Deliveries not Verified/Witnessed by an Independent and Competent Party", "page": 11, "level": 1}}]], "page": 12, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "Recommendation", "metadata": {"headings": [{"headings_0": {"content": "Recommendation", "page": 12, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 11, "level": 1}}], "page": 12, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "I advised the Accounting Officer to liaise with the relevant stakeholders to ensure that the storage facilities are renovated. \n5.3", "metadata": {"headings": [{"headings_0": {"content": "Recommendation", "page": 12, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 11, "level": 1}}, [{"headings_0": {"content": "Recommendation", "page": 12, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 11, "level": 1}}]], "page": 12, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "Utilization and Maintenance of Medical Equipment", "metadata": {"headings": [{"headings_0": {"content": "Utilization and Maintenance of Medical Equipment", "page": 12, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 12, "level": 1}}], "page": 12, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "According to Section 7 of Operation Manual for Regional Medical Equipment Maintenance Workshops and Medical Equipment Maintenance Guidelines, 2013, the RRH should plan and budget for maintenance under two main categories of Planned Preventive Maintenance and Breakdown maintenance to ensure efficient maintenance of medical equipment. \n5.4", "metadata": {"headings": [{"headings_0": {"content": "Utilization and Maintenance of Medical Equipment", "page": 12, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 12, "level": 1}}, [{"headings_0": {"content": "Utilization and Maintenance of Medical Equipment", "page": 12, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 12, "level": 1}}]], "page": 12, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "Training of Health Workers, Engineers & Technicians", "metadata": {"headings": [{"headings_0": {"content": "Training of Health Workers, Engineers & Technicians", "page": 12, "level": 1}}, {"headings_1": {"content": "Utilization and Maintenance of Medical Equipment", "page": 12, "level": 1}}], "page": 12, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "National Medical Equipment Policy (2009), paragraph 5.2.2 explains that; for effective equipment management, proper equipment user and application training must be carried out for the Health Workers and Engineers and Technicians in the use, operation, care, handling and equipment maintenance.", "metadata": {"headings": [{"headings_0": {"content": "Training of Health Workers, Engineers & Technicians", "page": 12, "level": 1}}, {"headings_1": {"content": "Utilization and Maintenance of Medical Equipment", "page": 12, "level": 1}}], "page": 12, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "- The Hospital did not have user trainers per each health facilities as is required by the Policy.\n- The Hospital had an Equipment training plan. For the donated equipment (X-Ray Machine) by JICA in the year under review, the different users of the equipment were trained on how to use and maintain equipment.", "metadata": {"headings": [{"headings_0": {"content": "Training of Health Workers, Engineers & Technicians", "page": 12, "level": 1}}, {"headings_1": {"content": "Utilization and Maintenance of Medical Equipment", "page": 12, "level": 1}}], "page": 12, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "list"}}, {"content": "Inadequate training of other users on how to use the equipment leads to underutilization of equipment. \nAccounting Officer explained that the lack of user trainers at lower-level facilities was due to lack of trained staff; which was a mandate of the Ministry of Health that trains and certifies user trainers", "metadata": {"headings": [{"headings_0": {"content": "Training of Health Workers, Engineers & Technicians", "page": 12, "level": 1}}, {"headings_1": {"content": "Utilization and Maintenance of Medical Equipment", "page": 12, "level": 1}}, [{"headings_0": {"content": "Training of Health Workers, Engineers & Technicians", "page": 12, "level": 1}}, {"headings_1": {"content": "Utilization and Maintenance of Medical Equipment", "page": 12, "level": 1}}]], "page": 13, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "Recommendation", "metadata": {"headings": [{"headings_0": {"content": "Recommendation", "page": 13, "level": 1}}, {"headings_1": {"content": "Training of Health Workers, Engineers & Technicians", "page": 12, "level": 1}}], "page": 13, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "The Accounting Officer should liaise with Ministry of Health to ensure that the health facility has a user trainer. \n5.5", "metadata": {"headings": [{"headings_0": {"content": "Recommendation", "page": 13, "level": 1}}, {"headings_1": {"content": "Training of Health Workers, Engineers & Technicians", "page": 12, "level": 1}}, [{"headings_0": {"content": "Recommendation", "page": 13, "level": 1}}, {"headings_1": {"content": "Training of Health Workers, Engineers & Technicians", "page": 12, "level": 1}}]], "page": 13, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "Failure to Maintain an Updated Medical Equipment Database With Relevant", "metadata": {"headings": [{"headings_0": {"content": "Failure to Maintain an Updated Medical Equipment Database With Relevant", "page": 13, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 13, "level": 1}}], "page": 13, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "Information on the Operational Status of The Equipment", "metadata": {"headings": [{"headings_0": {"content": "Information on the Operational Status of The Equipment", "page": 13, "level": 1}}, {"headings_1": {"content": "Failure to Maintain an Updated Medical Equipment Database With Relevant", "page": 13, "level": 1}}], "page": 13, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "Paragraph 4.1.1 of the Operation Manual for Regional Medical Equipment Maintenance Workshops and Medical Equipment Maintenance Guidelines (2013) explains that an accurate inventory is important for proper maintenance planning and scheduling. It should be carried out in good time to inform decision making on equipping gaps, disposal and budgeting. \nI noted that following;", "metadata": {"headings": [{"headings_0": {"content": "Information on the Operational Status of The Equipment", "page": 13, "level": 1}}, {"headings_1": {"content": "Failure to Maintain an Updated Medical Equipment Database With Relevant", "page": 13, "level": 1}}, [{"headings_0": {"content": "Information on the Operational Status of The Equipment", "page": 13, "level": 1}}, {"headings_1": {"content": "Failure to Maintain an Updated Medical Equipment Database With Relevant", "page": 13, "level": 1}}]], "page": 13, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "- The Hospital has an equipment inventory database called Nomad that captures government health facility equipment in the region. The database is maintained by the Ministry of Health.\n- The equipment were not coded using relevant inventory code in both the database and the Hospital Asset register.", "metadata": {"headings": [{"headings_0": {"content": "Information on the Operational Status of The Equipment", "page": 13, "level": 1}}, {"headings_1": {"content": "Failure to Maintain an Updated Medical Equipment Database With Relevant", "page": 13, "level": 1}}], "page": 13, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "list"}}, {"content": "Poor equipment inventory and records management makes it difficult to reliably track equipment maintenance. \nThe Accounting Officer explained that the vote relies on codes issued by MOH and MoFPED for the NOMADS and IFMS assets management module respectively and that both systems were being managed by the ministries. He further stated that the codes in NOMADS database were not aligned to the ones in the IFMS assets management module.", "metadata": {"headings": [{"headings_0": {"content": "Information on the Operational Status of The Equipment", "page": 13, "level": 1}}, {"headings_1": {"content": "Failure to Maintain an Updated Medical Equipment Database With Relevant", "page": 13, "level": 1}}, [{"headings_0": {"content": "Information on the Operational Status of The Equipment", "page": 13, "level": 1}}, {"headings_1": {"content": "Failure to Maintain an Updated Medical Equipment Database With Relevant", "page": 13, "level": 1}}]], "page": 13, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": [["1.", "Portal X\u2013Ray Machine", "", "The X-Ray Machine is not functional. This renders the equipment utilised."], ["2.", "Ultra  Sound Scan  Equipment", "", "The Ultra Sound Scan Equipment is only operated or manned by one person. The Radiology section tends to the overcrowded as one person serve many patients."]], "metadata": {"headings": [{"headings_0": {"content": "Information on the Operational Status of The Equipment", "page": 13, "level": 1}}, {"headings_1": {"content": "Failure to Maintain an Updated Medical Equipment Database With Relevant", "page": 13, "level": 1}}], "page": 14, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "columns": ["SN", "Equipment", "Pictorial Evidence", "Audit Findings"], "type": "table"}}, {"content": "This has affected service delivery in absence of the operators. \nThe Accounting Officer explained that the department only had one personnel who could not operate both machines at the same time. However additional staff had been deployed in the department", "metadata": {"headings": [{"headings_0": {"content": "Information on the Operational Status of The Equipment", "page": 13, "level": 1}}, {"headings_1": {"content": "Failure to Maintain an Updated Medical Equipment Database With Relevant", "page": 13, "level": 1}}, [{"headings_0": {"content": "Information on the Operational Status of The Equipment", "page": 13, "level": 1}}, {"headings_1": {"content": "Failure to Maintain an Updated Medical Equipment Database With Relevant", "page": 13, "level": 1}}]], "page": 14, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "Recommendation", "metadata": {"headings": [{"headings_0": {"content": "Recommendation", "page": 14, "level": 1}}, {"headings_1": {"content": "Information on the Operational Status of The Equipment", "page": 13, "level": 1}}], "page": 14, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "I advised the Accounting Officer to liaise with MoPS and MoFPED to recruit staff to operate the machines. \n5.7", "metadata": {"headings": [{"headings_0": {"content": "Recommendation", "page": 14, "level": 1}}, {"headings_1": {"content": "Information on the Operational Status of The Equipment", "page": 13, "level": 1}}, [{"headings_0": {"content": "Recommendation", "page": 14, "level": 1}}, {"headings_1": {"content": "Information on the Operational Status of The Equipment", "page": 13, "level": 1}}]], "page": 14, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "Failure to Dispose Off Non-Functioning Equipment", "metadata": {"headings": [{"headings_0": {"content": "Failure to Dispose Off Non-Functioning Equipment", "page": 14, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 14, "level": 1}}], "page": 14, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "Section 5.5 of National medical equipment policy (2009) on Disposal of Medical Waste the reasons for disposal include obsolescence, uneconomical use, and lack of spare parts. Maintenance workshop managers should report to the health facility in- charges or designated administration officers any equipment that is due for decommissioning and disposal. The workshop managers should advise on the risk that could arise from continuous use of the equipment. Accordingly, the health facility in-charges and designated administration officers should report the cases to the accounting officers to initiate the disposal process. Disposal procedures of medical equipment should be in line with the Environment Laws of Uganda, and PPDA Regulations.", "metadata": {"headings": [{"headings_0": {"content": "Failure to Dispose Off Non-Functioning Equipment", "page": 14, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 14, "level": 1}}], "page": 14, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": [["1.", "Assorted Equipment", "", ""]], "metadata": {"headings": [{"headings_0": {"content": "Failure to Dispose Off Non-Functioning Equipment", "page": 14, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 14, "level": 1}}], "page": 14, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "columns": ["SN", "Equipment", "Pictorial evidence", "Management response"], "type": "table"}}, {"content": "2. Portable X -ray Machine", "metadata": {"headings": [{"headings_0": {"content": "Failure to Dispose Off Non-Functioning Equipment", "page": 14, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 14, "level": 1}}], "page": 15, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "list"}}, {"content": "The Accounting Officer explained that this was caused by the delayed approval of the values by the Chief Government Valuer(CGV). However, the vote had started the process of Disposal of obsolete equipment.", "metadata": {"headings": [{"headings_0": {"content": "Failure to Dispose Off Non-Functioning Equipment", "page": 14, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 14, "level": 1}}], "page": 15, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "Recommendation", "metadata": {"headings": [{"headings_0": {"content": "Recommendation", "page": 15, "level": 1}}, {"headings_1": {"content": "Failure to Dispose Off Non-Functioning Equipment", "page": 14, "level": 1}}], "page": 15, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "I advised the Accounting Officer to follow up the matter with CGV. \n5.8 Dilapidated Buildings  \nThe Public Service Standing Orders state that the management of all Government properties in a given Ministry, Department or Local Government is the direct responsibility of the Responsible Officer, who shall make arrangements for the maintenance of such properties. Similarly, Paragraph 16.2 of the Treasury Instruction 2017 requires the Accounting Officer to prepare a budget for asset maintenance annually. \nAudit inspection of Hospital staff houses revealed that some of them were dilapidated and in dire need of repair the photos below refers. The inspection also revealed that toilets were not sufficient thus posing a risk of disease outbreak which could in turn affect the Hospital Patients as well. \nA detailed analysis of the Hospital budget revealed that the Hospital did not provide for asset maintenance as required by the Treasury Instructions.", "metadata": {"headings": [{"headings_0": {"content": "Recommendation", "page": 15, "level": 1}}, {"headings_1": {"content": "Failure to Dispose Off Non-Functioning Equipment", "page": 14, "level": 1}}, [{"headings_0": {"content": "Recommendation", "page": 15, "level": 1}}, {"headings_1": {"content": "Failure to Dispose Off Non-Functioning Equipment", "page": 14, "level": 1}}], [{"headings_0": {"content": "Recommendation", "page": 15, "level": 1}}, {"headings_1": {"content": "Failure to Dispose Off Non-Functioning Equipment", "page": 14, "level": 1}}], [{"headings_0": {"content": "Recommendation", "page": 15, "level": 1}}, {"headings_1": {"content": "Failure to Dispose Off Non-Functioning Equipment", "page": 14, "level": 1}}]], "page": 15, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": [["", ""], ["Staff Housing units", "Toilets"]], "metadata": {"headings": [{"headings_0": {"content": "Recommendation", "page": 15, "level": 1}}, {"headings_1": {"content": "Failure to Dispose Off Non-Functioning Equipment", "page": 14, "level": 1}}], "page": 15, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "columns": ["column_0", "column_1"], "type": "table"}}, {"content": "5.9", "metadata": {"headings": [{"headings_0": {"content": "Recommendation", "page": 15, "level": 1}}, {"headings_1": {"content": "Failure to Dispose Off Non-Functioning Equipment", "page": 14, "level": 1}}], "page": 16, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "Poor State of the Mortuary", "metadata": {"headings": [{"headings_0": {"content": "Poor State of the Mortuary", "page": 16, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 15, "level": 1}}], "page": 16, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "Section 104.3 of the Ministry of Health Service Standards and Service Delivery Standards for The Health Sector July 2016, requires a health facility to have a functional refrigerated storage system.  \nFurthermore, section 7.50.2 requires a health facility to have suitable infrastructure and equipment for the handling, storage and transportation of bodies. \nI noted that the mortuary had limited space, and utilizes a malfunctioning refrigerator. These inadequacies impacts the proper conduct of post-mortem examinations and the ability to preserve bodies until funeral arrangements are made. \nThe Accounting Officer attributed the frequent breakdowns of the old statutes of the equipment and inadequate resources of the Hospital to acquire a new one.", "metadata": {"headings": [{"headings_0": {"content": "Poor State of the Mortuary", "page": 16, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 15, "level": 1}}, [{"headings_0": {"content": "Poor State of the Mortuary", "page": 16, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 15, "level": 1}}], [{"headings_0": {"content": "Poor State of the Mortuary", "page": 16, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 15, "level": 1}}]], "page": 16, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "Recommendation", "metadata": {"headings": [{"headings_0": {"content": "Recommendation", "page": 16, "level": 1}}, {"headings_1": {"content": "Poor State of the Mortuary", "page": 16, "level": 1}}], "page": 16, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "I advised the Accounting Officer should liaise with Ministry of Health to obtain adequate funding for the effective operation of the regional Mortuary. \n6.0", "metadata": {"headings": [{"headings_0": {"content": "Recommendation", "page": 16, "level": 1}}, {"headings_1": {"content": "Poor State of the Mortuary", "page": 16, "level": 1}}, [{"headings_0": {"content": "Recommendation", "page": 16, "level": 1}}, {"headings_1": {"content": "Poor State of the Mortuary", "page": 16, "level": 1}}]], "page": 16, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "Government to Government Assistance for the Regional Referral Hospital Strengthening Activities", "metadata": {"headings": [{"headings_0": {"content": "Government to Government Assistance for the Regional Referral Hospital Strengthening Activities", "page": 16, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 16, "level": 1}}], "page": 16, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "In the year 2022, the Government of Uganda through the Ministry of Finance, Planning & Economic Development in concurrence with Ministry of Health agreed upon terms and conditions and provide information and procedures concerning the implementation of the Regional Referral Hospital Strengthening Activities which encompass on-going support for and planned assistance for multiple regional referral Hospital. \nThe Regional Referral designated under the Consolidated Implementation Letter (CIL) include Jinja, Mbarara, Lira, Moroto, Mbale, Gulu and Kabale. \nMy review of the Consolidated Implementations letter CIL, Budget, work plan and expenditure under the G2G project revealed the following; \n6.1", "metadata": {"headings": [{"headings_0": {"content": "Government to Government Assistance for the Regional Referral Hospital Strengthening Activities", "page": 16, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 16, "level": 1}}, [{"headings_0": {"content": "Government to Government Assistance for the Regional Referral Hospital Strengthening Activities", "page": 16, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 16, "level": 1}}], [{"headings_0": {"content": "Government to Government Assistance for the Regional Referral Hospital Strengthening Activities", "page": 16, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 16, "level": 1}}], [{"headings_0": {"content": "Government to Government Assistance for the Regional Referral Hospital Strengthening Activities", "page": 16, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 16, "level": 1}}]], "page": 16, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "Delayed Commencement of Project", "metadata": {"headings": [{"headings_0": {"content": "Delayed Commencement of Project", "page": 16, "level": 1}}, {"headings_1": {"content": "Government to Government Assistance for the Regional Referral Hospital Strengthening Activities", "page": 16, "level": 1}}], "page": 16, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "Paragraph 4.1 of the CIL states that actions and undertakings are necessary to begin to implement the Hospital activities under the CIL is October 1 2021. \n6.2", "metadata": {"headings": [{"headings_0": {"content": "Delayed Commencement of Project", "page": 16, "level": 1}}, {"headings_1": {"content": "Government to Government Assistance for the Regional Referral Hospital Strengthening Activities", "page": 16, "level": 1}}, [{"headings_0": {"content": "Delayed Commencement of Project", "page": 16, "level": 1}}, {"headings_1": {"content": "Government to Government Assistance for the Regional Referral Hospital Strengthening Activities", "page": 16, "level": 1}}]], "page": 16, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "Utilisation of the G2G Budget", "metadata": {"headings": [{"headings_0": {"content": "Utilisation of the G2G Budget", "page": 17, "level": 1}}, {"headings_1": {"content": "Delayed Commencement of Project", "page": 16, "level": 1}}], "page": 17, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "I reviewed the IFMS to assess the extent of implementation of the approved budget and noted that the Hospital during the year under review had a budget of UGX.3,646,573,567 out of which 100% was released. \nHowever, the Hospital spent UGX.752,833,935 leaving a balance of UGX.2,893,739,632 representing 21% absorption of released funds.  \nThe unspent funds have affected services delivery. \nThe Accounting Officer explained that the under absorption of G2G funds was due to the delayed release of the consolidated implementation letter (issued in October", "metadata": {"headings": [{"headings_0": {"content": "Utilisation of the G2G Budget", "page": 17, "level": 1}}, {"headings_1": {"content": "Delayed Commencement of Project", "page": 16, "level": 1}}, [{"headings_0": {"content": "Utilisation of the G2G Budget", "page": 17, "level": 1}}, {"headings_1": {"content": "Delayed Commencement of Project", "page": 16, "level": 1}}], [{"headings_0": {"content": "Utilisation of the G2G Budget", "page": 17, "level": 1}}, {"headings_1": {"content": "Delayed Commencement of Project", "page": 16, "level": 1}}]], "page": 17, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "2022. that resulted into delayed recruitment of project staff (that was majorly completed by March 2023) as well late approval of G2G budgets.", "metadata": {"headings": [{"headings_0": {"content": "Utilisation of the G2G Budget", "page": 17, "level": 1}}, {"headings_1": {"content": "Delayed Commencement of Project", "page": 16, "level": 1}}], "page": 17, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "list"}}, {"content": "Recommendation", "metadata": {"headings": [{"headings_0": {"content": "Recommendation", "page": 17, "level": 1}}, {"headings_1": {"content": "Utilisation of the G2G Budget", "page": 17, "level": 1}}], "page": 17, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "I advised the Accounting Officer to roll over these activities for implementation in the subsequent period. \n6.3", "metadata": {"headings": [{"headings_0": {"content": "Recommendation", "page": 17, "level": 1}}, {"headings_1": {"content": "Utilisation of the G2G Budget", "page": 17, "level": 1}}, [{"headings_0": {"content": "Recommendation", "page": 17, "level": 1}}, {"headings_1": {"content": "Utilisation of the G2G Budget", "page": 17, "level": 1}}]], "page": 17, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "Untimely submission of required report", "metadata": {"headings": [{"headings_0": {"content": "Untimely submission of required report", "page": 17, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 17, "level": 1}}], "page": 17, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "Para 10.7 requires the Hospital to prepare and submit to USAID a performance report that includes a comparison of actual accomplishments with the goals, standard, and objectives established for the relevant outputs. For instance, Quarterly updates on the Risk Mitigation Plan and Quarterly Financial reporting are required to be submitted 30 days after the end of each quarter, PEPFAR program expenditures reports by September 30 th , Quarterly VAT reports by 25 th of the month following the quarter. \nI was not availed any report to confirm whether the Hospital adhered to the provision.  \nAccounting Officer explained that the required documents were not readily availed by then due to inaccessibility of the responsible staff; however, the documents were still not availed for verification.", "metadata": {"headings": [{"headings_0": {"content": "Untimely submission of required report", "page": 17, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 17, "level": 1}}, [{"headings_0": {"content": "Untimely submission of required report", "page": 17, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 17, "level": 1}}]], "page": 17, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "Recommendation", "metadata": {"headings": [{"headings_0": {"content": "Recommendation", "page": 17, "level": 1}}, {"headings_1": {"content": "Untimely submission of required report", "page": 17, "level": 1}}], "page": 17, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "I advised the Accounting Officer to avail the required information to Parliament for follow up.", "metadata": {"headings": [{"headings_0": {"content": "Recommendation", "page": 17, "level": 1}}, {"headings_1": {"content": "Untimely submission of required report", "page": 17, "level": 1}}], "page": 17, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "MANAGEMENT\u2019S RESPONSIBILITY FOR THE FINANCIAL STATEMENTS", "metadata": {"headings": [{"headings_0": {"content": "MANAGEMENT\u2019S RESPONSIBILITY FOR THE FINANCIAL STATEMENTS", "page": 18, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 17, "level": 1}}], "page": 18, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "Under Article 164 of the Constitution of the Republic of Uganda, 1995 (as amended) and Section 45 of the PFMA, 2015, the Accounting Officer is accountable to Parliament for the funds and resources of Gulu Regional Referral Hospital. \nThe Accounting Officer is also responsible for the preparation of financial statements in accordance with the requirements of the PFMA, 2015 (as amended), the Financial Reporting Guide, 2018 and for such internal control as management determines necessary to enable the preparation of financial statements that are free from material misstatement whether due to fraud or error. \nIn preparing the financial statements, the Accounting Officer is responsible for assessing the Gulu Regional Referral Hospital ability to continue delivering its mandate, disclosing, as applicable, matters affecting ability to deliver its mandate for the foreseeable future, unless the Accounting Officer has a realistic alternative to the contrary.", "metadata": {"headings": [{"headings_0": {"content": "MANAGEMENT\u2019S RESPONSIBILITY FOR THE FINANCIAL STATEMENTS", "page": 18, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 17, "level": 1}}, [{"headings_0": {"content": "MANAGEMENT\u2019S RESPONSIBILITY FOR THE FINANCIAL STATEMENTS", "page": 18, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 17, "level": 1}}], [{"headings_0": {"content": "MANAGEMENT\u2019S RESPONSIBILITY FOR THE FINANCIAL STATEMENTS", "page": 18, "level": 1}}, {"headings_1": {"content": "Recommendation", "page": 17, "level": 1}}]], "page": 18, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "AUDITOR\u2019S RESPONSIBILITY FOR THE AUDIT OF FINANCIAL STATEMENTS", "metadata": {"headings": [{"headings_0": {"content": "AUDITOR\u2019S RESPONSIBILITY FOR THE AUDIT OF FINANCIAL STATEMENTS", "page": 18, "level": 1}}, {"headings_1": {"content": "MANAGEMENT\u2019S RESPONSIBILITY FOR THE FINANCIAL STATEMENTS", "page": 18, "level": 1}}], "page": 18, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "My objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor\u2019s report that includes my opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with ISSAIs will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financial statements. As part of an audit in accordance with ISSAI\u2019s, I exercise professional judgment and maintain professional scepticism throughout the audit. I also:", "metadata": {"headings": [{"headings_0": {"content": "AUDITOR\u2019S RESPONSIBILITY FOR THE AUDIT OF FINANCIAL STATEMENTS", "page": 18, "level": 1}}, {"headings_1": {"content": "MANAGEMENT\u2019S RESPONSIBILITY FOR THE FINANCIAL STATEMENTS", "page": 18, "level": 1}}], "page": 18, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "- Identify and assess the risks of material misstatement of the financial statements, whether due to fraud or error, design and perform audit procedures responsive to those risks, and obtain audit evidence that is sufficient and appropriate to provide a basis for my opinion. The risk of not detecting a material misstatement resulting from fraud is higher than for one resulting from error, as fraud may involve collusion, forgery, intentional omissions, misrepresentations, or the override of internal control.\n- Obtain an understanding of internal control relevant to the audit in order to design audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of the Gulu Regional Referral Hospital\u2019s internal control.\n- Evaluate the appropriateness of accounting policies used and the reasonableness of accounting estimates and related disclosures made by management.\n- Conclude on the appropriateness of management\u2019s use of the going concern basis of accounting and, based on the audit evidence obtained, whether a material uncertainty exists related to events or conditions that may cast significant doubt on the Gulu Regional Referral Hospital\u2019s ability to deliver its mandate. If I conclude that a material uncertainty exists, I am required to draw attention in my auditor\u2019s report to the related disclosures in the financial statements or, if such disclosures are inadequate, to modify my opinion. My conclusions are based on the audit evidence obtained up to the date of my auditor\u2019s report. However, future events or conditions may cause the Gulu Regional Referral Hospital to fail to deliver its mandate.\n- Evaluate the overall presentation, structure and content of the financial statements, including the disclosures, and whether the financial statements represent the underlying transactions and events in a manner that achieves fair presentation.", "metadata": {"headings": [{"headings_0": {"content": "AUDITOR\u2019S RESPONSIBILITY FOR THE AUDIT OF FINANCIAL STATEMENTS", "page": 18, "level": 1}}, {"headings_1": {"content": "MANAGEMENT\u2019S RESPONSIBILITY FOR THE FINANCIAL STATEMENTS", "page": 18, "level": 1}}], "page": 18, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "list"}}, {"content": "I communicate with the Accounting Officer regarding, among other matters, the planned scope and timing of the audit and significant audit findings, including any significant deficiencies in internal control that I identify during my audit. \nI also provide the Accounting Officer with a statement that I have complied with relevant ethical requirements regarding independence, and to communicate with him/her all relationships and other matters that may reasonably be thought to bear on my independence, and where applicable, related safeguards. \nFrom the matters communicated with the Accounting Officer, I determine those matters that were of most significance in the audit of the financial statements of the current period and are therefore the key audit matters. I describe these matters in my auditor\u2019s report unless law or regulation precludes public disclosure about the matter or when, in extremely rare circumstances, I determine that a matter should not be communicated in my report because the adverse consequences of doing so would reasonably be expected to outweigh the public interest benefits of such communication. \nOTHER REPORTING RESPONSIBILITIES  \nIn accordance with Section 19 (1) of the National Audit Act, 2008, I report to you, based on my work described on the audit of Financial Statements, that, the activities, financial transactions and information reflected in the financial statements that have come to my notice during the audit, are in all material respects, in compliance with the authorities which govern them.", "metadata": {"headings": [{"headings_0": {"content": "AUDITOR\u2019S RESPONSIBILITY FOR THE AUDIT OF FINANCIAL STATEMENTS", "page": 18, "level": 1}}, {"headings_1": {"content": "MANAGEMENT\u2019S RESPONSIBILITY FOR THE FINANCIAL STATEMENTS", "page": 18, "level": 1}}, [{"headings_0": {"content": "AUDITOR\u2019S RESPONSIBILITY FOR THE AUDIT OF FINANCIAL STATEMENTS", "page": 18, "level": 1}}, {"headings_1": {"content": "MANAGEMENT\u2019S RESPONSIBILITY FOR THE FINANCIAL STATEMENTS", "page": 18, "level": 1}}], [{"headings_0": {"content": "AUDITOR\u2019S RESPONSIBILITY FOR THE AUDIT OF FINANCIAL STATEMENTS", "page": 18, "level": 1}}, {"headings_1": {"content": "MANAGEMENT\u2019S RESPONSIBILITY FOR THE FINANCIAL STATEMENTS", "page": 18, "level": 1}}], [{"headings_0": {"content": "AUDITOR\u2019S RESPONSIBILITY FOR THE AUDIT OF FINANCIAL STATEMENTS", "page": 18, "level": 1}}, {"headings_1": {"content": "MANAGEMENT\u2019S RESPONSIBILITY FOR THE FINANCIAL STATEMENTS", "page": 18, "level": 1}}]], "page": 19, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "REPORT ON THE AUDIT OF COMPLIANCE WITH LEGISLATION", "metadata": {"headings": [{"headings_0": {"content": "REPORT ON THE AUDIT OF COMPLIANCE WITH LEGISLATION", "page": 19, "level": 1}}, {"headings_1": {"content": "AUDITOR\u2019S RESPONSIBILITY FOR THE AUDIT OF FINANCIAL STATEMENTS", "page": 18, "level": 1}}], "page": 19, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "There were no material findings in respect of the compliance criteria for the applicable subject matters. \nJohn F.S. Muwanga", "metadata": {"headings": [{"headings_0": {"content": "REPORT ON THE AUDIT OF COMPLIANCE WITH LEGISLATION", "page": 19, "level": 1}}, {"headings_1": {"content": "AUDITOR\u2019S RESPONSIBILITY FOR THE AUDIT OF FINANCIAL STATEMENTS", "page": 18, "level": 1}}, [{"headings_0": {"content": "REPORT ON THE AUDIT OF COMPLIANCE WITH LEGISLATION", "page": 19, "level": 1}}, {"headings_1": {"content": "AUDITOR\u2019S RESPONSIBILITY FOR THE AUDIT OF FINANCIAL STATEMENTS", "page": 18, "level": 1}}]], "page": 19, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}, {"content": "Appendices", "metadata": {"headings": [{"headings_0": {"content": "Appendices", "page": 20, "level": 1}}, {"headings_1": {"content": "REPORT ON THE AUDIT OF COMPLIANCE WITH LEGISLATION", "page": 19, "level": 1}}], "page": 20, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": "Appendix 1 (a): Utilization of Warrants", "metadata": {"headings": [{"headings_0": {"content": "Appendix 1 (a): Utilization of Warrants", "page": 20, "level": 2}}, {"headings_1": {"content": "Appendices", "page": 20, "level": 1}}], "page": 20, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": [["Human Capital Development", "Advertising and Public Relations", "2,200,000"], [null, "Allowances (Incl. Casuals, Temporary, sitting allowances)", "2,141,367,229"], [null, "Beddings, Clothing, Footwear and related Services", "8,990,390"], [null, "Books, Periodicals & Newspapers", "1,290,000"], [null, "Consultancy Services", "60,000"], [null, "General Staff Salaries", "119,599,810"], [null, "Gratuity", "466,064,932"], [null, "Information and Communication Technology Services", "5,522,233"], [null, "Information and Communication Technology Supplies", "214,409,838"], [null, "Laboratory supplies and services", "75,000"], [null, "Maintenance - Buildings and Structures", "653,500"], [null, "Maintenance - Machinery & Equipment Other than Transport Equipment", "772,000"], [null, "Maintenance - Other Fixed Assets", "27,905,679"], [null, "Maintenance - Transport Equipment", "4,867,120"], [null, "Medical expenses (Employees)", "190,705,338"], [null, "Medical expenses (To general public)", "20"], [null, "Medical Supplies and Services", "61,936,881"], [null, "Membership dues and Subscription fees", "1,010,000"], [null, "Pension", "824,012,158"], [null, "Postage and Courier", "102,000"], [null, "Printing, Stationery, Photocopying and Binding", "13,398,895"], [null, "Property Management Expenses", "1,034,940"], [null, "Rent", "700,000"], [null, "Residential Buildings \u2013 Acquisition", "870,000,000"], [null, "Small Office Equipment", "885,000"], [null, "Special Meals and Drinks", "6,166,784"], [null, "Staff Training", "9,139,215"], [null, "Systems Recurrent costs", "168,639"], [null, "Travel inland", "359,282"], [null, "Welfare and Entertainment", "89,485,454"], ["", "", "**5,062,882,337**"]], "metadata": {"headings": [{"headings_0": {"content": "Appendix 1 (a): Utilization of Warrants", "page": 20, "level": 2}}, {"headings_1": {"content": "Appendices", "page": 20, "level": 1}}], "page": 20, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "columns": ["Programme", "Activities", "Amount"], "type": "table"}}, {"content": "Appendix 1 (b): Implementation of Planned Outputs i). Fully implemented out-puts", "metadata": {"headings": [{"headings_0": {"content": "Appendix 1 (b): Implementation of Planned Outputs i). Fully implemented out-puts", "page": 21, "level": 2}}, {"headings_1": {"content": "Appendix 1 (a): Utilization of Warrants", "page": 20, "level": 2}}], "page": 21, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": [["SN", "Program", "Sub-Program", "PIAP-out", "Budget Out-put", "Total Output expenditure", "Total  No. of Activities", "Number of fully Implemented"], ["1.", "12 Human Capital Development", "02 Population Health, Safety and Management", "1203010508 Health facilities at all levels equipped with appropriate and modern medical and diagnostic equipment.", "320011 Equipment maintenance", "166,220,020", "9", "9"], ["2.", "13 Human Capital Development", "3 Population Health, Safety and Management", "1203010514 Reduced morbidity and mortality due to HIV/AIDS, TB and malaria and other communicable diseases.", "320009 Diagnostic Services", "49,304,006", "11", "7"], ["3.", "14 Human Capital Development", "4 Population Health, Safety and Management", "1203010514 Reduced morbidity and mortality due to HIV/AIDS, TB and malaria and other communicable diseases", "320033 Outpatient Services", "186,460,601", "14", "9"], ["4.", "15 Human Capital Development", "5 Population Health, Safety and Management", "1203011405 Reduced morbidity and mortality due to HIV/AIDS, TB and malaria and other communicable diseases.", "000013 HIV/AIDS mainstreaming", "752,833,935", "3", "3"], ["", "", "", "", "**Total**", "**1,154,818,562**", "", ""]], "metadata": {"headings": [{"headings_0": {"content": "Appendix 1 (b): Implementation of Planned Outputs i). Fully implemented out-puts", "page": 21, "level": 2}}, {"headings_1": {"content": "Appendix 1 (a): Utilization of Warrants", "page": 20, "level": 2}}], "page": 21, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "columns": ["column_0", "column_1", "column_2", "column_3", "column_4", "column_5", "column_6", "column_7"], "type": "table"}}, {"content": "ii). Partially Implemented out-puts", "metadata": {"headings": [{"headings_0": {"content": "ii). Partially Implemented out-puts", "page": 21, "level": 2}}, {"headings_1": {"content": "Appendix 1 (b): Implementation of Planned Outputs i). Fully implemented out-puts", "page": 21, "level": 2}}], "page": 21, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "heading"}}, {"content": [["N o .", "Progra m", "Sub- program", "PIAP-Outs", "Budget Out-put", "Activities", "Total Out-put expenditure", "Tota l No activ ities in the outp ut", "Numb er of fully imple mente d activiti es", "No of partiall y  imple mente d activiti es", "No of activiti es that were not imple mente d", "Manag ement\u2019s Respon se"], ["1", "12- Huma n Capital Manag ement", "02- Population Health, safety and Manageme nt", "1203010514 Reduced morbidity and mortality due to HIV/AIDS, TB and malaria and other communicable diseases.", "320009 Diagnosti c Services", "Training of service providers", "50,774,000", "11", "7", "4", "0", ""], [null, null, null, null, null, "Training of KP friendly services", null, null, null, null, null, ""], [null, null, null, null, null, "Procurement of HIV test kits", null, null, null, null, null, ""], [null, null, null, null, null, "Engagement of stakeholders in the HIV prevention effort to address the social cultural the HIV Epidemic factors that drive", null, null, null, null, null, ""], ["2", "12- Huma n", "02- Population Health,", "1203010514 Reduced morbidity and mortality due to", "320033 Outpatie nt", "Training of CSOs and service providers", "187,252,800", "14", "9", "5", "0", ""], [null, null, null, null, null, "Training of health workers to deliver KP friendly services", null, null, null, null, null, ""]], "metadata": {"headings": [{"headings_0": {"content": "ii). Partially Implemented out-puts", "page": 21, "level": 2}}, {"headings_1": {"content": "Appendix 1 (b): Implementation of Planned Outputs i). Fully implemented out-puts", "page": 21, "level": 2}}], "page": 21, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "columns": ["column_0", "column_1", "column_2", "column_3", "column_4", "column_5", "column_6", "column_7", "column_8", "column_9", "column_10", "column_11"], "type": "table"}}, {"content": "18", "metadata": {"headings": [{"headings_0": {"content": "ii). Partially Implemented out-puts", "page": 21, "level": 2}}, {"headings_1": {"content": "Appendix 1 (b): Implementation of Planned Outputs i). Fully implemented out-puts", "page": 21, "level": 2}}], "page": 21, "document_name": "Gulu Regional Referral Hospital Report of the Auditor General, 2023", "type": "paragraph"}}], "table_of_contents": [{"content": ["Table of Contents", "Page", "List of Acronyms - iii", "OPINION - 1", "BASIS FOR OPINION - 1", "KEY AUDIT MATTERS - 1", "  1.0 Implementation of the Approved Budget - 1", "  2.0 Management of the Government Salary Payroll - 5", "EMPHASIS OF MATTER - 6", "  3.0 Change in Accounting Treatment for Non-current Assets - 6", "OTHER MATTER - 7", "  4.0 Long Outstanding Payables - 7", "OTHER MATTER - 7", "  5.0 Management of Essential Medicines and Health Supplies - 7", "6.0 Government to Government Assistance for the Regional Referral Hospital", "Strengthening Activities - 13", "OTHER INFORMATION - 14", "MANAGEMENT\u2019S RESPONSIBILITY FOR THE FINANCIAL STATEMENTS - 15", "AUDITOR\u2019S RESPONSIBILITY FOR THE AUDIT OF FINANCIAL STATEMENTS - 15", "OTHER REPORTING RESPONSIBILITIES - 16", "REPORT ON THE AUDIT OF COMPLIANCE WITH LEGISLATION - 16"], "page": 2}]}