The Republic of Uganda Report of the Auditor

THE REPUBLIC OF UGANDA

REPORT OF THE AUDITOR GENERAL ON THE FINANCIAL STATEMENTS OF THE MINISTRY OF HEALTH FOR THE YEAR ENDED 30TH JUNE 2019

OFFICE OF THE AUDITOR GENERAL UGANDA

TABLE OF CONTENTS

List of Acronyms ...... ii Qualified Opinion ...... 1 Basis for Qualified Opinion ...... 1 1.0 Un Supported Adjustments in the Financial Statements ...... 1 2.0 Mischarge/Diversion of Funds ...... 1 Key Audit Matter ...... 2 3.0 Implementation of the approved budget ...... 2 4.0 Domestic Arrears ...... 6 5.0 Contingent Liabilities ...... 8 Other Information ...... 8 Management Responsibilities for the Financial Statements ...... 8 Auditor’s Responsibilities for the audit of the Financial Statements...... 9 Other Reporting Responsibilities ...... 10 Report on the Audit of Compliance with Legislation ...... 10 6.0 Technical/ Engineering Audit of the Rehabilitation and Expansion of Kayunga and Yumbe Hospitals implemented by Ministry of Health...... 10 7.0 Technical/Engineering audit of the Construction of Staff Houses in Selected Health Facilities In Seven Districts Of Karamoja Region i.e Kaabong, Kotido, Abim, Moroto, Napak, Amudat And Nakapiripirit Under The Karamoja Region Staff Housing Project (KRSHP) ...... 13 8.0 Staff Performance Management Initiatives...... 16 9.0 Payroll Management ...... 18 Appendix I: Showing Details of the extent of delivery of planned outputs ...... 19 Appendix II: Mischarge/Diversions ...... 37

LIST OF ACRONYMS

A/C Account IDA International Development Agency ISSAIs International Standards of Supreme Audit Institutions NMS National Medical Stores TI Treasury Instructions TSSA Treasury Single Sub Account UGX Uganda Shillings UNICEF United Nations Children’s Fund UNRO Uganda National Research Organisation URHVP Uganda Reproductive Health Voucher Project USD United states Dollars

REPORT OF THE AUDITOR GENERAL ON THE FINANCIAL STATEMENTS OF THE MINISTRY OF HEALTH

FOR THE YEAR ENDED 30TH JUNE, 2019

THE RT. HON. SPEAKER OF PARLIAMENT

Qualified Opinion I have audited the financial statements of the Ministry of Health for the year ended 30th June 2019. These financial statements comprise of the statement of Financial Position as at 30th June 2019, and the Statement of Financial Performance, Statement of Changes in Equity and 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

In my opinion, except for the effects of the matters described in the Basis for Qualified Opinion Paragraph, the financial statements of the Ministry of Health for the year ended 30th June 2019 are prepared, in all material respects, in accordance with section 51 of the Public Finance Management, 2015 and the Financial Reporting Guide, 2018.

Basis for Qualified Opinion

1.0 Un Supported Adjustments in the Financial Statements The review of the financial statements revealed unsupported adjustments relating to domestic arrears, overdraft and bounced EFTs which as a whole have a material effect on the presentation of the financial statements as explained below;

 In the Statement of Changes in Equity was an adjustment of UGX. 1,655,638,328 relating to the recognition of additional arrears for the prior year. However, the adjustment was not supported by a detailed schedule showing the arrears. I was, therefore, unable to confirm the appropriateness of the adjustment The review of the statement of reconciliation of movement of cash during the year showed the Ministry paid UGX. 1,037,888,831 to make good of the overdraft on its treasury single account in the previous year. I was not provided with appropriate evidence and documentation to support the reported overdraft.

 The Statement of Changes in Equity and the Reconciliation of movement of cash during the year indicated an adjustment of UGX. 313,653,500 relating to EFT payments effected in the previous year that bounced. However, there was no supporting schedule of the bounced EFTs and the expenditure was not first recognized as payables before settlement as required by Paragraph 5.1.2 of the Financial Reporting Guide 2018. I was therefore not able to verify the validity of the expenditure and the appropriateness of the adjustment.

2.0 Mischarge/Diversion of Funds A sum of UGX. 3,089,769,035 was charged on various budget lines which do not reflect the nature of the expenditure as defined by the Government Chart of Accounts (Appendix II refers). However, there was no evidence that the budget variations were authorized as required by Section 22 of the PFMA, 2015. Unauthorized budget variations impact on the credibility of the budget and have the effect of misrepresenting the expenditure reported in the financial statements.

I advised the Accounting officer to always adhere to the approved budget allocations or seek approvals in case of reallocations

I conducted my audit in accordance with International Standards of Supreme Audit Institutions (ISSAIs). My responsibilities under those standards are further described in the Auditor’s Responsibilities for the Audit of the Financial Statements section of my report. I am independent of the Ministry in accordance with the Constitution of the Republic of Uganda 1995 (as amended), the National Audit Act, 2008, the International Organization of Supreme Audit Institutions (INTOSAI) Code of Ethics, the International Ethics Standards Board for Accountants Code of Ethics for Professional Accountants (Parts A and B) (IESBA Code), and other independence requirements applicable to performing audits of Financial Statements in Uganda. I have fulfilled my other ethical responsibilities in accordance with the IESBA Code, and in accordance with other ethical requirements applicable to performing audits in Uganda. I believe that the audit evidence I have obtained is sufficient and appropriate to provide a basis for my opinion.

Key Audit Matter

Key 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. I have determined the matters described below to be key audit matters communicated in my report.

3.0 Implementation of the approved budget Section 45 of the Public Finance and Management Act, 2015, requires the Accounting Officer to control the regularity and proper use of the money appropriated to the vote.

According to Section 45 (3) of the same Act, the Accounting Officer shall enter into an annual performance contract with the Secretary to Treasury which shall bind the Accounting Officer to deliver on the activities in the work plan for the vote for the financial year. Work plans are based on outputs to be achieved for the financial year, and during implementation, effort is required to achieve the agreed objectives/targets for the entity within the available resources.

It has been observed over the years that planned and budgeted for activities of a number of Government entities are not implemented thereby affecting service delivery.

In the overall office wide planning, I assessed risks like inadequate release of funds and failure to undertake budget monitoring and supervision that are likely to be the causes of failure to implement entity planned activities. The focus was put on the planned outputs of the entities which greatly impact on the wellbeing of communities.

Consequently, I developed specific procedures to review the performance of the budget of the entity and these procedures included;

 Ascertaining the amount received by the entity and the source of the funding  Inquiring from management of off-budget financing received and ascertaining the basis for the off-budget financing, if any.  Comparing the approved budget against the actual receipts

 Comparing the planned vote function outputs against the actuals and determining the variances  Reviewing utilisation of the funds.

Based on the procedures performed, I observed that the Ministry is a government body set up with the mandate of policy formulation and dialogue with Health Development Partners; resource mobilization and budgeting; strategic planning; regulation; advising other Ministries on health matters; setting standards and quality assurance; capacity development and technical support; provision of nationally coordinated services such as epidemic control; coordination of health research and; monitoring and evaluation of the overall sector performance.

In order to achieve this mandate, the MOH planned to implement and achieve a number of both recurrent and development outputs under various programmes.

A review of the Ministry’s Ministerial Policy Statement, approved work plans and budgets revealed that the Ministry had a revised approved budget of UGX. 162,541,779,360 out of which UGX. 150,337,311,644 was released.

The key deliverables for the financial year 2018/19 are summarized in the table below.

Table: Showing key deliverables for MOH for the year

Programme/ Key deliverables Budget Cumulative Project Amount percentage of UGX (‘000’) the approved budget Project: 1027 080272: Government Buildings and 853,000 Institutional support Administrative Infrastructure to Ministry of Health 0.08 080275: 720,000 Purchase of Motor Vehicles and Other Transport Equipment 0.14 080280: 0 0 Hospital construction/ rehabilitation Output 080201 Monitoring, Supervision 5,241,882 and Evaluation of Health Systems 0.60 Project: 1185 Italian 080282: 5,609,770 support to HSSP and Staff houses construction and PRDP rehabilitation 1.10 080201 Monitoring, Supervision and 120,000 Evaluation of Health Systems 1.11 Project: 1187 080280: 2,306,000 Support to Mulago Hospital Construction/rehabilitation 1.31 Hospital 080201 Monitoring, Supervision and 264,000 Rehabilitation Evaluation of Health Systems 1.34 Project: 1243 080280: 12,852,574 Rehabilitation and Hospital Construction/rehabilitation 2.47 construction of 080201 Monitoring, Supervision and 50,000 General hospitals Evaluation of Health Systems 2.48 Project: 1344 080277: 5,000,000 Renovation and Purchase of Specialized Machinery & Equipping of Equipment 2.92 Kayunga and Yumbe 080280: 43,326,108 General Hospitals Hospital Construction/rehabilitation 3.83 080201 Monitoring, Supervision and 2,625,961 Evaluation of Health Systems 6.98

Programme/ Key deliverables Budget Cumulative Project Amount percentage of UGX (‘000’) the approved budget Project: 1394 080280: 980,000 regional hospital for Hospital Construction/rehabilitation 7.07 pediatric surgery 080201 Monitoring, Supervision and 20,000 Evaluation of Health Systems 7.07 Project: 1440 080275 Purchase of Motor Vehicles USD Uganda and Other Transport Equipment 831,198 Reproductive

Maternity and Child 080276: 5,656,696 Health Services Purchase of Office and ICT Equipment, Improvement including Software 7.57 Project 080277: 7,972,524 Purchase of Specialized Machinery & Equipment 8.28 080281: Health center construction 33,260,868 and rehabilitation 11.22 080201 Monitoring, Supervision and 26,086,485 Evaluation of Health Systems 13.53 Project: 0220 global 080575 Purchase of Motor Vehicles 1,030,733 Fund for Aids, TB and Other Transport Equipment and Malaria 13.62 080577: 7,599,782 Purchase of Specialized Machinery & Equipment 14.29 080503 Monitoring and Evaluation 2,175,269 Capacity Improvement 14.48 1436: GAVI vaccines 080572: 12,015,379 and Health sector Government Buildings and Development plan Administrative Infrastructure support 15.54 080575: Purchase of Motor Vehicles 6,483,155 and Other Transport Equipment 16.12 080577: 197,567 Purchase of Specialized Machinery & Equipment 16.13 080503 Monitoring and Evaluation 40,136,910 Capacity Improvement 19.68

The Ministry planned to achieve the above deliverables through implementation of 41 outputs. I sampled 28 out-puts budgeted at UGX. 1,022,297,782,000 (including external funding) representing 87.71% of the total budget for review and set out below are the key findings.

Sn Observation Recommendati on 1 Revenue performance I advised the I reviewed the NTR estimates, revenue sources and rates charged at Accounting vote level for the financial year 2018/2019 and noted that the entity Officer to liaise did not budget for NTR, however, UGX.134,218,800 was collected. with MoFEPD to Failure to budget for revenue misleads the users of the financial ensure that any statements. lapses in the budgeting system Management explained that the budgeting system does not cater for are rectified NTR which is not appropriated in aid.

2 Un-remitted off-budget receipts I advised the I noted the entity had off-budget financing to a tune of USD. Accounting 6,202,468.79 and UGX. 4,678,591,035 which was not paid into the Officer to liaise Consolidated Fund contrary to Section 36(6), 43 and 44(20) of the with the Ministry PFMA, 2015. of Finance and The off-budget receipts are summarized in the table below. Economic Project Funder Opening Receipts Payments Closing Development to Name balance as at during the during the balance as at 01/07/2018 year year 30/06/2019 ensure that all planned URHVP IDA 72,468.79 6,130,000 1,445,204.40 (USD) 4,757,264.39 development UNICEF (UGX) 1,776,109,598 2,902,481,437 4,103,083,143 575,507,890 partner disbursements

are captured in Off-budget financing distorts planning and financial reporting and the Vote’s may result in duplication of activities. approved budget

estimates Management explained that funding mechanisms depend on the

preferences and negotiations between GoU and Partners. The off budget support from Partners to MoH is based on the MoUs that are time-based and output oriented for specific activities that may arise anytime. Some Partners prefer using their own Financial Management Systems.

3 Budget shortfall I observed that:  The entity budgeted to receive UGX. 162,541,779,360, however I advised the UGX. 149,884,922,533 was warranted resulting in a budget Accounting shortfall of UGX. 12,656,856,827 representing a funding level of Officer to liaise 92.2%. Of the amount warranted, UGX. 150,337,311,644 was with the released MoFP&ED to  Of the amount released, UGX.150,334,054,569 was spent by the ensure that the entity resulting in unspent balance of UGX.3,257,075 Vote’s approved representing an absorption level of almost 100%. The unspent budget is fully balances were disclosed as Cash and cash equivalents in the released so that Statement of Financial Position. Refer to the table below; all planned activities are MOH APP Warr RELEAS Variance Expendi Unspent implemented. EST (A) anted E(B) C=(A-B) ture (B-D) (billion (billion) (billion) (D) (billion) (billion)

FY18/19 162.541 150.337 12.204 150.334 0.003

Budget shortfalls resulted in partial or non-implementation of planned activities.

4 Non Quantification of outputs/activities

Out of the 41 outputs planned to implemented, by the entity during I advised the the financial year, I sampled and reviewed 28 outputs with a budget Accounting of UGX.1,022,297,782,000 representing 87.71% of the total budget Officer to as indicated the table below. institute measures to Table showing outputs planned and sampled ensure that Details Number Budget outputs and Total Planned Outputs 41 1,131,093,000,000 activities are Outputs sampled 28 1,022,297,782,000 properly Percentage Sampled 68.29% 87.71% quantified when preparing the

Review of the entity performance reports for the financial year annual plans and 2018/2019 revealed that out of 28 outputs assessed, 11 outputs budgets. representing 39.29% of the total outputs were not quantified to enable measurement of performance. Details in Appendix I.

Failure to plan and report on the quality/quantity of activities implemented renders it difficult to establish individual activity costs for each planned output, and this curtails effective accountability when funds are subsequently spent. Further, without clearly spelt out planned outputs, I could not ascertain whether funds appropriated by Parliament and released were actually spent and the intended objectives achieved.

5 Implementation of the quantified planned outputs An analysis of the outputs/activities that were quantified revealed that I advised although the entity absorbed 100% of the funds that were released, the some of the activities remained either partially or not implemented at all. Accounting Officer to Out of the 17 quantified outputs assessed, 1 output/activity representing ensure that 3.57% were fully implemented; 5 outputs representing 17.86% was activities are partially implemented while 11 outputs representing 39.28% were not implemente implemented at all. Details are in Appendix I. Set out below is a table d as showing the summary of the status of implementation. planned

Table showing the level of implementation S/n Reporting Outputs Performance in % 1 Fully Implemented 1 3.57 2 Partially Implemented 5 17.86 3 Not Implemented 11 39.28 4 Could not be assessed due 11 39.28 to lack of targets Total outputs 18 100

Failure to implement planned activities implies that the expected services to the beneficiary communities were not attained.

Emphasis of Matter Without qualifying my opinion, I draw attention to the following matters.

4.0 Domestic Arrears 4.1 Outstanding domestic arrears

Section 21(2) of the Public Finance management Act, 2015 states that a vote shall not take any credit from any local company or body unless it has no un paid domestic arrears from a debt in the previous financial year; and it has capacity to pay the expenditure from the approved estimates as appropriated by Parliament for that financial year.

Further paragraph 10.10.17 of the Treasury Accounting Instructions 2017 states that “An Accounting Officer will ensure that no payments due in any financial year remain unpaid at the end of that year. Towards the close of each financial year the Head of

Finance and Accounts function will take steps to obtain bills from any persons to whom money may be due, and submit payment vouchers for them to the appropriate Accounting Officer for payment”.

A trend analysis of the domestic arrears showed a movement of arrears from UGX. 43,515,530,682 in the previous year to UGX. 42,047,806,279 in the year under review, a decrease of 3.37%. The arrears remained unsettled at the close of the year. The table below shows the trend analysis of the domestic arrears for the past three years:

No Year End Amount (UX) % increase/decrease 1 30th June 2017 38,057,820,416 2 30th June 2018 43,515,530,682 14.34 3 30th June 2019 42,047,806,279 -3.37

I also noted that domestic arrears totalling to UGX. 100,000,000 (excluding interest) in- respect of outstanding court awards to Ms. Aijuka Miriam were not recognized in the financial statements.

Accrued domestic arrears impact negatively on the budget performance in the subsequent year as outputs anticipated in the appropriated budget cannot be attained due to settlement of the arrears. They may also result in litigation for non- payment of services already consumed.

The Accounting Office explained that the Domestic arrears in question were accumulated over a long period of time. Although Management is committed to clear the balance, the budget proposal is always grossly underfunded.

I advised the Accounting Officer to ensure that sufficient budget provisions are made in the next budget to enable settlement of the outstanding domestic arrears. I also advised the accounting Officer to write down un-claimed and un-supported domestic arrears.

4.2 Budgeting for Domestic Arrears

Section 13(10) (a) (iv) of the Public Finance Management Act, 2015 defines an annual budget as the financing estimates for the financial year to which the budget relates, including a plan for Government debt and any other financial liabilities for the financial year to which the annual budget relates.

MOH had arrears to the tune of UGX.46,522,711,341 (including those in the Reconciliation of movement of cash during the year and in the Statement of Changes in Equity) outstanding from prior year. According to the approved budget estimates, for the financial year under review, a budget provision of only UGX.197,440,913 was made towards the settlement of domestic arrears.

It was observed that a total of UGX.20,258,934,225 (including those in the Reconciliation of movement of cash during the year) was paid by MOH in settlement of part of the outstanding domestic arrears during the year. Failure to budget for domestic arrears exposes the entity to a risk of nugatory expenditures in the future as a result of likely litigation from suppliers. There is also a risk of diverting funds for purposes of arrears settlement.

The Accounting Office explained that during budgeting, they were guided that domestic arrears other than utilities, obligations arising out of membership to international organizations and contractual obligations should be handled at the vote level within the appropriated resources. Based on that guidance, management set aside some resources within the appropriated resources to cater to domestic arrears.

I advised the Accounting Officer to seek further guidance in respect of budgeting for arrears as resources allocated on other budgeting lines are for activities appropriated for the year. Where funds allow, reallocations should be sought early to allow settlement of arrears under the right budget lines.

5.0 Contingent Liabilities The financial statements indicate that the Ministry had contingent liabilities amounting to UGX. 46,206,660,072 due to two on-going court cases. The Ministry is therefore exposed to a risk of a financial loss if the cases are not decided in its favour.

I advised the Accounting Officer to liaise with the responsible authorities to ensure that the on-going court cases are handled with due care to avoid loss of funds.

Other Information The Accounting Officer is responsible for the other information. The other information comprises the statement of responsibilities of the Accounting Officer and the commentaries by the Head of Accounts and the Accounting Officer and other supplementary information. The other information does not include the financial statements and my auditors’ report thereon. My opinion on the financial statements does not cover the other information and I do not express an audit opinion or any form of assurance conclusion thereon.

In connection with my audit of the financial statements, my responsibility is to read the other information and, in doing so, consider whether the other information is materially consistent with the financial statements or my knowledge obtained in the audit, or otherwise appears to be materially misstated. If, based on the work I have performed, I conclude that there is a material misstatement of this other information, I am required to report that fact. I have nothing to report in this regard.

Management Responsibilities for the Financial Statements Under Article 164 of the Constitution of the Republic of Uganda, 1995 (as amended) and Section 45 of the Public Finance Management Act, 2015, the Accounting Officer is accountable to Parliament for the funds and resources of Ministry Of Health.

The Accounting Officer is also responsible for the preparation of financial statements in accordance with the requirements of the Public Finance Management Act, 2015 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.

In preparing the financial statements, the Accounting Officer is responsible for assessing the Ministry’s ability to continue as a going concern, disclosing, as

8 applicable, matters related to going concern and using the going concern basis of accounting, unless the Accounting Officer has a realistic alternative to the contrary.

The Accounting Officer is responsible for overseeing the Ministry’s financial reporting process.

Auditor’s Responsibilities for the Audit of the Financial Statements. 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’s 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 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 ISSAIs, I exercise professional judgment and maintain professional scepticism throughout the audit. I also:-

 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.

 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 Ministry’s internal control.

 Evaluate the appropriateness of accounting policies used and the reasonableness of accounting estimates and related disclosures made by the management.

 Conclude on the appropriateness of management’s 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 Ministry’s ability to continue as a going concern. If I conclude that a material uncertainty exists, I am required to draw attention in my auditor’s 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’s report. However, future events or conditions may cause the Ministry to cease to continue as a going concern.

 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.

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.

I also provide the Accounting Officer with a statement that I have complied with relevant ethical requirements regarding independence, and to communicate with them all relationships and other matters that may reasonably be thought to bear on my independence, and where applicable, related safeguards.

From 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’s 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.

Other Reporting Responsibilities In 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; except for the matters raised in compliance with legislation section below, and whose effect has been considered in forming my opinion on financial statements, 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.

Report on the Audit of Compliance with Legislation The material findings in respect of the compliance criteria for the applicable subject matters are as follows;

6.0 Technical/ Engineering Audit of the Rehabilitation and Expansion of Kayunga and Yumbe Hospitals implemented by the Ministry of Health. In the financial year 2018/19, the Ministry of Health implemented the above infrastructure projects worth USD 16,670,711.22 for Kayunga Hospital and USD 18,601,958.21 for Yumbe Hospital.

As part of the annual audit of the financial statements for the year ended 30th June 2019, these projects were selected for a technical /engineering audit. The Key audit findings resulting from the engineering audit and corresponding recommendations resulting from the engineering audit for the Kayunga and Yumbe Hospital rehabilitation projects are presented below, detailed findings, quality results, quantity verification and pictures of defective works are presented in a separate report which has been issued on infrastructure component.

KAYUNGA HOSPITAL The rehabilitation and construction works of Kayunga hospital were contracted by the Ministry of Health to Arab Contractors Osman Ahmed Osman at a contract price of USD 16,670,711.22 and supervised by Dar Engineering in association with Joadah Consult Ltd at a supervision cost of USD 1,433,803. At the time of audit execution in

August 2019, the physical progress of the works was at 78.9% while the financial progress was at 39% a) Document Review i. Delayed handover of land for lagoon construction

Handover of the land for rehabilitation and expansion of the lagoon was delayed causing delay in the commencement of works in this area of the project. By August 2018, only 35% of the required land had been handed over to the contractor to commence works. b) Inspection of works Inspection of works was carried out on 9th, 12th, and 13th August 2019 in the presence of Consultant and the Contractor’s representatives. The following observations were made;  Excavated trenches for pipe work not backfilled and exposed.  Friction hinges on top hung windows not holding window in place when open.  Uncovered inspection chambers without warning signs or tape  Crack in plaster in the living room of Doctor’s House K4A.  Insufficient compaction on edges of lagoon  Several workers on site were executing works without required personal protective equipment such as gloves, safety boots, helmets and safety belts for those working at heights c) Quantity verification Sample items of executed works were measured in the presence of the supervising consultant and contractor’s representatives and compared with certified quantities in interim payment certificates. Quantities of the items measured were compared with the quantities certified as per IPC No.6. An overpayment of USD 41,057.08 was noted. d) Supervision of Works i. Quality of progress reports The supervising consultant’s monthly progress reports lacked key information such as graphical representation of financial progress against program based on the approved contract schedules, details of impediments to the works and proposals for overcoming these, contractor’s labour and minutes of site meetings as laid down in the terms of reference that would inform the client’s decision making and cost control.

YUMBE HOSPITAL The rehabilitation and construction works of Yumbe hospital were contracted by the Ministry of Health to Sadeem Al-Kuwait General Trading and Contracting Company at a contract price of USD.18,601,958.21 and supervised by Dar Engineering in association with Joadah Consult Ltd at a supervision cost of USD 1,433,803. At the time of audit execution in August 2019, the physical progress of the works was at 73.4% while the financial progress was at 61.1%.

a) Document Review i. Design Process

Whereas it was observed that the design process generally followed the requisite procedures, the following matters were observed; Inadequate Assessment for Design and Rehabilitation Works A review of the housing assessment and detailed design reports indicated inadequacies in the assessment of the design and rehabilitation works. For the rehabilitation works, the extent of structural deterioration and level of rehabilitation required for each structure was not clearly highlighted by the design consultant in the reports. This has resulted in a number of variations in items/quantities which should have been envisaged during the design phase. ii. Payment of Interim Valuations Whereas payments for the IPC’s foreign components were made on time, payments from the GoU component in all the IPCs were delayed beyond the 90 days from approval date by the engineer and these may attract interest on delayed payments. iii. Payment for Preliminaries Payments for Employers’ Supervision (GCP.21) USD 124,900 had been remitted to the contractor to cater for the consultant’s supervision. Payment of the salaries for the project manager and two clerks of works were being made through the contractor. The payment of the Consultant’s representatives through the contractor could compromise their independence thereby negatively impacting their decision-making ability. Furthermore, there was no documentation provided as a basis for this monthly payment to the contractor in the IPCs Payment of Water for the Works The audit established that a payment of USD 34,629 has been made to the contractor for water for works contrary to the requirements stipulated in section 1.36 of the technical specifications which requires the Contractor to provide at his own risk and cost, water for use in connection with the works b) Inspection of the Works Inspection of works was carried out from 19th August 2019 to 22nd August 2019 in the presence of Consultant, MoH and the Contractor’s representatives. The following matters were observed; i. Defects such as; Broken and non-uniform colour corner strips on the window of the sluice room of the OPD at Kuru, Cracked/broken tiles in sluice room of the OPD at Kuru, Damaged section of the wall above the skirting in all rooms in the OPD at Kuru, Cracked/peeling plaster in the right-hand side gable of the OPD, Open joint between splash apron and the external block wall for Doctors house Y4A block D, Damaged window seal on Y4A block D, broken paving slabs of 600mmx 600mm on the splash apron for the New Staff House (Y4C) block A, Cracks in the plaster of the wall at the door entrance for the first unit of Y4C block A, Spalling of the internal wall plaster above the skirting of Y4C block A, Poorly prepared wall surfaces and ceilings before application of the undercoat ii. Other observations made included; Use of a combination of cast in-situ and precast concrete slabs, inadequate curing of some of the concrete members,

poor materials management, poor handling of fresh concrete, none use of spacer blocks iii. Absence of warning tapes, signage/ barricades, non-use of Personal Protective Equipment (PPE’s) by the contractor’s employees, Poor management of stormwater drainage and the site environment, exposed electrical wires c) Quantities Verification At the time of the audit, sample items of executed works were measured in the presence of the supervising consultant and contractor’s representatives and compared with certified quantities in interim payment certificates. Audit established overstatement of quantities for some items certified for payment and payments for unexecuted/installed works like medical gases, booster pumps, kitchen eco stoves and vulcathene dilution traps among others. This resulted in an overpayment of USD228,597.7 of which USD 223,521 was due to payment for works not yet executed. The Accounting Officer indicated that the payment of USD 223,521 that had been made for unexecuted works had been recovered in the subsequent valuations (IPC 7); however, documentation availed indicated that only USD. 140,023.66 was recovered out of the USD. 223,521 leaving a balance of USD. 83,498 7.0 Technical/Engineering audit of the Construction of Staff Houses in Selected Health Facilities In Seven Districts Of Karamoja Region i.e Kaabong, Kotido, Abim, Moroto, Napak, Amudat And Nakapiripirit Under The Karamoja Region Staff Housing Project (KRSHP)

In the financial year 2018/19, the Ministry of Health implemented the above infrastructure project worth USD 5,592,885.18 (18% VAT Inclusive). As part of the annual audit of the financial statements for the year ended 30th June 2019, these projects were selected for a technical /engineering audit. Key audit findings resulting from the engineering audit and corresponding recommendations are presented below, Health facilities constructed at Kaabong and Nakapirpirit were not evaluated due to lack of access at the time of the audit. Detailed findings, quality results, quantity verification and pictures of defective works are presented in a separate report which has been issued on infrastructure component. a) Planning and Design

i. Delayed Grant disbursements before project completion period

The government of Uganda signed a Grant Financing Agreement amounting to Euros 4, 200,200 with the government of the Italian Republic on 23rd December 2010, to be disbursed in three instalments over a three year period with the purpose of giving financial support to the Health systems strengthening for Karamoja Region. Audit review of the Annual report on the progress of works of 2017-2018, revealed that the financing agreement subsequently expired and resulted in delay to dispatch the second and third instalments of Euros 1,400,000 each from Government of Italy impacting on the execution of the works. A second financing agreement was agreed and subsequently the second instalment was disbursed and received on 22nd December 2017, after the expiry of the contract. The audit noted that the third instalment was disbursed from Italy in May 2019 and credited on the accounts of the project on 6th June 2019, however by then the contractor had long abandoned works which were to have been completed by 19th December 2017.

ii. Delayed Commencement of works by the contractor. Audit review of contractual documents revealed that there was delayed commencement of works by the contractor caused by delayed payment of advance to the contractor by over 119 days (over 3 months ) to enable the contractor undertake mobilisation of materials and equipment necessary for execution of works in disregard of the contract agreement clause 51.1 of the special conditions of contract (SCC) which requires payment of advance to the contractor within 30 days after certification which delayed commencement of works.

Audit noted that whereas the works contract between the Ministry of Health and the contractor was signed on the 8th February 2016 with an effective start date of 22nd February 2016 i.e. 14 days after contract signature as per clause 1.1 of the SCC the Ministry of health communicated that the effectiveness of civil works was 20th June 2016, when the contractor received advance payment in spite of the contractor submitting an Advance Payment guarantee on 25th March 2016, which lead to a delay in commencement of works iii. Delayed procurement of the Consultant The review of the annual report on the progress of works (2017/2018) and procurement files revealed that the contractor for the civil works was procured on 8th February 2016 while the commencement date of the project was 20th June 2016. The minutes for the 1st site meeting were held on the 16th of August 2016.

However, the consultancy contract was signed on 14th September 2016 implying that the consultant had been procured after works had commenced (delay of 86 days (over 2.8 months)) and so the consultant was on-site without a legal contract. Besides it is good practice to have the consultant procured before the contractor is in place, so as to ensure effective supervision of works and undertake design reviews should the necessity arise. iv. Execution of consultancy works without a contract at Commencement Audit review of progress reports revealed that the consultant commenced services on the 20th of June 2016, yet his contract was signed on 14th September 2016. Since the works contract was to expire on 19th December 2017, it is assumed that the consultant commenced works three (3) months before contract signature so as to get paid for 12 months as per the civil works contract duration.

v. Delayed Implementation of works The works commenced on 20th June 2016 and were to be completed by 19th December 2017. The review of the annual report - progress of works (2017/2018) showed that the works had achieved 61.60% physical progress by the time the contract expired. A Letter dated 27th November 2017 indicated that the progress of works was affected by delay in payments to the contractor which led to two stoppages with the second stoppage starting on 6th November 2017 till the contract expired. At the time of audit in August and September 2019, works had been abandoned as neither the contractor nor supervising consultant was at site because their contracts had all expired.

vi. Expired guarantees and all risk policies The review of progress reports and correspondence revealed that all the contractor’s guarantees and insurance policies expired and there was no evidence at the time of audit that they had been renewed. The contract of the contractor expired on 19th December 2017 and by the time of contract expiry, only USD 268,330.75 of the USD 1,118,577.03 advanced to the contractor had been recovered in IPC No.6. Since the advance payment guarantee also expired, this puts the government at risk of losing USD 850,246 if the contractor doesn’t get a new contract to execute the remaining works.

vii. Delays in the release of Government Counterpart financing of UGX 4,596,698,646 Audit review of the grant performance and interim financial statements for FY ended 30th June 2018, revealed that the government of Uganda through the Ministry of Finance, Planning, and Economic Development (MoFED), did not provide counterpart funding of UGX 4,596,698,646. Details of previous payments indicate that all payments to the contractor have been made using the grant funds, yet part of the GOU funding was to cater for the project VAT component. The GoU has provided only Ugx 280,000,000 as per the performance report. viii. Delayed payment of IPCs A review of the payment certificates revealed that all the IPCs were not paid within the stipulated time period as provided for in the contract with the IPC No 7 submitted on 10th November 2017 yet to be paid, Delays in payments to the contractor lead to disruptions of contractor cash flow and affects ability of the contractor to execute works efficiently.

ix. Abandonment of works Review of project correspondence shows that due to delayed payment of IPCs 3,4, &5, the contractor stopped works from 6th March 2017, to 17th July 2017 after four (4) months of project time. On 17th July 2017, the contractor resumed works after payment of USD 1,304,322.18 (but with an outstanding amount on IPC 5 of USD 94,243.77). The audit noted that works were again suspended in November 2017 due to a lack of funds to clear the outstanding balance of USD 94.243.77 for IPC 5, and the entire IPC 6. The Contracts for both the Contractor and Consultant later expired on 19th December 2017 and have not been renewed to date. Consequently, works have not been implemented since 19th December 2017.

x. Delayed payment of Contractual claim No.1 On the 10th August 2017, the PS received a claim of interest, and expenses due to delayed payments, from the contractor amounting to USD 1,043,169.16. This was forwarded to the Consultant for review vide letter dated 3rd October 2017. In his response dated 8th November 2017, the project manager (consultant), recommended for payment of USD 75,491.72 (VAT Inclusive). Audit review of the project correspondence revealed that to-date; the claim has not been cleared. b) Inspection of works Inspection of works at the health facilities in Moroto, Kotido, Amudat, Napak and Abim districts was carried out from Tuesday 10th September 2019 to Friday 13th September 2019 in the presence of District Health Officers (DHOs). Several defects

were observed on the facilities which are detailed in chapter three of this report At the time of audit inspection, the site had been abandoned although works were ongoing. I accordingly have advised the Accounting officer to ensure that the observed defects are rectified before end of the defects liability period (DLP). c) Quantity verification Sample items of executed works were measured at Kotido, Amudat and Moroto Health facilities in the presence of the District Health Officers (DHOs) and compared with certified quantities in interim payment certificates for which payment was made, It was noted that there was an overpayment for unexecuted works worth USD 43,838.90. I advised the Accounting Officer to ensure that this overpayment is recovered from the Contractor. d) Quality of Works

i. Quality test results A review of contract management files revealed that tests were carried out on cast concrete, steel reinforcement, water supply and wastewater pipes, cement, steel reinforcement, solid concrete blocks, coarse aggregates, and sand for concrete. Certificates of manufacturers for the components to be installed i.e. electricity, mechanical, plumbing, etc. were also found on file and compliant with specifications. Rebound hammer tests were carried out by the audit team on cast concrete to confirm the compressive test results found on file, Accordingly, the audit noted that the concrete elements cast met the required specifications as per CML Results found on file. The Audit team could not carry out more detailed tests because concrete elements had been plastered and the visible ones had large-sized aggregates (30-40 mm). e) Supervision of works

i. Insufficient site supervision

The project was formulated with 25 sites in very distant locations in the Karamoja region. A review of project progress reports revealed that the 25 sites are being supervised by only 7 clerks of works who are not sufficient if the project is to be effectively monitored. This has partly contributed to the poor quality mainly on concrete works.

8.0 Staff Performance Management Initiatives The Government of Uganda has been implementing Public Service Reforms since the 1990s geared towards cultivating a performance culture focused on results, excellence and professionalism.

Consequently, a number of performance management initiatives have been introduced for enhancing performance and service delivery in the Public Service. These include Open Performance Appraisal System, Rewards and Sanctions Framework, Client Charters and Service Delivery Standards and Performance Agreements/Plans among others.

To implement the staff performance management initiatives, public service issued Circular Standing Instructions No. 1 of 2010, Circular Standing Instruction No. 1 of 2016, Public Service Standing Orders, Circular Standing Instruction No.1 Of 2011 to

16 offer guidance to MDAs and Local Governments in undertaking the different activities on staff performance management.

The Ministry of Health has an approved organisation structure comprising of 853 staff out of which 481 posts have been filled, leaving a balance of 372 posts vacant. I undertook a review of the staff in post to examine how the entity has implemented the above initiatives and I noted the following;

 Only 3 of the 88 members of Senior Management had completed Performance Agreements by 31st July 2018. Delayed signing of performance agreements limits effective accountability and demonstration of commitment to government’s strategic goals as specified in the National Development Plan.  A summary report on the signing of performance agreements for traditional staff was not submitted to MoPS by 15th September. The Ministry of Public Service did not, therefore, carry out the monitoring process and to reporting to stakeholders as required and shortcomings in service delivery and transparency and accountability issues of senior managers were not addressed.  Out of 393 other categories of public officers in post at the beginning of the financial year 2018/19, none of the staff developed a performance plan by 15th July 2018.  Out of 481 Ministry staff in post at the beginning of the financial year, only 111 staff completed the performance appraisals and 370 staff did not undertake the activity.  A summary report on performance appraisal was not submitted to the MoPS by the deadline of 15th September 2019. The Ministry of Public Service did not, therefore, carry out the monitoring process as required.  There was no quarterly performance review undertaken by the staff during the year under review.  There were no performance improvement initiatives inbuilt in the performance plan for the subsequent year where performance targets have not been met to address those challenges.  The responsible officers did not submit a progress report on performance improvement plans to the Ministry of Public Service by 15th August. The Ministry of Public Service did not, therefore, carry out monitoring of implementation of Performance Improvement Plans and providing progress reports to the relevant stakeholders.  The Ministry did not submit reports to MOPS on absenteeism by the 15th of the 1st month of each quarter.  The Ministry did not establish a rewards and sanctions committee. Managers did not therefore reward excellent performance and sanction poor performance.  Investigations that did not involve the Police and Courts of Law took more than the prescribed three months. The rights of the affected staff were therefore violated.  There was no quarterly report on discipline submitted to the Ministry of Public Service.

I advised management to ensure that all the prescribed performance management procedures are enforced.

9.0 Payroll Management The review of the payroll and pension payments revealed the following areas of non- compliance with the established payroll management procedures which need to be addressed;

 Contrary to Paragraph 4.4 of Establishment Notice No.2 of 2019 dated 1st July 2019, UGX. 2,742,205,914 was paid out as pensions without the Responsible Officers to verifying the salary, gratuity and pension payment files sent to the IPPS/IFMS interface and ensuring their correctness before effecting payments. There is a risk that the affected pensioners were paid higher amounts for gratuity and are being paid higher amounts of monthly pension.

 I noted that pensioners aged 75 years and above were being paid pension without the availability of life certificates on their files. Some pensions may have been paid to deceased pensioners and hence the funds lost.

 The examination of pension files and the payrolls revealed that the late Drijaru Edith Oriyo with supplier number 176090 who died on 12/06/ 2004 and the late Galeeba Paskale with supplier number 187512 who retired on 23/10/1997 and died in 2010 was paid pension during the year under review. The payments to the late Drijaru Edith Oriyo since she died may be claimed by her family while the payment to the late Galeeba Paskale after the expiry of fifteen years was a loss to Government.

 Contrary to Paragraph 4.5 of the Establishment Notice No. 2 of 2019, gratuity payments worth UGX. 495,906,691 were uploaded to the IFMS without having been processed through the IPPS. There is a risk that making duplicate payments.

John F.S. Muwanga AUDITOR GENERAL

KAMPALA

27th December 2019

APPENDICES:

Appendix I: Showing Details of the extent of delivery of planned outputs

Project Output Planned Budgeted Revised Amount Amount Achieved Variance Causes for the Extent of Target for the amount budget released Spent Target by variances delivery FY 18/19 UGX UGX UGX UGX Financial year (‘000’) (‘000’) (‘000’) (‘000’) end Project: 1027 080272: Renovation of 853,000 1,223,000 859,450 859,450 Repairs and Construction This was Partially Institutional Government two blocks at maintenance of of external attributed to Implemented support to Buildings and MoH elevator at MOH showers was revision of the Ministry of Administrative Headquarter was undertaken not approved work Health Infrastructure and vector completed plan few weeks to control building Land for (96% the end of the FY undertaken construction of completion) which makes it water Waste by FY end hard to complete Repairs and Management such projects maintenance of Plant procured before FY end elevator at MOH for Kiruddu undertaken Hospital and the site handed over to National Water and Sewerage Corporation. The bidding process is still on-going and works are expected to commence in January 2020. 080275: Two Vehicles for 720,000 950,000 950,000 950,000 No vehicle for the Two Vehicles The audit team Not Purchase of the Top top leadership for the Top noted that the two Implemented Motor Leadership was procured by Leadership vehicles were Vehicles and (Hon. MoH and the end of the (Hon. MoH allocated to the Other Hon. MSH financial year and Hon. ministers for top Transport (PHC) procured MSH (PHC) leadership Equipment were not supervision under procured. URMCHIP and APC project that closed. In addition, a

Project Output Planned Budgeted Revised Amount Amount Achieved Variance Causes for the Extent of Target for the amount budget released Spent Target by variances delivery FY 18/19 UGX UGX UGX UGX Financial year (‘000’) (‘000’) (‘000’) (‘000’) end supplementary request of UGX 230,000,000 was approved for the procurement of five double cabin pickups. However, the annual work plan was not revised. 080280: No Targets set 0 200,000 200,000 200,000 No targets were The output Inadequate Could not be Hospital for the output in set at planning had no planning as established construction/ the work plan however the planned management since rehabilitation team established target set revised the budget management that external therefore the for the output but did not set showers were variance never set targets performance constructed, could not be and clear activities targets and office block ascertained to be spent on. In indicators to remodelled and addition, the team guide canteen ceiling noted that performance fitted. towards the end measurement of the FY 18/19 management diverted funds to payment of the contactor (DEHA investees LTD) UGX 156,236,594 without any work done contrary to the contract terms. Output No targets were 5,241,882 5,417,882 4,651,550 4,651,55 No targets were Without set This was Could not be 080201 set for the 0 set at planning to targets and attributed to poor established Monitoring, output enable the audit performance planning and without Supervision team to ascertain indicators for deliberate performance and the frequency of the output, diversion of funds targets and

Project Output Planned Budgeted Revised Amount Amount Achieved Variance Causes for the Extent of Target for the amount budget released Spent Target by variances delivery FY 18/19 UGX UGX UGX UGX Financial year (‘000’) (‘000’) (‘000’) (‘000’) end Evaluation of monitoring. In the variance to unplanned indicators. Health addition, there could not be activities. Systems were no established monitoring and evaluation reports availed to the audit team to confirm that monitoring activities were conducted under the project. Project: 1185 080282: Construction of 5,609,770 0 None of the 68 The The audit team Not Italian Staff houses 68 staff houses staff houses was construction noted that the Implemented support to construction in Kaabong, completed of the 68 staff variance was HSSP and and Abim, Kotido, houses stalled caused by delayed PRDP rehabilitation Amudat, in 2017 and release of funds Moroto, by the end of by the funder Nakapiripirit and the FY 18/19, (Italian Napak there was Government) as completed. zero (0) on funds were the planned released two target. weeks to the end of the financial year. It was also noted that the financing agreement for the project expired and government of Uganda and Italy entered into fresh negotiations to have a valid financing agreement in order to release

Project Output Planned Budgeted Revised Amount Amount Achieved Variance Causes for the Extent of Target for the amount budget released Spent Target by variances delivery FY 18/19 UGX UGX UGX UGX Financial year (‘000’) (‘000’) (‘000’) (‘000’) end funds for the project which affected implementation 080201 The output was 120,000 120,000 100,338 100,338 No targets were Without set This was Could not be Monitoring, not in the set at planning to targets and attributed to poor established Supervision approved enable the audit performance planning and without and annual work team to ascertain indicators for deliberate performance Evaluation of plan and no the frequency of the output, diversion of funds targets and Health targets were set monitoring. In the variance to unplanned indicators. Systems for the output addition, there could not be activities. For as only Budget were no established example, of the line items/ cost monitoring and UGX 100,337,528 centres were evaluation spent on this indicated for the reports availed to output, UGX output in the the audit team to 73,989,528 was approved confirm that diverted to other budget. monitoring activities not activities were related to the conducted under output the project. representing 73.74% of the total amount paid out. Project: 1187 080280: Final certificate 2,306,000 17,306,00 17,306,00 17,306,0 For Kawempe Medical This was not done Partially Support to Hospital for civil works at 0 0 00 Hospital the Equipment for because Implemented Mulago Construction Lower Mulago overall progress Lower Mulago rehabilitation of Hospital /rehabilitation Hospital, of work was at Hospital, lower Mulago was Rehabilitation Kawempe and 100% and the Kawempe and still on-going Kiruddu Contractor is Kiruddu Hospitals currently Hospitals was cleared. Medical handling the not installed. Equipment snags and installed at defects. For Lower Mulago Kiruddu Hospital Hospital, the overall Kawempe and Progress of work

Project Output Planned Budgeted Revised Amount Amount Achieved Variance Causes for the Extent of Target for the amount budget released Spent Target by variances delivery FY 18/19 UGX UGX UGX UGX Financial year (‘000’) (‘000’) (‘000’) (‘000’) end Kiruddu is at 100% and Hospitals the hospital is presently being used by Mulago Hospital. Rehabilitation work for lower Mulago Hospital is on-going and the current progress of work is at 96%. 080201 No targets were 264,000 264,000 227,400 226,149 No targets were Without set This was Could not be Monitoring, set for this set at planning to targets and attributed to poor established Supervision output enable the audit performance planning and without and team to ascertain indicators for deliberate performance Evaluation of the frequency of the output, intentions to targets and Health monitoring. In the variance divert funds to indicators. Systems addition, there could not be unplanned were no established activities as monitoring and management did evaluation not set targets for reports availed to the output. For the audit team to example, of the confirm that UGX 226,621,933 monitoring spent on this activities were output, UGX conducted under 56,684,942 was the project. diverted to other activities not related to the output representing 25.05% of the total amount spent.

Project Output Planned Budgeted Revised Amount Amount Achieved Variance Causes for the Extent of Target for the amount budget released Spent Target by variances delivery FY 18/19 UGX UGX UGX UGX Financial year (‘000’) (‘000’) (‘000’) (‘000’) end Project: 1243 080280: Rehabilitation 12,852,574 0 99.7% level of The variance This was in Could not be Rehabilitation Hospital works on completion of the could not be general attributed established and Construction/r Kawolo and refurbishment for ascertained to Poor planning. without construction ehabilitation Busolwe Kawolo Hospital since In addition, the performance of General hospitals achieved. performance audit team noted targets hospitals continued 0% rehabilitation targets were that failure to including on Busolwe not set at start the causality, OPD achieved as the planning by rehabilitation wards staff scope of works management. works on Busolwe houses. for Busolwe have However the was due to failure just been audit team by Government to concluded and established commit top up BoQs are being that no works funds (6 billion) developed were done on towards the Busolwe as construction of planned and Busolwe hospital the expected which prompted completion the funder not to date of issue a no kawolo objection for the Hospital consultant to (26/04/2019) commence a was not met detailed design, even after the BOQ’s and approved preparation of extension tender from documents. The 11/01/2019. delayed and long The medical procurement equipment for processes delayed kawolo had the delivery of the not been medical delivered by equipment to the end of the Kawolo Hospital. FY.

Project Output Planned Budgeted Revised Amount Amount Achieved Variance Causes for the Extent of Target for the amount budget released Spent Target by variances delivery FY 18/19 UGX UGX UGX UGX Financial year (‘000’) (‘000’) (‘000’) (‘000’) end 080201 No targets were 50,000 50,000 50,000 49,999 No targets were Without set This was Could not be Monitoring, set for this set at planning to targets and attributed to poor established Supervision output enable the audit performance planning and without and team to ascertain indicators for deliberate performance Evaluation of the frequency of the output, intentions to targets and Health monitoring. the variance divert funds to indicators. Systems could not be unplanned established activities as management did not set targets for the output. For example, of the UGX 49,999,956 spent on this output, UGX 23,396,956 was diverted to other activities not related to the output representing 46.79% of the total amount spent Project: 1344 080277: Kayunga and 5,000,000 No equipment Kayunga and The Audit team Not Renovation Purchase of Yumbe General was procured for Yumbe attributed this to Implemented and Equipping Specialized Hospitals fully Kayunga and General poor planning. of Kayunga Machinery & equipped and Yumbe hospitals Hospitals The equipping of and Yumbe Equipment furnished with were not fully the hospitals could General diagnostic, equipped and not take place Hospitals Laboratory, furnished with before completion ward, diagnostic, of the civil works. emergency, Laboratory, It was also noted maternity ward, that the funders equipment emergency, (BADEA, SFD, among others. maternity OFID and GoU) equipment were supposed to

Project Output Planned Budgeted Revised Amount Amount Achieved Variance Causes for the Extent of Target for the amount budget released Spent Target by variances delivery FY 18/19 UGX UGX UGX UGX Financial year (‘000’) (‘000’) (‘000’) (‘000’) end among clear every stage others. of the procurement process which makes it lengthy. Therefore the procurement of the specialized machinery and equipment for the hospitals could not have taken place in the year under review.

080280: Construction 43,326,108 6,630,000 5,480,923 5,480,92 Civil works 9.7% of the Work was 9.7% Partially Hospital works 3 progress was construction behind schedule Implemented Construction/r progressed up 73.5% and 57% works for because of ehabilitation to 75% for for Kayunga and Kayunga and logistical problems Kayunga and Yumbe Yumbe related to Yumbe General respectively. hospitals availability of local Hospitals. Construction were not materials and work on average done transportation of progressed up to materials to 65.3% for Yumbe Hospital Kayunga and Site Yumbe Hospitals 080201 No targets were 2,625,961 900,000 845,440 814,735 No targets were Without set This was Could not be Monitoring, set for this set at planning to targets and attributed to poor established Supervision output however, enable the audit performance planning and without and cost centres team to ascertain indicators for deliberate performance Evaluation of were created in the frequency of the output, intentions to targets and Health the budget for monitoring. the variance divert funds to indicators. Systems spending could not be unplanned purposes established activities as without management did corresponding not set targets for

Project Output Planned Budgeted Revised Amount Amount Achieved Variance Causes for the Extent of Target for the amount budget released Spent Target by variances delivery FY 18/19 UGX UGX UGX UGX Financial year (‘000’) (‘000’) (‘000’) (‘000’) end targets the output. For example, of the UGX 814,735,736 spent on this output, UGX 76,285,488 was diverted to other activities not related to the output representing 9.36% of the total amount spent Project: 1394 080280: 30% of hospital 980,000 11,876,33 11,876,33 11,876,3 80% completion Achieved The over Fully regional Hospital construction 8 8 38 of civil works 50% over and performance was Implemented hospital for Construction/r completed above the attributed to the paediatric ehabilitation planned supplementary surgery target funding from MoFPED of UGX 10,996,338,000. However, the audit team noted that the ministry did not revise the initial target given the additional funding. 080201 No targets were 20,000 20,000 20,000 19,998 No targets were Without set This was No targets Monitoring, set for this set at planning to targets and attributed to poor were set at Supervision output enable the audit performance planning and planning to and team to ascertain indicators for deliberate enable the Evaluation of the frequency of the output, intentions to audit team to Health monitoring. the variance divert funds to ascertain the Systems could not be unplanned frequency of established activities as monitoring. management did not set targets for

Project Output Planned Budgeted Revised Amount Amount Achieved Variance Causes for the Extent of Target for the amount budget released Spent Target by variances delivery FY 18/19 UGX UGX UGX UGX Financial year (‘000’) (‘000’) (‘000’) (‘000’) end the output. For example, of the UGX 19,998,000 spent on this output, UGX 15,000,000 was diverted to other activities not related to the output representing 75.01% of the total amount spent Project: 1440 080275 No targets and USD USD 1 Station Wagon 04 Station Poor Contract Partially Uganda Purchase of performance 831,198 582,369 and 8 Double Wagon Type management Implemented Reproductive Motor indicators set Cabin Pickups II had not Maternity and Vehicles and for this output were delivered been Child Health Other in the MoH work by the end of the delivered by Services Transport plan. Review of FY the end of the Improvement Equipment the project work FY 18/19 Project plan indicated that 13 Motor Vehicles were planned to be procured (5 Station Wagons and 8 Double Cabin Pickups 080276: Birth and Death 5,656,696 136,591 The set target The BDR This was Not Purchase of Registration was not achieved equipment attributed to Implemented Office and (BDR) by the end of the was not delays in the ICT equipment and financial year. procured. procurement Equipment, associated process as the including materials bidders quoted Software procured higher prices than including server, the available

Project Output Planned Budgeted Revised Amount Amount Achieved Variance Causes for the Extent of Target for the amount budget released Spent Target by variances delivery FY 18/19 UGX UGX UGX UGX Financial year (‘000’) (‘000’) (‘000’) (‘000’) end computers, funds and the Birth Death procurement was Adoption order retendered. Information Currently the draft System. contract was submitted to the solicitor General for clearance on 9th September 2019 and was approved on 26th September, 2019 080277: Critical 7,972,524 226,447 The set target Critical This is attributed Not Purchase of Reproductive was not achieved Reproductive to the delay to Implemented Specialized Maternal by the end of the Maternal commence the Machinery & Neonatal Child financial year. Neonatal procurement Equipment & Adolescent Child & process and Health services Adolescent delayed (RMNCAH) Health submission of the equipment services required medical including (RMNCAH) equipment to the patient beds, equipment National Advisory operating including Committee for tables, patient beds, Medical gynaecology operating Equipment examination tables, (NACME) and the couch, gynaecology minister of Health instrument examination for adoption. trolley among couch, In addition, others, instrument management also procured & trolley among explained that the distributed. others, were procurement not procured process was & distributed. delayed by a number of activities such as re-distribution of

Project Output Planned Budgeted Revised Amount Amount Achieved Variance Causes for the Extent of Target for the amount budget released Spent Target by variances delivery FY 18/19 UGX UGX UGX UGX Financial year (‘000’) (‘000’) (‘000’) (‘000’) end critical medical equipment that were idle in Health centres to Regional Referrals, verification exercise of all equipment in the Health centres in the country, updating of specifications for required medical equipment based on equipment policy and updating equipment packages. 080281: Maternity units 33,260,868 704,813 No achieved The This was Not Health centre constructed in target registered construction attributed to a Implemented construction HCIIIs in by financial year of the long procurement and selected end maternity process and rehabilitation districts which units in the delayed include: Tororo, HCIII’s was submission of the Kabale, Mayuge, not done. drawings to the Kiruhura, World Bank for Buhweju, approval. Mitooma, Management also Yumbe, Zombo, explained that the Koboko, expression of Alebtong, interest took a lot Soroti, Lira, of time and that Otuke, among actual others. construction is Supervising now planned to

Project Output Planned Budgeted Revised Amount Amount Achieved Variance Causes for the Extent of Target for the amount budget released Spent Target by variances delivery FY 18/19 UGX UGX UGX UGX Financial year (‘000’) (‘000’) (‘000’) (‘000’) end consultants for commence in civil works January, 2020. Procured 080201 No targets were 26,086,485 255,000 231,750 230,790 No targets were Without set This was No targets Monitoring, set for this set at planning to targets and attributed to poor were set at Supervision output in the enable the audit performance planning and planning to and MoH annual team to ascertain indicators for deliberate enable the Evaluation of work plan the frequency of the output, intentions to audit team to Health monitoring and the variance divert funds to ascertain the Systems the link between could not be unplanned frequency of GoU counterpart established activities as monitoring. funding and the management did targets. not set targets for the output for accountability purposes. For example, of the UGX 230,789,740 spent on this output, UGX 174,539,740 was diverted to other activities not related to the output representing 75.63% of the total amount spent Project: 0220 080575 1 Motor Vehicle 1,030,733 377,592 The output was 1 Motor Delayed Not global Fund Purchase of Procured not achieved by Vehicle procurement Implemented for Aids, TB Motor the end of the and Malaria Vehicles and financial year. Other Transport Equipment 2 film Vans to The planned The 2 film The audit team Not support target was not vans were not noted that one Implemented

Project Output Planned Budgeted Revised Amount Amount Achieved Variance Causes for the Extent of Target for the amount budget released Spent Target by variances delivery FY 18/19 UGX UGX UGX UGX Financial year (‘000’) (‘000’) (‘000’) (‘000’) end Behavioural achieved by the procured by film van had been Change and end of the the end of the procured in FY 17- Communication financial year 18- financial year 18. Request for interventions 19 additional two film vans was submitted which Global Fund objected and gave a no objection to procure one film van to make them two. As a result the ministry has initiated a request for procurement of the one film van. 080577: GenXpert 7,599,782 The planned The GenXpert The audit team Not Purchase of machines target was not machines noted that a Implemented Specialized achieved by the were not GenXpert machine Machinery & end of the procured was procured in Equipment financial year 18- FY 17-18 (at USD 19 1,241,000) and a provision for the GenXpert machines was included in again in the work plan for FY 18-19 in case need arises. This is poor planning as it affects funding to other priority activities. condom vending The planned Condom The audit team Not machines target was not vending noted that the Implemented

Project Output Planned Budgeted Revised Amount Amount Achieved Variance Causes for the Extent of Target for the amount budget released Spent Target by variances delivery FY 18/19 UGX UGX UGX UGX Financial year (‘000’) (‘000’) (‘000’) (‘000’) end achieved by the machines ministry took long end of the were not to get the financial year 18- procured specifications for 19 the vending machine. However, the project has written a letter to Global fund Geneva seeking a no objection to reallocate the funds to procurement of ARV’s brooders for The output was brooders for Delayed Not rats and not achieved by rats and procurement Implemented mosquitoes for the end of the mosquitoes tests financial year. for tests not procured sputum The output was sputum Delayed Not equipment not achieved by equipment procurement Implemented the end of the not procured financial year. Other Management The variance Poor planning Could not be equipment failed to specify could not be ascertained procured and disclose the ascertained without targets other equipment due to failure and and so the audit by specifications team could not management ascertain the to disclose specific the other equipment equipment procured that was procured

Project Output Planned Budgeted Revised Amount Amount Achieved Variance Causes for the Extent of Target for the amount budget released Spent Target by variances delivery FY 18/19 UGX UGX UGX UGX Financial year (‘000’) (‘000’) (‘000’) (‘000’) end 080503 No targets were 2,175,269 2,175,269 2,171,722 1,825,23 No targets were Without set This was No targets Monitoring set for this 3 set at planning to targets and attributed to poor were set at and output enable the audit performance planning and planning to Evaluation team to ascertain indicators for deliberate enable the Capacity the frequency of the output, intentions to audit team to Improvement monitoring and the variance divert funds to ascertain the the link between could not be unplanned frequency of GoU counterpart established activities as monitoring. funding and the management did targets. No M&E not set targets for reports were the output for availed to the accountability audit team to purposes. For confirm that example, of the actually the UGX activities were 1,825,893,307 conducted spent on this output, UGX 14,367,144 was diverted to other activities not related to the output representing 0.79% of the total amount spent 1436: GAVI 080572: 1 UNEPI office 12,015,379 560,157 The planned 1 UNEPI The funds that Not vaccines and Government designed and target was not office was not were meant for Implemented Health sector Buildings and constructed achieved by the designed and the designing and Development Administrative end of the constructed construction of plan support Infrastructure financial year 18- the UNEPI office 19 were relocated by management to the procurement of incinerators. However, clearance to re-

Project Output Planned Budgeted Revised Amount Amount Achieved Variance Causes for the Extent of Target for the amount budget released Spent Target by variances delivery FY 18/19 UGX UGX UGX UGX Financial year (‘000’) (‘000’) (‘000’) (‘000’) end allocate funds was not availed to the audit team. 30 District The planned 30 District The audit team Vaccine Stores target was not Vaccine noted that in 30 districts achieved by the Stores in 30 management constructed end of the districts were halted the process financial year 18- not of construction of 19 constructed the 30 district vaccine stores until all the pending civil works in the GAVI project are completed. 080575: 57 vehicles 6,483,155 No vehicle was 57 vehicles The process of Not Purchase of procured procured by the were not agreeing on funds Implemented Motor end of the procured (grants) flow Vehicles and financial year 18- modalities were Other 19 protracted thereby Transport taking long to sign Equipment the MOU to have funds for the activity. medium-size No medium-size Medium-size Signing of the Not motorized boats motorized boats motorized MoU to have the Implemented procured were procured by boats were funds availed for the end of the not procured activity financial year 18- implementation 19 was delayed by protracted discussions about the modalities of funds flow. 2 refrigerated No refrigerated 2 refrigerated The process of Not trucks procured truck was trucks were agreeing on funds Implemented (grants) flow

Project Output Planned Budgeted Revised Amount Amount Achieved Variance Causes for the Extent of Target for the amount budget released Spent Target by variances delivery FY 18/19 UGX UGX UGX UGX Financial year (‘000’) (‘000’) (‘000’) (‘000’) end procured by the not procured modality was end of the protracted thereby financial year 18- taking long to sign 19 the MOU to have funds for the activity. 080577: Spare parts for 197,567 The planned Spare parts There was no Not Purchase of cold chain target was not for cold chain signed MoU to Implemented Specialized equipment achieved by the equipment warrant release of Machinery & procured. end of the were not funds for activity Equipment financial year 18- procured. implementation 19 from the funder/ donor 080503 No targets were 40,136,910 258,484 258,484 253,119 No targets were Without set This was attributed No targets Monitoring set for this set at planning to targets and to poor planning were set at and output enable the audit performance and deliberate planning to Evaluation team to ascertain indicators for intentions to divert enable the Capacity the frequency of the output, funds to unplanned audit team to Improvement monitoring and the variance activities as ascertain the the link between could not be management did frequency of not set targets for GoU counterpart established monitoring. the output for funding and the accountability targets. purposes. For example, of the UGX 253,119,161 spent on this output, UGX 17,225,923 was diverted to other activities not related to the output representing 6.81% of the total amount spent

Appendix II: Mischarge/Diversions Project 1344 Renovation and Equipping of Kayunga and Yumbe General Hospitals, (Output 080280 Hospital Construction/rehabilitation)

D128/NOV18/1344 MOH contribution towards the construction of the 16/11/2018 1,565,191,615 EMERGENCY LIFE 80280 312101 paediatric hospital. SUPPORT FOR CIVILIAN WAR VICTIMS D48/AUG18/1344 MOH contribution towards the construction of the 31/08/2018 1,112,451,439 EMERGENCY LIFE 80280 312101 paediatric hospital. SUPPORT FOR CIVILIAN WAR VICTIMS Sub-Total 2,677,643,054

Project 1185 Italian Support to HSSP and PRDP (Output 080201 Monitoring, Supervision and Evaluation of Health Systems)

D99/JUN19/0220 Facilitation during technical support supervision and 19/06/2019 9,528 Muwanga Cissy 80201 227001 collection of accountabilities. D102/NOV18/0220 Fuel Consumption for Q2 2018/2019 16/11/2018 7,500,000 Vivo Energy Uganda 80201 227004 Limited D31/AUG18/0220 Fuel for Q1 2018/2018 activities.Projects 9/8/2018 7,500,000 United Bank For Africa 80201 227004 Government Fuel D10 /MAY19/1027 Deposit of fuel for Q.4 of FY 2018/19 under projects. 16/05/2019 5,000,000 Vivo Energy Uganda 80201 227004 Limited D125/JUN19/1344 Establishment of a document management system for 21/06/2019 31,779,661 Klan Logistics Limited 80201 225001 MOH. D125/JUN19/1344 Establishment of a document management system for 21/06/2019 5,720,339 Klan Logistics Limited 80201 225001 MOH. D38/JAN19/1413 Facilitation to check the current Audit Comment of 24/01/2019 2,020,000 NAKALEMBE 80201 227001 Motor Vehicles in the District Western and Central IMMACULATE 797321 Region. D42/JAN19/1413 Facilitation to check the current Audit Comment of 24/01/2019 1,160,000 Segawa Moses 35712 80201 227001 Motor Vehicles in the District Western and Central Region. D37/JAN19/1413 Facilitation to check the current Audit Comment of 24/01/2019 1,100,000 Tukahirwa James 80201 227001 Motor Vehicles in the District Western and Central Byenjeru Region.

D41/JAN19/1413 Facilitation to check the current Audit Comment of 24/01/2019 1,100,000 GORRET NABYONGA 80201 227001 Motor Vehicles in the District Western and Central Region. D40/JAN19/1413 Facilitation to check the current Audit Comment of 24/01/2019 550,000 NDAWULA ENOCK 15303 80201 227001 Motor Vehicles in the District Western and Central Region. D39/JAN19/1413 Facilitation to check the current Audit Comment of 24/01/2019 550,000 Mukungu Bob 80201 227001 Motor Vehicles in the District Western and Central Region. D36/JAN19/1440 Fuel for Q3 2018/2019 16/01/2019 10,000,000 Vivo Energy Uganda 80201 227004 Limited Sub-Total 73,989,528 Project 1187 Support to Mulago Hospital Rehabilitation (Output 080201 Monitoring, Supervision and Evaluation of Health Systems)

D27/MAR19/1187 Sitting allowance for IHMS evaluation committee 26/03/2019 1,200,000 Byanyima Kusaba 80201 211103 members for Bbosa Tony(400,000), Nakkazi Rosemary Emily(400,000) and Lwanyo Simon Peter(400,000) D30/MAR19/1187 Sitting allowance for IHMS evaluation committee 26/03/2019 400,000 AMENY JIMMY 80201 211103 members. 1000847864 D31/MAR19/1187 Sitting allowance for IHMS evaluation committee 26/03/2019 400,000 LORNAH NAMAKOYE 80201 211103 members. D25/MAR19/1187 Sitting allowance for IHMS evaluation committee 26/03/2019 400,000 Byanyima Kusaba 80201 211103 members. Rosemary D04 /MAR19/1187 Advance for Development of the database for E Card 20/03/2019 10,000,000 Tukahirwa James 80201 228002 for MOH Vehicle management Byenjeru D89/NOV18/1187 Sitting allowance for members of the Integrated 9/11/2018 900,000 Byanyima Kusaba 80201 211103 Health Management System Committee that sat on Rosemary 9th, 10th, 11th, 12th and 13th of July 2018 for Bbosa Tonny and Nakazzi E D87/NOV18/1187 Sitting allowance for members of the Integrated 9/11/2018 500,000 Byanyima Kusaba 80201 211103 Health Management System Committee that sat on Rosemary 9th, 10th, 11th, 12th and 13th of July 2018. D88/NOV18/1187 Sitting allowance for members of the Integrated 9/11/2018 450,000 AMENY JIMMY 80201 211103 Health Management System Committee that sat on 1000847864 9th, 10th, 11th, 12th and 13th of July 2018.

D92/NOV18/1187 Sitting allowance for members of the Integrated 9/11/2018 450,000 LORNAH NAMAKOYE 80201 211103 Health Management System Committee that sat on 9th, 10th, 11th, 12th and 13th of July 2018. D261/DEC18/1187 Facilitation to a team who Verified list of Equipment 21/12/2018 5,200,000 Omojong Yovan Patrick 80201 211103 and Furniture supplied to Kawempe and Kiruddu hospitals. D23/MAR19/0220 Servicing of Motor Vehicles No. UG 5337M, UG 15/03/2019 652,376 The Cooper Motor 80201 228002 5563M, UG 5337M and UG 5410M. Corporation Uganda Limited D23/MAR19/0220 Servicing of Motor Vehicles No. UG 5337M, UG 15/03/2019 117,428 The Cooper Motor 80201 228002 5563M, UG 5337M and UG 5410M. Corporation Uganda Limited D102/NOV18/0220 Fuel Consumption for Q2 2018/2019 16/11/2018 20,000,000 Vivo Energy Uganda 80201 227004 Limited D10 /MAY19/1027 Deposit of fuel for Q.4 of FY 2018/19 under projects. 16/05/2019 7,000,000 Vivo Energy Uganda 80201 227004 Limited R93/JUN19/1344 Advance requirements at inhouse service bay. 17/06/2019 1,270,715 DAVID LUBYAYI 80201 228002 R456/FEB19/1436 Servicing of Motor Vehicle No.UG 5415M 1/3/2019 630,867 The Cooper Motor 80201 228002 Corporation Uganda Limited R456/FEB19/1436 Servicing of Motor Vehicle No.UG 5415M 1/3/2019 113,556 The Cooper Motor 80201 228002 Corporation Uganda Limited D36/JAN19/1440 Fuel for Q3 2018/2019 16/01/2019 7,000,000 Vivo Energy Uganda 80201 227004 Limited Sub-Total 56,684,942

Project 1243 Rehabilitation and Construction of General Hospitals (Output 080201 Monitoring, Supervision and Evaluation of Health Systems) D102/NOV18/0220 Fuel Consumption for Q2 2018/2019 16/11/2018 5,500,000 Vivo Energy Uganda 80201 227004 Limited D31/AUG18/0220 Fuel for Q1 2018/2018 activities.Projects 9/8/2018 5,500,000 United Bank For Africa 80201 227004 Government Fuel D99/JUN19/0220 Facilitation during technical support supervision and 19/06/2019 338,000 Muwanga Cissy 80201 227001 collection of accountabilities.

D10 /MAY19/1027 Deposit of fuel for Q.4 of FY 2018/19 under projects. 16/05/2019 2,500,000 Vivo Energy Uganda 80201 227004 Limited D22/SEP18/1413 Overtime allowance for the support staff in top 10/9/2018 764,739 Nabayego Harriet 14974 80201 211103 management offices for Q.1 of FY 2018/19. D23/SEP18/1413 Overtime allowance for the support staff in top 10/9/2018 764,739 Nabaala Musitafa 80201 211103 management offices for Q.1 of FY 2018/19. 1006840869 D24/SEP18/1413 Overtime allowance for the support staff in top 10/9/2018 764,739 Kisitu Meddy 80201 211103 management offices for Q.1 of FY 2018/19. 1002068956 D25/SEP18/1413 Overtime allowance for the support staff in top 10/9/2018 764,739 Nyakuni Kosta 80201 211103 management offices for Q.1 of FY 2018/19. D36/JAN19/1440 Fuel for Q3 2018/2019 16/01/2019 6,500,000 Vivo Energy Uganda 80201 227004 Limited Sub-Total 23,396,956 Project 1344 Renovation and Equipping of Kayunga and Yumbe General Hospitals (Output 080201 Monitoring, Supervision and Evaluation of Health Systems) D02/MAR19/1344 Maintenance of MOH flower gardens for January, 7/3/2019 1,498,597 CLEAN ENVIRONMENT 80201 224004 Febuary and March 2019. JANITORIAL (U) LIMITED D02/MAR19/1344 Maintenance of MOH flower gardens for January, 7/3/2019 269,747 Clean Environment 80201 224004 Febuary and March 2019. Janitorial (U) Limited D125/JUN19/1344 Establishment of a document management system for 21/06/2019 1,533,898 Klan Logistcs Limited 80201 225002 MOH. D125/JUN19/1344 Establishment of a document management system for 21/06/2019 276,102 Klan Logistcs Limited 80201 225002 MOH. D11/JUN19/1344 Facilitation for the activities to mark the Budget week. 12/6/2019 1,602,000 Kabagambe Richard 80201 225002 Tureebe D99/JUN19/0220 Facilitation during technical support supervision and 19/06/2019 347,373 Muwanga Cissy 80201 227001 collection of accountabilities. D98/JU N19/0220 Facilitation during technical support supervision and 19/06/2019 160,454 ISAAC EREGU ODONGO 80201 227001 collection of accountabilities. D43/MAR19/0220 Facilitation during the Inspector General of Global 26/03/2019 2,109,000 Ebuju Kokas 80201 227001 Fund field visits. D38/MAR19/0220 Facilitation during the Inspector General of Global 26/03/2019 1,320,000 Kamasaka Carolyn 80201 227001 Fund field visits. D41/MAR19/0220 Facilitation during the Inspector General of Global 26/03/2019 1,320,000 Balidawa Hudson 80201 227001 Fund field visits.

D44/MAR19/0220 Facilitation during the Inspector General of Global 26/03/2019 1,320,000 Mulyazaawo Mathias 80201 227001 Fund field visits. Kasule D42/MAR19/0220 Facilitation during the Inspector General of Global 26/03/2019 660,000 Kisuule Musoke Gideon 80201 227001 Fund field visits(Driver) D45/MAR19/0220 Facilitation during the Inspector General of Global 26/03/2019 660,000 Ebuju Kokas 80201 227001 Fund field visits(Driver) D39/MAR19/0220 Facilitation during the Inspector General of Global 26/03/2019 660,000 Oyesiga Edbert 80201 227001 Fund field visits(Mukulu Musa) D36/MAR19/0220 Facilitation during the Inspector General of Global 26/03/2019 30,673 Lucia Ayebazibwe 80201 227001 Fund field visits(Driver) Baguma D102/NOV18/0220 Fuel Consumption for Q2 2018/2019 16/11/2018 16,895,000 Vivo Energy Uganda 80201 227004 Limited D23/MAR19/0220 Servicing of Motor Vehicles No. UG 5337M, UG 15/03/2019 1,029,098 The Cooper Motor 80201 228002 5563M, UG 5337M and UG 5410M. Corporation Uganda Limited D23/MAR19/0220 Servicing of Motor Vehicles No. UG 5337M, UG 15/03/2019 185,238 The Cooper Motor 80201 228002 5563M, UG 5337M and UG 5410M. Corporation Uganda Limited D149/NOV18/1027 Deposit of funds to cater for MOH power bills. 26/11/2018 8,500,000 Umeme Limited. 80201 223005 D10 /MAY19/1027 Deposit of fuel for Q.4 of FY 2018/19 under projects. 16/05/2019 10,470,008 Vivo Energy Uganda 80201 227004 Limited D118/JUN19/1027 Servicing of MOH IT Equipments. 20/06/2019 8,644,067 Numwe Uganda Limited 80201 228003 D118/JUN19/1027 Servicing of MOH IT Equipments. 20/06/2019 1,555,933 Numwe Uganda Limited 80201 228003 D86/APR19/1187 Funds advanced for washing of Hon. MOH motor 30/04/2019 411,000 Otwom Robson 80438 80201 228002 vehicle No.UG 5603 M. R455/FEB19/1436 Procurement of Vehicle spare parts for MOH garage. 1/3/2019 1,150,254 MAC EAST AFRICA LTD 80201 228002 R455/FEB19/1436 Procurtement of Vehicle spare parts for MOH garage. 1/3/2019 207,046 MAC EAST AFRICA LTD 80201 228002 D36/JAN19/1440 Fuel for Q3 2018/2019 16/01/2019 13,470,000 Vivo Energy Uganda 80201 227004 Limited Sub-Total 76,285,488 Project 1393 Construction and Equipping of the International Specialized Hospital of Uganda (Output 080201 Monitoring, Supervision and Evaluation of Health Systems)

D75a/MAY19/1344 Deposit of funds for airtime in respect of KAYUP 12/6/2019 3,023,000 MTN Uganda Limited 80201 222001 project day to day operations.

D101/MAY19/1344 Funds deposited for internet in respect of KAYUP 12/6/2019 1,356,000 AFRICELL UGANDA 80201 222001 project. LIMITED D102/MAY19/1344 Funds deposited for internet in respect of KAYUP 12/6/2019 297,000 MTN Uganda Limited 80201 222001 project. D102/NOV18/0220 Fuel Consumption for Q2 2018/2019 16/11/2018 5,000,000 Vivo Energy Uganda 80201 227004 Limited D31/AUG18/0220 Fuel for Q1 2018/2018 activities Projects 9/8/2018 5,000,000 United Bank For Africa 80201 227004 Government Fuel Sub-Total 14,676,000 Project 1394 Regional Hospital for Paediatric Surgery (Output 080201 Monitoring, Supervision and Evaluation of Health Systems) D102/NOV18/0220 Fuel Consumption for Q2 2018/2019 16/11/2018 3,750,000 Vivo Energy Uganda 80201 227004 Limited D31/AUG18/0220 Fuel for Q1 2018/2019 activities for Projects 9/8/2018 3,750,000 United Bank For Africa 80201 227004 Government Fuel D36/JAN19/1440 Fuel for Q3 2018/2019 16/01/2019 7,500,000 Vivo Energy Uganda 80201 227004 Limited Sub-Total 15,000,000 1440 Uganda Reproductive Maternal and Child Health Services Improvement Project (Output 080201 Monitoring, Supervision and Evaluation of Health Systems) D25/JUN19/1440 Honoraria for extra work done in GAVI and URMCHPP 12/6/2019 24,000,000 ATWINE DIANA 80201 211102 projects for the period July 2018 to June 2019. D26/JUN19/1440 Honoraria for extra work done in GAVI and URMCHPP 12/6/2019 20,400,000 Ssegawa Ronald 80201 211102 projects for the period July 2018 to June 2019. Gyagenda 68469 D27/JUN19/1440 Honoraria for extra work done in GAVI and URMCHPP 12/6/2019 5,600,000 Naluzze Harriet 80201 211102 projects for the period July 2018 to June 2019. D14/JUN19/1440 Perdiem during supervision and site site meetings of 12/6/2019 754,000 PETER WAFULA 80201 211103 Spain Uganda Debt Swap Project. KAZINDU D87/APR19/1440 Funds advanced to cater for Imprest and equipment 30/04/2019 120,000 MBABAZI JULIET 15665 80201 211103 for URMNCHIP. D14/JUN19/1440 Perdiem during supervision and site site meetings of 12/6/2019 3,096,000 PETER WAFULA 80201 227001 Spain Uganda Debt Swap Project. KAZINDU D15/JUN19/1440 Perdiem during supervision and site site meetings of 12/6/2019 1,925,000 Ndawula Muhamad 80201 227001 Spain Uganda Debt Swap Project. 15399 D34a/NOV18/1440 Facilitation for a follow-up on funds disbursed to 6/11/2018 2,330,000 GORRET NABYONGA 80201 227001 RRHs for Health Promotion Campaigns.

D32/NOV18/1440 Facilitation for a follow-up on funds disbursed to 6/11/2018 1,979,000 KILAMA CHARLES 18344 80201 227001 RRHs for Health Promotion Campaigns. D39/NOV18/1440 Facilitation for a follow-up on funds disbursed to 6/11/2018 910,000 Naluzze Harriet 80201 227001 RRHs for Health Promotion Campaigns. D33/NOV18/1440 Facilitation for a follow-up on funds disbursed to 6/11/2018 910,000 DAVID KATABARWA 80201 227001 RRHs for Health Promotion Campaigns. 69408 D35/NOV18/1440 Facilitation for a follow-up on funds disbursed to 6/11/2018 770,000 Tukahirwa James 80201 227001 RRHs for Health Promotion Campaigns. Byenjeru D41/NOV18/1440 Facilitation for a follow-up on funds disbursed to 6/11/2018 770,000 KIGUDDE IVAN 80201 227001 RRHs for Health Promotion Campaigns. D38/NOV18/1440 Facilitation for a follow-up on funds disbursed to 6/11/2018 770,000 Kanakulya Robert 80201 227001 RRHs for Health Promotion Campaigns. D40/NOV18/1440 Facilitation for a follow-up on funds disbursed to 6/11/2018 770,000 Betty Ligyalingi 80201 227001 RRHs for Health Promotion Campaigns. D42/NOV18/1440 Facilitation for a follow-up on funds disbursed to 6/11/2018 385,000 Kagimu Zacheaus 15050 80201 227001 RRHs for Health Promotion Campaigns. D37/NOV18/1440 Facilitation for a follow-up on funds disbursed to 6/11/2018 385,000 Wantate Joseph 15814 80201 227001 RRHs for Health Promotion Campaigns. D98/JU N19/0220 Facilitation during technical support supervision and 19/06/2019 773,000 ISAAC EREGU ODONGO 80201 211103 collection of accountabilities. D102/NOV18/0220 Fuel Consumption for Q2 2018/2019 16/11/2018 19,500,000 Vivo Energy Uganda 80201 227004 Limited D31/AUG18/0220 Fuel for Q1 2018/2018 activities.Projects 9/8/2018 17,500,000 United Bank For Africa 80201 227004 Government Fuel D87/APR19/1440 Funds advanced to cater for Imprest and equipment 30/04/2019 1,250,000 MBABAZI JULIET 15665 80201 221009 for URMNCHIP. D149/NOV18/1027 Deposit of funds to cater for MOH power bills. 26/11/2018 7,500,000 Umeme Limited. 80201 223005 D27/MAY19/1344 Funds advanced to cater for 12 months(April 2019 to 24/05/2019 1,250,000 Bagenda Alfred 80201 221009 March 2020) subscription fees for the hosting space and the domain name service controller. D91/JUN19/1413 The 7th CPA Economic Forum Registration Fees for 17/06/2019 1,223,000 Institute of Certifed 80201 211103 Kajubi Peter, Odoch Bernard and Kilama Charles. Public Accountants of Uganda D86/MAR19/1413 Facilitation for a follow-up on accountability of funds 3/4/2019 1,670,000 Odoch Bernard. 80201 211103 disburbed to various districts for support on Ebola and

Rift Valley fever outbreaks.

D89/MAR19/1413 Facilitation for a follow-up on accountability of funds 3/4/2019 1,320,000 Omoding Moses G 80201 211103 disburbed to various districts for support on Ebola and 018296 Rift Valley fever outbreaks. D88/MAR19/1413 Facilitation for a follow-up on accountability of funds 3/4/2019 1,320,000 Nagawa Robinah 80201 211103 disburbed to various districts for support on Ebola and Deborah 869026 Rift Valley fever outbreaks. D87/MAR19/1413 Facilitation for a follow-up on accountability of funds 3/4/2019 1,320,000 MAZALIRE KAVULE 80201 211103 disbursed to various districts for support on Ebola and AUGUSTINE Rift Valley fever outbreaks. Sub-Total 120,500,000

Project 0220 Global Fund for AIDS, TB and Malaria (Output 080503 Monitoring and Evaluation Capacity Improvement)

D60/JAN19/0220 Being payment for fuel and per diem to facilitate 24/01/2019 3,056,000 ERIAB KIIZA BIHEMAISO 80503 211103 support supervision by Accounts and other staff D08a/JUN19/1315 Deposit of PAYE deductions from IsDB project staff 19/06/2019 3,092,604 UGANDA REVENUE 80503 211102 salaries for June 2019. AUTHORITY D112a/JUN19/1344 Deposit of 5% balance on social security contribution 20/06/2019 1,135,000 National Social Security 80503 212101 for KAYUP project technical staff for November 2017. Fund-Fund Contributions D110/JUN19/1187 Deposit of 10% social security contribution for MKCCA 19/06/2019 2,543,540 National Social Security 80503 212101 project technical staff for June 2019. Fund-Fund Contributions D111/JUN19/1344 Deposit of 10% social security contribution for KAYUP 19/06/2019 2,270,000 National Social Security 80503 212101 project technical staff for December 2017. Fund-Fund Contributions D112/JUN19/1344 Deposit of 10% social security contribution for KAYUP 19/06/2019 2,270,000 National Social Security 80503 212101 project technical staff for November 2017. Fund-Fund Contributions Sub-Total 14,367,144 Project 1436 GAVI Vaccines and Health Sector Development Plan Support (Output 080503 Monitoring and Evaluation Capacity Improvement) D23/MAR19/0220 Servicing of Motor Vehicles No. UG 5337M, UG 15/03/2019 1,886,375 The Cooper Motor 80503 228002 5563M, UG 5337M and UG 5410M. Corporation Uganda Limited

D23/MAR19/0220 Servicing of Motor Vehicles No. UG 5337M, UG 15/03/2019 339,548 The Cooper Motor 80503 228002 5563M, UG 5337M and UG 5410M. Corporation Uganda Limited D149/NOV18/1027 Deposit of funds to cater for MOH power bills. 26/11/2018 15,000,000 Umeme Limited. 80503 223005

Sub-Total 17,225,923 Grand Total 3,089,769,035