THE REPUBLIC OF UGANDA

REPORT OF THE AUDITOR GENERAL

ON THE FINANCIAL STATEMENTS OF THE UGANDA GLOBAL FUND TO FIGHT AIDS,

TUBERCULOSIS AND MALARIA PROJECT – HEALTH SYSTEMS STRENGTHENING

COMPONENT IN THE MINISTRY OF HEALTH FOR THE YEAR ENDED 30TH JUNE 2015

GRANT NO.UGD-011-G09-S

OFFICE OF THE AUDITOR GENERAL

UGANDA

1

TABLE OF CONTENTS

PAGE LIST OF ACRONYMS 2

REPORT OF THE AUDITOR GENERAL ON THE FINANCIAL STATEMENTS OF THE

UGANDA GLOBAL FUND TO FIGHT AIDS, TUBERCULOSIS AND MALARIA PROJECT –

HEALTH SYSTEMS STRENGTHENING COMPONENT IN THE MINISTRY OF HEALTH

FOR THE YEAR ENDED 30TH JUNE 2015’ GRANT NO.UGD-011-G09-S 3

DETAILED REPORT OF THE AUDITOR GENERAL ON THE FINANCIAL STATEMENTS OF

THE UGANDA GLOBAL FUND TO FIGHT AIDS, TUBERCULOSIS AND MALARIA

PROJECT - HEALTH SYSTEMS STRENGTHENING COMPONENT IN THE MINISTRY OF

HEALTH FOR THE FINANCIAL YEAR ENDED 30TH JUNE 2015 5

1.0 INTRODUCTION 5

2.0 BACKGROUND INFORMATION 5

3.0 GRANT OBJECTIVES 6

4.0 ACHIEVEMENTS OF THE GRANT 6

5.0 AUDIT SCOPE 6

6.0 PROCEDURES PERFORMED 7

7.0 Categorization of audit findings 8

7.1 Profiling of audit observations 8

2

LIST OF ACRONYMS

DHIS District Health Information System

DHO District Health Officers

GAAPs Generally Accepted Accounting Principles

GF Global Fund

GoU Government of Uganda

HMIS Health Management Information Systems

HSS Health System Strengthening

LFA Local Fund Agent

M&E Monitoring and Evaluation

MoFPED Ministry of Finance Planning and Economic Development

MoH Ministry of Health

PDR Portfolio Disbursement Release

PDU Procurement and Disposal Unit

PMTCT Preventing of Mother-to-Child Transmission

PR Principal Recipient

PSS Public Service Standing Orders

RPMT Regional Performance Monitoring Teams

SOP Standard Operating Procedures

SR Sub Recipient

TB Tuberculosis

UGX Uganda Shillings

USD United States Dollars

VHTs Village Health Teams

VPP Voluntary Pooled Procurement

3

REPORT OF THE AUDITOR GENERAL ON THE FINANCIAL STATEMENTS OF THE

UGANDA GLOBAL FUND TO FIGHT AIDS, TUBERCULOSIS AND MALARIA PROJECT –

HEALTH SYSTEMS STRENGTHENING COMPONENT IN THE MINISTRY OF HEALTH

FOR THE YEAR ENDED 30TH JUNE 2015’ GRANT NO.UGD-011-G09-S

THE RT. HON. SPEAKER OF PARLIAMENT

I have audited the accompanying financial statements of the Uganda Global Fund to Fight Aids,

Tuberculosis and Malaria Project – Health Systems Strengthening Component in the Ministry of

Health for the year ended 30th June 2015. These financial statements comprise of the

Statement of Financial Position as at 30th June 2015, Statement of Fund Accountability,

Statement of Cash Flow together with other accompanying statements, notes and accounting

policies.

Management Responsibility 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 the Global Fund – HSS component. The Accounting

Officer is also responsible for the preparation of financial statements in accordance with the

requirements of the Government of Uganda, donor regulations, guidelines and the Generally

Accepted Accounting Principles (GAAPs) and for maintenance of such internal control as

management determines is necessary to enable the preparation of financial statements that are

free from material misstatement whether due to fraud or error.

Auditor’s Responsibility

My responsibility as required by Article 163 of the Constitution of the Republic of Uganda, 1995

(as amended) and Sections 13 and 19 of the National Audit Act, 2008 is to express an opinion

on the financial statements based on my audit. I conducted my audit in accordance with the

International Standards on Auditing. The standards require that I comply with ethical

requirements and plan and perform the audit to obtain reasonable assurance about whether the

financial statements are free from material misstatement.

An audit involves performing audit procedures to obtain audit evidence about the amounts and

disclosures in the financial statements as well as evidence supporting compliance with relevant

laws and regulations. The procedures selected depend on the Auditor’s judgment, including the

assessment of risks of material misstatement of the financial statements whether due to fraud

4

or error. In making those risk assessments, the Auditor considers internal controls relevant to

the entity’s preparation and fair presentation of financial statements 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 entity’s internal controls. An audit also includes evaluating

the appropriateness of accounting policies used and the reasonableness of accounting estimates

made by management, as well as evaluating the overall presentation of the financial

statements.

I believe that the audit evidence I have obtained is sufficient and appropriate to provide a basis

for my audit opinion.

Part “A” of my report sets out my opinion on the financial statements. Part “B” which forms an

integral part of this report presents in detail all the significant audit findings made during the

audit which have been brought to the attention of management.

PART "A"

Opinion

In my opinion the Financial Statements of the Uganda Global Fund to Fight Aids, Tuberculosis

and Malaria Project - Health Systems Strengthening Component in the Ministry of Health

present fairly in all material respects the Financial Position as at 30th June 2015 and the

Statement of Fund Accountability, Statement of Cash Flow together with other accompanying

statements, notes and accounting policies for the year then ended in accordance with the basis

of accounting stated under Note 10.2 (a) to the Financial Statements and in conformity with the

grant reporting guidelines, terms and conditions.

John F. S. Muwanga AUDITOR GENERAL

7th December 2015

5

PART “B”

DETAILED REPORT OF THE AUDITOR GENERAL ON THE FINANCIAL STATEMENTS OF

THE UGANDA GLOBAL FUND TO FIGHT AIDS, TUBERCULOSIS AND MALARIA

PROJECT - HEALTH SYSTEMS STRENGTHENING COMPONENT IN THE MINISTRY OF

HEALTH FOR THE FINANCIAL YEAR ENDED 30TH JUNE 2015

This section outlines in detail the audit scope, audit findings, my recommendations and

management responses in respect thereof.

1.0 INTRODUCTION

I am mandated by Article 163 (3) of the Constitution of the Republic of Uganda, 1995

(as amended), to audit and report on the public accounts of Uganda and of all public

offices including the courts, the central and local government administrations,

universities and public institutions of the like nature and any public corporation or other

bodies or organizations established by an Act of Parliament. Accordingly, I carried out

the audit of the above project to enable me report to Parliament and the Development

Partners.

2.0 BACKGROUND INFORMATION

During the implementation of the Uganda Global Fund to fight Aids, Tuberculosis and

Malaria project, gaps and constraints were identified in the Health system, which if not

addressed would impact on the expected outcomes. Interventions were required to

address the identified gaps and constraints, which resulted in the implementation of the

Health Systems Strengthening Component (HSS).

The HSS grant duration is two years commencing on 1st Aug 2012 and ending on 31st

July 2014, with a total budget of USD.4, 762,711. The Grant has had three

disbursements so far, namely USD.2, 051,883 released on 25th July 2012. A further

USD.328, 178 was disbursed on the 2nd November 2012 directly to the Voluntary Pooled

Procurement (VPP) for the procurement of laboratory microscopes and delivery kits to

200 facilities and the most recent on 25th June 2014 of USD.2,272,147. An aggregate

amount of USD.4, 652,208 has been disbursed to date to the Country.

6

3.0 GRANT OBJECTIVES

The grant is guided by five objectives, namely;

Establish 12 Regional Performance Monitoring Teams (RPMT) to strengthen the

active surveillance of program outputs and to support the performance management

of the implementing agencies at the sub-national level.

Facilitate the employment of 600 vital cadres for HIV (PMTCT), TB and Malaria to

fully operationalize health services for the attainment of the program objectives.

Strengthening the logistics management capacity at the sub-national level with a

focus on quantification, distribution, and stock monitoring at High Volume Health

facilities.

Strengthen the laboratory capacity at the sub-national level for basic laboratory

monitoring.

Strengthening Village Health Teams (VHTs) to undertake community level activities

that support the objectives of HIV, Malaria and TB.

4.0 ACHIEVEMENTS OF THE GRANT

The achievements of the Grant in the period under review included:

Recruited 82 of the 96 Regional Performance Monitoring Teams to strengthen the

active surveillance of program outputs and support the performance management of

the implementing agencies at the sub national level;

Procured 30 motorcycles for medicine management supervisors in 30 underserved

districts and 12 motor vehicles (Mini buses) for 12 Regional Performance Monitoring

Teams; and

Printing Home Based Management of Fever (HBMF) registers whose distribution was

concluded.

5.0 AUDIT SCOPE

The audit was carried out in accordance with the International Standards on Auditing

and accordingly included a review of the accounting records, agreed procedures as was

considered necessary. In conducting my reviews, special attention was paid to establish

whether:

a. The Financial Statements have been prepared in accordance with the Public Finance

Management Act, 2015 and comply with the Generally Accepted Accounting

7

Principles (GAAPs) taking into consideration the Government of Uganda (GoU)

regulatory framework regarding Public Finance and that they present fairly the

financial performance and position of the Grant as at 30th June 2015;

b. Funds were used in accordance with the conditions of the Grant Agreement, with

due attention to economy and efficiency and only for the purposes for which the

funds were provided;

c. Goods, works and services have been procured in accordance with the relevant

financing agreement and the GoU procurement regulations;

d. A sufficient Internal Control structure was in place and internal controls worked as

intended throughout the year.

e. All necessary supporting documents and records have been maintained and are in

agreement with the financial statements presented and;

f. Fixed assets are real and properly evaluated and the property rights or related

beneficiaries' rights are established in accordance with the Grant conditions.

6.0 PROCEDURES PERFORMED

1) Revenue/Receipts

Obtained information on funds provided by the Development Partners and reconciled

the amounts to the cashbooks and bank statements.

2) Expenditure

Vouched transactions to establish whether documentation in support of the

expenditures were in tandem with the amounts and descriptions on the vouchers;

reviewed and reconciled the bank statement transactions to test for occurrence and

whether they were properly controlled and accounted for.

3) Internal Control System

Reviewed the internal control system and its operations to establish whether the

controls were sound and were applied throughout the period under review.

4) Procurement

Reviewed the procurement of goods and services under the Grant during the period

under review and reconciled with the procurement plan.

8

5) Periodic reports of the project

Reviewed the Agreement provisions and reports and reconciled them with the grant

activities during the period under review.

6) Financial Statements

Examined, on a test basis, evidence supporting the amounts and disclosures in the

financial statements; assessed the accounting principles used and significant

estimates made by management; as well as evaluating the overall financial

statement presentation.

7.0 Categorization of audit findings The following system of profiling of the audit findings has been adopted to better

prioritise the implementation of audit recommendations.

N

o

Category Description

1 High significance Has a significant / material impact, has a high likelihood of

reoccurrence, and in the opinion of the Auditor General, it

requires urgent remedial action. It is a matter of high risk or

high stakeholder interest.

2 Moderate significance Has a moderate impact, has a likelihood of reoccurrence,

and in the opinion of the Auditor General, it requires

remedial action. It is a matter of medium risk or moderate

stakeholder interest.

3 Low significance Has a low impact, has a remote likelihood of reoccurrence,

and in the opinion of the Auditor General, may not require

much attention, though its remediation may add value to the

entity. It is a matter of low risk or low stakeholder interest.

7.1 Profiling of audit observations

The following table shows the profiling of the various audit observations:

No Title of finding Significance

1 Outstanding Regional Planning and Monitoring Teams (RPMT) Wages.

High

2 Delay in Fulfilling Conditions Precedent.

High

3 Unacceptable Performance Objective.

Moderate

4 Review of prior year audit findings

Low

9

Management had in all material respects complied with the financing agreement and

government of Uganda Financial Regulations except in the following issues which have

been brought to the attention of the Accounting Officer.

8.0 DETAILED FINDINGS 8.1 Outstanding wages

At the end of the financial year 2014/2015, staff of the Regional Planning and

Monitoring Team (RPMT) had not been paid wages for the months of March, April, May

and June totaling UGX.336,569,548. This was attributed to the delay by RPMT leaders to

send time sheets for staff salary payments.

Delayed salary payment demotivates staff and subsequently undermines service

delivery.

In response, the Accounting Officer explained that this grant was performance based

and required approved time sheets before effecting any payments. By rejecting

unsupported wage claims, team leaders would be compelled to submit time sheets

before 28th day of each month.

I advised the Accounting Officer to ensure sensitization of the affected staff about the

requirement of time sheets and proper supervision of the team leaders.

8.2 Delay in Fulfilling Conditions Precedent.

In the Project Grant Agreement, conditions precedent outline pre-requisites to be full-

filled by the Principal Recipient of the Global Fund, before further disbursements can be

made for implementation of the project.

A review of the project grant performance report made between 1st July-2014 and 31st

Dec 2014 established that the Principal Recipient did not meet some of the conditions

precedent as a requirement for the implementation of the Global Fund Grant. This

therefore resulted into non-disbursement and/ or delayed disbursement of funds. Some

of the conditions that were not met were;

10

An update of names, titles and authenticated specimen signatures of each person

authorized to sign disbursement requests.

Lack of list of sub-recipients.

Lack of gap analysis for functional microscopes.

Lack of an acceptable operational manual.

Delays in fulfilling conditions precedent, lead to late fund disbursements which

may affect the project lifecycle and achievement of its objectives.

In response, the Accounting Officer explained that;

Grant signatories were changed from time to time depending on the change of

office bearers and all signatories were updated following recent changes at both

MoFPED and MoH.

Gap analysis for microscopes was completed and submitted to Global Fund and the

funds were subsequently released.

The grant operational manual was updated and approved by the Global Fund.

I advised management to always fulfill conditions precedent in a timely manner to avoid

delays in grant disbursements.

8.3 Unacceptable Performance Rating

The Grant Performance report dated 26th May 2015 which is part of the grant

performance information for the Project with code UGD-011-G09-S revealed that while

most objectives performed adequately and even beyond the expectations rating, the

number of staff trained on data management and logistics management systems,

attained only 13% from period 1-5 which is rated as unacceptable .

Lack of trained staff in data and logistics management constrains efficiency in data

collection, storage and management.

In response, the Accounting Officer explained that, on 23rd September 2012, GoU

agreed with the Global Fund that the grant funds would support commodities, while GoU

and in-country partners would fund in country operations including training. To date,

GoU has not provided the funds for in-country operations and training.

11

The 13% performance on training was only possible with support from in country

partners. I advised the Accounting Officer to liaise with the Ministry of Finance and set

aside funds for training of staff in data logistics and management as they are key

components of the project..

9.0 Review of prior year audit recommendations

A review of the status of implementation of prior year audit recommendations revealed

that some recommendations had not been implemented. As a result, the planned

activities could not be implemented during the period thus affecting the

project completion timelines and the attainment of the overall project goals and

objectives. The table refers.

Review of Prior Year Audit Recommendations

Audit Issue Recommendation Current Status Management

Response

1.0 AUDIT

FINDINGS

1.1 Delayed Release

of Project Funds

.

I have advised the

Project

Management

to ensure timely

release of funds

to enable

implementation

of planned

activities, thus

ensuring

attainment of

project objectives

Funds are still not

released in time as

evidenced by

payment of salary

arrears that

occurred

The situation was

only

slightly

addressed with

Funds are being

released/ disbursed

on quarterly basis

and in accordance

with the approved

work plan/budgets.

The issue of delayed

movement of monies

from holding account to

operations accounts

had been severally

brought to the attention

of Accountant General

for redress

L.2 Global Fund GoU

Counterpart Funding –

I have advised

management to

There is still a

challenge in GOU

meeting the

Implementation takes

place upon

Government’s release

12

Audit Issue Recommendation Current Status Management

Response

Inadequate releases

always liaise with

MoFPED to plan

properly for the

release of funds to

ensure proper

implementation of

all planned project

activities.

Counter- part

funding

requirement.

GoU has slightly

increased the co-

funding compared

to previous year.

Partially

addressed

of funds and

management so far

duly adhered to that.

1.5 Review of

implementation of

recommendations

1.5.1 Status of

conditions precedent

and/or other special

conditions

It was observed that the

Principal Recipient had

three conditions

precedent and/or other

special conditions to be

fulfilled before

and after the first

disbursement could be

made. While one

condition had been met,

the other two remained

outstanding.

I have advised

management to

expedite the

implementation of

the outstanding

conditions in order

not to frustrate

further

disbursement of

funds

No proof has been

provided to

confirm that the

two conditions In

appendix 2 had

been addressed

Pending In

progress

The process of

subsuming the RPMTs

is still ongoing. In the

meantime, their

supporting grant has

been extended to

December 2016.

Still ongoing

1.5.2 Follow up of

Local Fund Aqent (LFA

) findings and

recommendations

I have advised the

Project

Management to

No proof has been

provided to

confirm that the

Resource Centre was

currently printing and

rolling out revised data

collection tools across

the country. Once

13

Audit Issue Recommendation Current Status Management

Response

The Local Fund Agent

(LFA) raised a number of

issues during

the year on the Grant.

While some actions had

been taken by

Management to address

the recommendations, a

number of them

remained outstanding

and this could affect

grant disbursements.

ensure that it fully

addresses the

outstanding issues

raised by the LFA.

LFA

recommendations

had been

addressed

Pending- in

progress

completed, accuracy

from primary tools will

be achieved. In

addition, PR has

planned to conduct

regular data quality

audits across all

districts. However, GoU

funding for this and

other in-country

operations has not

been realized

Still Ongoing

Delayed implementation of prior year audit issues hinders attainment of the project objectives.

I advised the Accounting officer to ensure that audit recommendations are implemented

promptly so as to attain the project objectives.

14

MANAGEMENT LETTER FOR THE UGANDA GLOBAL FUND TO FIGHT AIDS, TUBERCULOSIS AND MALARIA PROJECT -

HEALTH SYSTEMS STRENGTHENING COMPONENT

GRANT NO.UGD-011-G09-S

The following system of grading of the management letter issues has been provided in order to better prioritize implementation of

recommendations:-

Grade Remarks

Grade 1 Findings are those which are particularly significant and the involvement of management may be required for their

resolution. These are high level issues which impact seriously on the achievement of overall grant goals.

Grade II Findings are those that may have significant impact on the control environment. Here control environment looks at risk

factors derived from management’s attitude to risk as regards operational activities within the PR/Sub-recipient

organization.

Grade III Findings are those which are less significant than Grade 1 and II but nevertheless merit attention.

No Findings Management Responses Verifica

tion

Finding

s

Audit

Conclusions

Grade

1.0 Outstanding Regional planning and monitoring

teams (RPMT) salary

At the end of the financial year 2014/2015, several RPMT

staff had not been paid salary for the months of March,

April, May and June totaling UGX.336,569,548.72 as per

Appendix I. This was attributed to the delay by RPMT

leaders in sending time sheets for salary payments.

Delayed salary payment has the effect of demotivating

The auditors’ observation is noted.

Given that this is a performance based

grant, management emphasized the

need for time sheets before payment

could be effected. Being a new

requirement, the teams initially did not

consider this important, hence the

delays. Team leaders have now been

compelled to submit time sheets timely

N/A The issue is

sustained

I

15

staff and subsequently undermining service delivery.

Recommendation

The Accounting Officer should ensure adequate

supervision of staff involved in preparing time sheets.

by 28th day of each month.

1.1 Double payment

Section F (a) of the Uganda Public Service Standing order

(PSS) 2010 requires that a public servant draws only one

salary while serving in the Public service of the

Government of Uganda. A review of the staff contracts

file revealed that an officer contracted by the Ministry of

Health on a non- pensionable contract service as a

pharmacy resource focal person under the Regional

Planning and Monitoring Teams (RPMTs) and posted to

Mbarara RPMT regional office also worked in Itojo

Hospital under Ntungamo District Local Government.

At the time of audit the Officer had received salary from

the project amounting to UGX.13,783,668 which amounts

to double payment.

Recommendation

The Accounting officer is advised to put in place

supervision mechanism aimed at ensuring that RPMT

staffs are not involved in double employment. Meanwhile

any double payment should be recovered accordingly.

The observation was noted earlier and

the officer terminated way before the

audit. It was partly due to this

realization that the ministry introduced

time sheets to avoid double play by

tasking officers to account for their

time. The Officer in question opted to

return to his original station and a

demand note was issued to commence

proceedings for recovery.

No

evidence

of

recovery

The issue is

dropped I

16

2.0 Inadequate Monitoring and Evaluation

Mechanism

Program Grant Agreement, article 14.a Sub

Recipients, recommends that the Principal Recipient may

provide Grant Funds to other entities provided that the

PR, from time to time assesses the capacity of each sub

recipient to implement Program activities and report

thereon, makes such assessments available to global

fund upon request and selects each sub recipient based

on a positive assessment of that sub recipient's capacity

to carry out the program activities that are assigned to it

and in a transparent manner. UGX. 605,074,927 was

advanced to Makerere College of Sciences for operational

research to review condom programming and HIV

prevention interventions under a memorandum of

understanding dated 26th March 2015. However a report

of a study carried out to assess Public Sub-recipients pre-

award for grant implementation and management

revealed that Makerere University School of Public Health

was among those rated as having the weakest capacity in

Monitoring and Evaluation due to the following reasons

among others;

Lack of Monitoring and Evaluation (M $ E)

plans,

insufficient M $ E documentation and

Inadequate budgets.

In the circumstances, there is possibility that the project

did not achieve value for money incurred.

Recommendation

Makerere University was contracted to

conduct Operations Research, whose

implementations is guided by a

research/study protocol alongside with

study tools (questionnaires, guides

e.t.c). Therefore it does not require

separate M&E Plans as the M&E for

research is imbedded within the study

protocol before approval can be

obtained from Institutional Review

Boards. Requirement for a separate

M&E is not essential in this case but in

any case their score on M&E capacity

assessment exercise we conducted

was 23/30, which was considered

above average. The University was

chosen in addition to its comparative

advantage of being mandate to

conduct health related research.

N/A The issue is

kept in view

I

17

The college should put in place adequate monitoring and

evaluation mechanisms before receipt of more funds.

3.0 Weaknesses in Sub-Recipients Grant

Implementation and Management

Under article 14(a) of the Program Grant Agreement for

Global Fund, the Principal Recipient may provide Grant

funds to other entities to carry out Program activities

provided the Principal, assesses the capacity of each sub-

recipient and selects them based on positive assessment.

However a pre-award assessment study carried

out during the period indicated that public and

non- public sub-recipients scored either average

or below average. The report highlighted some of

the weakest areas as;

Some sub recipients (SRs) did not have

Public Sector SRs draw their mandate

from the Constitution to implement

government health program. The

purpose of capacity assessment for

Public Sector SRs is not to eliminate

entities but to identify capacity gaps so

as to address the identified

weaknesses. However, there are no

SRs under this grant as it is

implemented centrally by the PR

through the RPMTs.

N/A The issue is

dropped

I

18

internal organizational systems like

foundational documents, previous capacity

building in key grant management areas,

evidence of skilled staff and availability of

office equipment.

Availability of adequate financial

management systems in auditing, insurance

and capacity to produce quality reports

timely.

Strong SRs with capacity and good internal

organizations had their ratio of the global

fund grant to the overall organization’s

budget affected by low amounts available for

M $ E, an indication that they relied more on

global fund grant than their own resources.

The Grant Fund may be mismanaged due to lack

of previous experience, lack of evidence of sustainability

and technical coordination.

Recommendation

The Principal Recipient should select sub-recipients in

accordance with proper management capacity as outlined

above.

4.0 Delay in Fulfilling Conditions Precedent.

Project Grant Agreement, conditions precedent outlines

conditions to be filled by the Principal Recipient of the

Global Fund, before further disbursements can be made

for implementation of the project. A review of the project

grant performance report made between 1st July-2014

and 31st Dec 2014 established that the Principal

Grant signatories are changed from

time to time depending on the change

of office bearers, as was the case

during the period for this audit. All

signatories have been updated

following recent changes at both

MoFPED and MoH.

N/A The issue is

maintained

I

19

Recipient did not meet some of the conditions precedent

as a requirement for the implementation of the Global

Fund Grant. This therefore resulted into non-

disbursement and delayed disbursement of funds. Some

of the conditions that were not met were;

An update of names, titles and authenticated

specimen signatures of each person

authorised to sign disbursement request.

Lack of list of sub-recipient.

Lack of gap analysis for functional

microscopes.

Lack of an acceptable operational manual.

Delays in fulfilling conditions precedent leads to delay in

fund disbursement which may affect the project lifecycle

and immediate achievement of its objectives.

Recommendation

The Principal Recipient should always fulfill conditions

precedent in a timely manner.

There are no SRs in this grant.

Gap analysis for microscopes was

completed and submitted to Global

Fund and the funds were released.

The grant operational manual was

updated and approved by the Global

Fund.

5.0

5.1

Review of the HSS Grant performance report

Unacceptable Performance Objective.

The Grant Performance report dated 26th May 2015 which

is part of the grant performance information for Project

with code UGD-011-G09-S revealed that while most

objectives attained adequate and even beyond

expectations rating, key grant information indicate that

objective 4.1- (number of staff trained on data

management and logistics management system),

attained only 13% from period 1-5 which is rated as

Overall, on 23rd September 2012, GoU

agreed with the Global Fund that grant

funds support commodities, while GoU

and in-country partners would funds in

country operations including training.

To date, GoU has not provided the

funds for in-country operations and

training.

The 13% performance on training was

possible with support from partners

like MEEPP, METS and SURE and for

N/A The issue is

sustained

II

20

unacceptable. The table below and Appendix IV show

the details.

Period. 1 2 3 4 5

Target. 450 1,380 900 0 456

Results. Resu t pending 0 0 0 60

Lack of trained staff in data and logistics management

constrains efficiency in data collection, storage and

quality.

Recommendation

The Accounting Officer is advised to prioritize training of

data and logistics management staff for effective

handling of project data and logistics.

the funds used to orient 60 RPMTs on

DHIS2 data management as part of

the critical health systems

strengthening activities which were

accepted by exception.

5.2 Key Grant Performance – (Program Impact and

Outcome indicators) - HSS Grant

Although there was satisfactory results in the areas of

Treatment success rate, new smear positive TB cases and

Percentage of live births attended by skilled health

personnel that were above the target, Maternal mortality

ratio (per 100'000 live birth, Child Mortality (per 1000 live

births, Infant Mortality Rate (per 1000 live births

treatment according to national policy, did not have

results to show baseline survey out-come from goal 3,

while goals I and 2 did not show any impact indicators.

The summary table below and Appendix IV refer.

Goal Impact

indicator

The result for this indicator will be

obtained from the Uganda

Demographic and Health Survey and

the AIDS Indicator Survey, which are

yet to be conducted. The timelines for

these two population based surveys

were postponed.

N/A The is Kept In

View

I

21

Goal

1

To Reduce the incidence

rate of HIV by 40% by the

year 2012

There were

no Impact

Indicators

into this

Goal.

Goal

2

To improve the quality of

life of PHA by mitigating

the health effects of

HIV/AIDS by 2012

There were

no Impact

Indicators

into this

Goal.

Goal

3

To build an effective

support system that

ensures quality, equitable

and timely service delivery

App IV.

The reasons for failure to have impact indicators on some

of the goals were not clear.

Recommendation

The Accounting Officer is advised to ensure compilation

and submission of impact indicators for ease of

assessment of progress made.

6.0 Review of prior year audit recommendations

A review of the status of implementation of prior year

audit recommendations revealed the status indicated in

Appendix III.

Delayed implementation of prior year audit issues hinders

attainment of the project objectives.

Recommendation

The Accounting officer is advised to ensure that audit

Refer to responses in appendix A

significa

nt

number

of issues

are still

remain

unresolv

ed

The issue is

sustained

1

22

recommendations are implemented promptly so as to

attain the project objectives.