USE AND MANAGEMENT FUND

Dr. Winfred Philemon KyambileDistrict Medical Officer

HANANG

CHF BEST PRACTICE WORKSHOPDAR ES SALAAM

02/02/2007

Management of Funds

• In managing the funds, we are using the following CHF management tools for Documentation of accurate premiums, user fees transactions and maintaining up to date records.

CHF MANAGEMENT TOOLS• Patient Register/ Indent system Register.• CHF membership Register• CHF member card filing system• CHF and User fee receipt books• CHF Financial ledger• CHF daily status report register• CHF monthly status report register • CHF - TRACT soft ware• Cash book• Stores ledger• CHF cheque books• Local authority payment voucher

Patient Register

– It is consistent with Indent system– Is used to record All patients who has been

attended at the HF.– It contains Date of visit, patient particulars,

Diagnosis prescription and a method of payment column eg NHIF, Papo kwa papo (P), No Payment, Exemption (E) and Receipt No. Column.

– It is very Important in Daily Reconciliation of fees collected. The cash received is reconciled to the number of patients seen at the facility on that day and that a receipt was issued for all cash received.

Form 1: Patient Register

• DISTRICT: Hanang• Health Facility: Dawar DispensaryS/N Date Name Village/

Hamlet

Age Sex Diagnosis Prescription Method of payment

(Papo kwa papo = P

E = Exempt CHF,

P=No Payment: NHIF

REC. NO

1 1/12/2006 Hilda Dawar 20 F Malaria NHIF 0063201

2 2/12/2006 Salome Dawar 35 F Skin rash CHF 003059

3 3/12/2006 Anna Dawar 45 F Machete wound

CHF 003085

4 4/12/2006 Basso Dawar 25 M Cough P 0015633

5 5/12/2006 Yuda Dawar 2 M Malaria No payment-pay later

No payment

8 8/12/2006 Juma Dawar 34 M Eye Infection

CHF 003100

CHF membership Register

– This register contains information of the CHF membership. It shows the following information.

• CHF card No, Date of purchase, Household information and expiry date.

• Membership type eg. New member purchasing membership for the first time (N) or is renewing a membership (R).

• The amount paid and the Receipt number.

FORM 2: CHF MEMBERSHIP REGISTER Hanang District

Health Facility: ---------- CHF CARD NO

Date of purchase

Receipt Number

Name Ward No. of members

Membership Type Expiry Date Amount

New Renewal

3085 1/7/2006 16001 Samti Dawar 8 N 30/06/2007 10,000

3086 1/7/2006 16002 Abdu Dawar 10 R 30/06/2007 10,000

3087 2/7/2006 16003 Bura Basotu 7 N 30/06/2007 10,000

3088 2/7/006 16004 Qamara Dirma 14 R 01/07/2007 10,000

CHF Daily status report Register

• Used In Daily recording and daily reconciliation of fees using the patient register and the CHF membership Register

CHF Daily Status Report Register

• Hanang District

• Health Facility: --------------------- Month & Year --------------------- Date Number of Patients REVENUE

User Fees CHF Members NHIF Members Exemption No Payment Total Number of Visits

Users fees collected

CHF fees collected

Other collections (Including Late User Fees)

Total Fees

Today Month to date

Today Month to date

Today Month to date

Today Month to date

Today Month to date

Today Month to date

1 2 2 5 5 0 0 0 0 1 1 8 8 2,000 15,000 0 17,000

2 2 4 3 8 0 0 0 0 1 2 6 14 2,000 20,000 0 22,000

3 3 7 1 9 0 0 0 0 0 2 4 18 3,000 5,000 0 8,000

4

5

6

STEPS FOR DAILY RECORDING AND RECONCILIATION OF FEES

• At the end of the Day, the HF in charge counts the total number of the patients in the patient Register, noting the totals separately for those paying user fees, CHF members, NHIF members, Exempted patients and those who make no payment (eg some re-visits; poor, accident victims and those treated on credit to pay later). The In charge then records them in the CHF Daily status Report Register.

STEPS CONT.

• The In charge makes sure that for each patient paying user fee, a receipt number is noted in the patient Register, and makes sure that the Total amount of user fees collected matches the Total of the user fee receipts value.

STEPS CONT.

• The in charge also, retrieves the CHF member ship Register and counts the number of new CHF memberships sold during the day. Then records the number of CHF membership fees that should have been collected on that day. The in charge should make sure that the amount that have been collected in CHF membership fees matches the total of the CHF Receipts issued that day.

DEPOSITING FUNDS AT THE CHMT

• Funds collected at the HF are deposited on a regular basis at the DMO’s office, who

• in turn bank them in a CHF Account.• The In charge depositing funds at Dmo’s

Office, should present to the CHMT member the following.

• User fee receipt book, CHF receipts book and a daily CHF status report register book.

DEPOSITING FUNDS CONT.

• The Council has established and maintains a separate bank account for CHF money. All the CHF premiums, user fees and other contributions such as NHIF and Matching grants from the government are deposited.

CHF financial Ledger

• This tracks the collection, use and balance of CHF money. All user and CHF membership fees collected should be recorded on a daily basis. In addition, deposits, expenditures and matching grants received should be recorded in the CHF financial ledger.

Form 4:CHF Financial Ledger

Hanang District

Health Facility:Gidahababieg Dispensary, Year 2006

Cash Book DMO/CHMT

Transactions

Date Details Daily Fees collected

Cash on

hand

Deposits Expenditure CHF Account Balance

5/12/2006 Opening Balance 2,048,464.00

6/12/2006 Fees Collected 15,000.00 15,000.00

7/12/2006 Fees Collected 10,000.00 25,000.00

8/12/2006 Deposit Fees 25,000.00 2,073,464.00

8/12/2006 Petty Cash 20,000.00 2,053,464.00

8/12/2006 Fees Collected 20,000.00 20,000.00

9/12/2006 Building Materials 253,000.00 1,800,464.00

CHF monthly status report register

This records utilization, CHF membership and fee collection information on a monthly basis. The information entered into the CHF monthly status report is based on the patient register, CHF daily status report, CHF membership register and the CHF financial Ledger. The worksheet is to be filled in on last day of the month.

Form 5:CHF Monthly status report Register

Hanang District

Health Facility:Bassodesh Dispensary ; YEAR…2006……………

MonthNumber of Patients CHF Membership Fees Collected

TotalCollection

Expenditure

Balance

UserFees

CHFMembers

NHIFMembers

Exempt No Payment

Total no ofPatients

New Renewal Expired Total

Active

User

Fees

CHF

Fees

OtherCollection

Continuing members fromLast month 30

Jan. 150 200 5 20 2 377 2 4 1 35 20,000 50,000 0 70,000 10,000

Feb.

March

Dec.

TOTAL

THE COMMUNITY HEALTH FUND SOFTWARE (CHF – TRACK)

– Is a user friendly tool developed by East, central and southern African Health Community (ECSA) In collaboration with the ministry of Health to assist CHF managers to track and maintain CHF data at district, regional and national level. The tool can in future be used at lower Health facility levels.

Chf Track Cont.

• The Tool has In built formulae to assist in data analysis and generating of various reports regarding Management and performance of CHF.The soft-ware is intended to compliment existing tools of the Health Management Information system.

Chf Track cont.

(a)Data in puts • In order for the soft ware to achieve the above

purpose, it needs inputs of data from the following sources;

• Patient register• CHF membership register• CHF Daily station report register• Financial Ledger• Other population and Community data.

Chf Track cont.(b) Out-puts generated by the software• The software has been designed to generate the

following reports as output:-• Monthly status reports by health facility showing • Total member of patient attendance• The status of the CHF membership• Total revenue collected, expenditures and

balances• Quarterly and annual CHF summary reports• District performance and service utilization

status.

Chf Track Cont.

• NOTE: It is important to note that the quality of output generated by the soft-ware depends very much on the accuracy and Completeness of data collected from the Health facilities ie Daily filling of patient register, daily status report and financial register.

USE OF FUNDS.

– The CHF money is used according to the approved budgets that originate from Comprehensive Council health plan developed In a participatory manner.

– The ward or facility health committees will periodically requests purchases of items or any other expenditure according to the approved budget.

Use of funds cont.

• Expenditure is authorized by the Council Health service Board following the laid down Govt financial regulations.

• The Fund is usually used to supplement the Government/Council’s budget In

• Procuring drugs, equipment and medical supplies

• Minor works in Improving infrastructure • Paying salaries to Health sector employees on

temporary contracts.• Other activities aiming at improving the quality of

Health service delivery.