A majority of Rwandan hospitals are mismanaging funds compromising the quality of medical care for these hospitals, which largely affects the poor who depend on mutual health insurance locally known as “Mutuelle de Sante”.

In his 2015 report, the Auditor-General Obadiah Biraro, said that as many as 15 district hospitals mismanaged funds.

Only three district hospitals — Kibilizi, Ruhango and Muhororo —had clean audits.

The report points to lack of financial management skills by administrators.

“District hospitals continue to experience weaknesses in accounting and management of funds at their disposal.  The gaps noted include omission of transactions from the books of account, un-reconciled balances, unjustified suspense accounts and unsupported transactions among others,” Mr Biraro said.

“This is partly attributed to lack of adequate skills on the part of administrators who are responsible for the daily management of the hospitals. These administrators do not have a financial management background, resulting in poor handling of accounting and financial management activities,” he added.

Nathan Mugume, head of Health Communication Centre, said that the ministry of health had taken steps to address concerns raised by the auditor general.

“Administrators from all hospitals are now acquiring the necessary skills in hospital and finance management. Once trained, there will be no excuses because we shall expect them to be professional and qualified for their jobs,” he said.

On Monday, the Minister of Health, Agnes Binagwaho appeared before the budget parliament committee, where MPs pointed out that mismanagement of funds at the hospitals led to delays in restocking medicine, as well as contributed to poor service delivery, especially to poor Rwandans who depend on mutual health insurance.

“This is a very big challenge for clients using mutual health insurance because they are not reimbursed money paid when purchasing drugs in private pharmacies,” Constance Rwaka, chairman of the committee said.

At one of the University Teaching Hospital of Kigali — CHUK — the auditor general pointed out that there were delays to restock drugs and medical supplies over the past three years.

“The hospital has experienced stock outs of drugs and medical supplies for periods ranging from 14 to 458 days. In these cases, clients had to purchase drugs from private pharmacies, which is a big challenge for 80 per cent of CHUK patients who mainly use mutual health insurance scheme,” he said.

The ministry was also castigated for underutilising its 2015/2016 budget. It spent only 67 per cent of Rwf179 billion despite a dire need to refurbish many district hospitals with ailing infrastructure.

In order to promote efficiency of public hospitals, the government has devised several means, including privatisation. Last month, the government sold management rights of the national referral , King Faisal Hospital, to Oshens Healthcare, a subsidiary of Angola Capital Investment, in a deal worth $24 million.