By Ivan Kaahwa
“Health and Medicinal Supplies : Expired items were stored in the same space/room as non-expired items.
The government mandated the National Medical Stores (NMS) to procure all Essential Medicines and Health Supplies (EHMS) and distribute them to all health facilities in the country. Consequently, the funds for the procurement of EHMS are budgeted under NMS.
The 2023 Auditor General’s findings reveal under deliveries of ordered medicines and health supplies in all hospitals, with samples worth UGX 1.919 billion. The report highlights that in 3 out of the 8 sampled hospitals, expired items were stored in the same space/room as non-expired items. Significant drugs out of stock included Quetiapine, FLUANXOL 20MG, SEVOFLURANE 100% V/V, TRIFLUOPERAZINE TABLETS 5mg, ORAL MORPHINE 250ML 5MG/5ML, among others. All hospitals reported non-functional vital medical equipment such as Digital X-rays, MRI Machines, CT scan machines, etc., requiring repairs. The report notes that hospitals lacked Medical Maintenance Equipment Plans and training in medical equipment maintenance, with inadequate budget allocations for maintenance. According to the Auditor General, these gaps hinder health service delivery, advising the government to review the current funding arrangement of hospitals for sustainable health service delivery. The report further shows that out of the 3,254 health facilities, 3,183 had under deliveries of drugs and medical supplies worth UGX 26.403 billion. Deliveries were not following cycles, causing delayed deliveries and disruptions in patient treatment. Under Deliveries led to drug stock-outs and treatment disruptions across affected health facilities nationwide.
Forensics Management : DGAL’s stuck with 819 reports out of a sample of 1,981 investigations
The Directorate of Government Analytical Laboratories (DGAL) is responsible for providing forensic evidence to support the justice system. However, an audit of the management of forensic services at DGAL revealed significant underfunding during the financial year, with only 21% of the approved budget released. As a result, DGAL was unable to provide all planned forensic services to support the administration of justice. During the year, DGAL received 1,981 forensic cases for analysis and investigation. However, only 59% of these cases were concluded, leaving 41% pending. The time from receipt of a request to completion of an investigation took an average of 121 days, which is longer than the expected turnaround time of 90 days.Overall, the audit highlights issues with funding and efficiency in the management of forensic services at DGAL. These issues may have implications for the administration of justice and require attention to ensure that forensic evidence can be provided in a timely and effective manner. The audit report reveals that DGAL’s performance in dispatching forensic investigation reports to clients was only 59%, with 819 reports yet to be issued out of a sample of 1,981 investigations completed during the year. The average time taken to dispatch reports was two months. The laboratories lacked conducive storage for samples and exhibits, with inadequate space, poor aeration, no fume extraction systems, and inadequate power regulators for cooling facilities. DGAL had only filled 58% of the total approved established positions of 64 technical staff in the forensic department, leaving 27 vacancies that led to reduced efficiency in laboratory operations and increased workload for existing staff. Only 38% of the technical staff had received basic and specialized training in forensics, leaving a significant skilling gap. DGAL did not carry out regular maintenance, servicing, and calibration of several laboratory equipment used to examine forensic cases. Some equipment had not been serviced for more than two years.The Laboratory Information Management System’s performance review revealed that only 7% of the received forensic and general cases were registered on the system. Out of this number, only ten were received by different forensic laboratories but were not reported using the system.
Justice, Law and Order Sector : 144 cases worth UGX.45.18 billion not recorded in the databases
The Ministry of Justice, Constitutional Affairs, and Constitutional Affairs (MoJCA) allocated UGX.155 billion over the last three years for settling awards and compensations, with UGX.108 billion spent on these activities during that period. To streamline this process, the Ministry implemented the Directorate of Civil Litigation Information Management System (DCLIMS), a new system costing UGX.0.9 billion. DCLIMS provides unique identification for each file, tracks file volumes, and schedules meetings and court hearings. However, there were anomalies in the decentralization processes of court awards and the management of court awards and compensations. The system exhibited limited access and utilization, as cases handled by other government institutions were not recorded. Old files of decided cases haven’t been migrated, potentially leading to inaccurate government liability assessments from court cases. Notably, 144 cases worth UGX.45.18 billion weren’t recorded in the databases, and 18 court awards worth UGX.12.25 billion remained unpaid for periods ranging from seven to 19 years, resulting in an accumulated interest exceeding the principal amounts awarded by UGX.12.92 billion.Communication lapses were evident, with only one out of 29 cases being timely communicated to MDAs on court awards. Delays for the remaining 28 cases ranged from 20 days to five years, implying an average delay of over one year. These limitations in system functionalities hinder the receipt, processing, and recording of court awards and compensations, impacting budgeting and subsequent settlement by MDAs. The Accounting Officer explained that the current case management system faces various technical limitations, such as file indexing and tracing, electronic filing, usability, interoperability, and digital support for decision-making by management. An upgrade is underway to enhance the system’s robustness and enable information sharing with other institutions like the Judiciary and NIRA, among others.
Uganda Police Force : 362 Suspects detained beyond 48Hours while Bucket System reported in 19 detention centers
The Uganda Police Force allocated UGX.4.02 billion for managing detention facilities in the financial year 2022/2023. However, an assessment of these facilities revealed several issues. Firstly, 362 suspects held in the 42 inspected stations had been detained for more than 48 hours, with some held for over two weeks. Secondly, male cells were congested beyond their designed capacity in 60 out of the 184 policing districts inspected. Thirdly, 61 out of the 72 police stations inspected lacked detention cells for men, women, boys, and girls.Additionally, there were no special facilities for suspects with special needs, such as pregnant women and breastfeeding mothers, in any of the 72 inspected stations. Furthermore, 19 detention centers, especially in Gulu East Division, Mbale CPS, Hoima, and Rubanda, still use the bucket system, as most water-borne toilets were non-functional.Moreover, 81 Health Centre IIs managed by the Uganda Police lacked the capacity to offer primary health care services and were not gazetted by the National Medical Stores, resulting in no drug supplies. Lastly, an inspection of health centers revealed that none met the minimum set standards in terms of staff numbers, emergency delivery beds, placenta pits, and staff housing. The inadequate facilities negatively impact service delivery to officers and the public using these facilities. Overcrowding in cells raises the risk of spreading diseases like tuberculosis and hepatitis B, while also limiting clean air supply, posing health and security concerns for both suspects and the community. Failure to separate detainees by gender or age can lead to physical harassment and abuse, violating human rights and compromising privacy and dignity. Poor sanitary facilities, combined with high congestion, are unhygienic, degrading, and dehumanizing, further violating suspects’ rights. The author advises the government to ensure compliance with the law and review current practices to devise alternative rehabilitation methods. The Accounting Officer should engage MoFPED and Parliament for funding to improve detention facility conditions in the Uganda Police Force.
Uganda Prisons : Prisoners influx suffocates prisons, Prisons staff lack proper accomodation
In the financial year 2022/23, UGX.109.98 billion was allocated for managing detention facilities in Uganda prisons. An assessment of the conditions of these facilities revealed congestion, particularly in Isingiro, Yumbe, Hoima, and Fort Portal prisons, which surpass their designed holding capacity. This is exacerbated by the high number of prisoners on remand, constituting 49% of the total prisoner population of 76,041. 8,088 prison staff (56%) reside in dilapidated houses, semi-permanent structures, uniports, and grass-thatched houses.Although the Uganda Prisons Service planned to fence seven prisons at a cost of UGX.1 billion, only four have been completed. Prisons’ Standing Orders stipulate providing each prisoner with at least two uniforms, two blankets, and one felt mattress. However, UPS doesn’t supply felt mattresses except for some female prisoners and only provides one uniform. There is a shortage of trainers in prisons for training and rehabilitation exercises, and UPS lacks a rehabilitation policy to guide prisoner rehabilitation. Currently, UPS accommodates 280 children staying with their mothers in prison, but only five out of 19 regional prisons have daycare centers. Three prison stations lack proper places for caring for sick prisoners, and three others lack infrastructure for health facilities. Out of the required 1,519 health staff in 55 health facilities, only 217 (14%) are employed, resulting in a staff shortfall of 1,302 (76%). Finally, out of the 55 prison facilities inspected nationwide to determine if they were equipped with isolation centers for prisoners with transmittable diseases, it was noted that 46 prisons (84%) did not have such isolation centers for sick prisoners with transmittable diseases. The poor condition of prison facilities has adverse effects on the well-being of both prisoners and staff, exposing them to various health risks. The lack of proper rehabilitation and reintegration facilities for offenders can lead to increased recidivism rates. The Accounting Officer was advised to collaborate with key stakeholders to address funding challenges, inadequate staffing, and infrastructure issues. On the other hand management was advised to promote alternative justice options such as plea bargains, parole, bail, and speedy investigations to reduce the number of prisoners on remand.
Wetland Management : Government issued 20,000 titles in Wetlands
Despite the government’s commitment to wetland protection, concerns arise as 20,000 titles have been issued in wetlands, with only 3.3% cancellations in crucial areas such as Kampala, Wakiso, and Mukono.The issuance of 785 permits by NEMA, demonstrated a lack of evidence due inadequate monitoring of compliance by permit holders. Furthermore, 708 expired wetland user permits remain unrevoked. There was also absence of submitted annual environmental compliance audits for 776 developers with eligible permits.
Forest Reserves : Six Unlicensed eco-tourism sites doing business in Kajjansi and Lutoboka
There are 122 illegal titles within Central Forest Reserves (CFRs), and only two titles have been revoked following submission to the Ministry of Lands, Housing, and Urban Development. The Auditor General identified the presence of undemarcated external forest boundaries, posing a threat to CFRs’ integrity and increasing the risk of encroachment. There was a delayed approval of Eco-Tourism Guidelines pending since April 2014, affecting sustainable eco-tourism practices. Six unlicensed eco-tourism sites in Kajjansi and Lutoboka CFRs were identified.
The Auditor General of Uganda audited financial statements for 162 MDAs, 59 Statutory Corporations, and 2,278 Local Governments in accordance with the Constitution of the Republic of Uganda 1995 as amended, the National Audit Act 2008, and the Public Finance Management Act 2015 as amended. The Office undertook three thematic audits covering Implementation of the Approved Budget, Salary Payroll Management across Government of Uganda, and Implementation of the Parish Development Model (PDM). A Public Finance Management Assessment was conducted in seven entities as a pilot audit. The audit highlights provide key findings that require attention by policy makers and the public.