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KAMPALA: Kawempe National Referral Hospital (KNRH) has been thrust into the spotlight after the Auditor General exposed a string of management failures, including the hospital’s failure to use the government’s e-Afya electronic system to manage vaccines and medicines, even as staff reportedly complain that the much-publicised platform is faulty and offers little help in their day-to-day work.The findings, contained in the Auditor General’s report for the financial year ending December 2025, paint a worrying picture of weak procurement, poor planning, critical staffing shortages and persistent service delivery failures at one of Uganda’s busiest referral hospitals.At the centre of the report is the hospital’s failure to use the Ministry of Health’s e-Afya Electronic Medical Records (EMR) and Health Management Information System to manage vaccine and medicine inventories.The Auditor General found that there were challenges in the management of vaccines and medicines, including inappropriate storage of vaccines and medicines, inadequate records for vaccine utilisation and failure to use the e-Afya system to manage vaccine and medicine inventory.The audit findings come amid complaints from some hospital staff that the e-Afya system has persistent technical challenges and does not adequately support their work despite being promoted as a solution for digital management of patient records, laboratory services and pharmacy inventory. However, while staff have raised concerns about the system’s functionality, the Auditor General’s report specifically cites the hospital’s failure to use the system as one of the weaknesses affecting medicines and vaccine management.The report reveals that the hospital also fell short in procurement compliance after failing to indicate procurements reserved for registered associations as required under Public Procurement and Disposal of Public Assets (PPDA) guidelines. Consequently, no contracts were awarded to registered associations, contrary to the regulations.Auditors further found that the hospital failed to execute one procurement worth UGX 18.755 million, delaying delivery of the goods, works or services that patients were expected to benefit from.The Procurement and Disposal Unit (PDU) was itself found struggling with a lack of training needs assessments, inadequate performance reporting and inadequate staffing, shortcomings that affected its overall performance.Planning failures also featured prominently in the report.Auditors established that actual funding during implementation of the hospital’s strategic plan fell short of projected costs by 56 per cent, affecting execution of planned activities.Out of 28 sampled strategic plan targets, only 17 targets, representing 61 per cent, were fully achieved, while six targets, equivalent to 21 per cent, were only partially achieved. Another five targets, representing 18 per cent, could not even be assessed because the underlying activities lacked proper and measurable performance indicators.By November 2025, the hospital had only prepared a draft strategic plan for the next implementation period, but it had not yet been approved by the National Planning Authority, exposing the risk that hospital activities may not align with Uganda’s National Development Plan.The Auditor General also established that the hospital’s Budget Framework Paper and annual budget were only 76 per cent compliant with National Development Plan III outputs, indicating continued weaknesses in planning.Financially, Kawempe National Referral Hospital received an approved budget of UGX 23.642 billion, all of which was warranted. Of this, UGX 22.199 billion was utilised, representing an absorption rate of 94 per cent.The hospital also surpassed its revenue target, collecting UGX 619 million against a planned UGX 500 million, representing 24 per cent above the budgeted revenue.Auditors reviewed implementation of 13 sampled non-payroll outputs worth UGX 6.212 billion and found that 12 outputs were fully implemented, while one could not be assessed because it had not been properly quantified.Despite spending billions, patients continued to face serious service delivery challenges.The report identifies delays in conducting blood tests within expected timelines, congestion, non-functional equipment, inadequate medical equipment and insufficient maintenance budgets among the obstacles affecting patient care.Staff shortages remain equally alarming.Out of an approved establishment of 938 positions, only 440 posts, representing 47 per cent, were filled, leaving 495 positions, or 53 per cent, vacant, piling enormous pressure on the available health workers.The hospital has also been slow in implementing previous audit recommendations.Out of six recommendations contained in Parliament’s report on the Auditor General’s report for the financial year ended 30 June 2021, only two recommendations, representing 33 per cent, had been fully implemented, while four recommendations, equivalent to 66 per cent, remained only partially implemented.The latest audit findings now place the hospital’s management under intense pressure to explain why procurement weaknesses, planning failures, medicine management gaps, severe staffing shortages and poor implementation of previous audit recommendations continue to persist. They also reignite debate over the effectiveness of the e-Afya system, with staff questioning its functionality while auditors fault the hospital for failing to use it in managing medicines and vaccines.GOT A HOT STORY? LET US KNOW!Got breaking news, explosive secrets, or hard evidence?Email us: redpeppertips@gmail.comWe accept tips, documents, videos, photos, and recordings—the more evidence you have, the better.CONFIDENTIALITY IS OUR TOP PRIORITY. SOURCES ARE ALWAYS PROTECTED!About Post Author
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