Developing Countries’ Healthcare Systems

Developing Countries Healthc ar SystemsQuestion ball-shaped fund in the recent past suspended the reenforcement to Uganda government citing gross pecuniary misappropriation especially by Ministry of health authorizeds. As a fiscal consultant, identify and discuss the practices and policies that could work guide to this pecuniary loss and indicate both internal and external controls that should be put in side to minimize the reoccurrence of such scenarios.IntroductionDeveloping countries healthc atomic number 18 systems are a great deal funded by the donors countenances in addition to public bills from the governmental budgets. hardly in some cases, these funds may be mismanaged and this could lead to expectant fiscal losses hence depriving its beneficiaries. The distraction of those funds may wad contrary forms misspending, fraudulent misappropriation or defalcation (The Global strain To Fight AIDS, tebibyte and Malaria).In this essay, we review the case of Ugand a where The Global depot To Fight AIDS, Tuberculosis and Malaria in 2005 suspended the countrys funding following a release of an audit report that showed gross mis forethought of funds that were supposed to support the government of Uganda in its efforts to tackle AIDS, Tuberculosis and Malaria (Kapiriri Martin, 2006).The practices and policies that could have led to this mismanagement and embezzlement are identified and discussed together with the control measures, both internal and external, that should be undertaken to prevent such monetary diversion in the future.2. Practices and policies that could have led to fiscal mismanagementThe chore of fiscal resources mismanagement seems to be widespread non only in developing countries but too in developed ones (Food and Agriculture makeup of the United Nations, 1997). Several inadequate practices and policies are reportly involved in the occurrence of this problem.2. a. Non-existing clear financial norms and regulations/none compliance to financial norms and regulationsThe escape of clear norms and regulations to provide guidance to those involved in the management of financial resources can create a way for them to mismanage the funds that they are supposed to manage.Taking into consideration the case of Uganda, the lack of clear norms and regulations on how funds would have been used possibly created a financial managerial chaos that facilitated those who were in the positions of funds management, at each level of administrative ladder, to misappropriate or misuse them.On the opposite hand, financial norms and regulations energy have been in place but probably the management team, at different levels, was not compliant with them.2. b. wishing of transparency in administrative hierarchy, roles and responsibilitiesUndefined organisational and reporting structure, unclear roles and responsibilities among members of various teams involved in funds management might as well have created managerial dis direct which led to lack of financial accountability.2. c. Poor communicationPoor communication among members of different teams might also have been a break factor in funds financial management failure. Possibly, teams did not share key roll documents about funds management for reviews before being released as official documents. Further, they might not have coordination forums in which they should have discussed financial issues with key stakeholders in the effectuation of the projects.2. d. Managerial incompetence and unskilled financial/control officersIncompetence in the management of funds and implementing the planned activities might also have led to the preceding(prenominal) financial loss. Financial procedures might not have been observed, this might have been the results of incompetent managers coupled with unskilled financial officers and accountants.Further, according to Global Funds 2009 use of the Inspector general report on Lessons learnt from the country audits and reviews undertaken, Ugandas case, Principle Recipient management of replace-Recipient was poor as was shown by evidences in the report and this was one of the issues that the grant was suspended.Stating the same source, on that point were poor internal controls at different levels every at Principle Recipient level or at Sub Recipient level as was evidenced by the report. For example, some occur of money estimated at 4,939,497 US dollars were not accounted for, adequate supporting documents for some(prenominal) transactions were missing, work plan and budgets were not abode by which resulted in several expenses not cerebrate to the programmatic budget and work plan. In addition, records related to the expenses like books of account were not properly kept. There were also cases of idle expenses and when supporting documents were found, they were actually counterfeit.It is reported that professional financial management necessitates spotless financial and auditing tools. De ficiency in financial supervision and control mechanisms leads to financial mismanagement like diversion or misappropriation of funds (Mobegi et al, 2012).2. e. Lack of active involvement of some key stakeholdersAccording to Kapiriri and Martins (2006), one of the reported possible causes of mismanagement of Global Fund grants in Uganda was low levels of civic society betrothal. According to Global Funds requirements for grant eligibility, the participation of various stakeholders in the decision making is of paramount importance. But in Uganda, it was reported that part of key stakeholders, including civil society, who were supposed to be delineate in Country Coordinating instruments were not every involved or were lacking the capacity to provide meaningful inputs (Kapiriri Martins (2006).3. internal and external controls that should be put in place to minimize the reoccurrence of such scenariosIt is stated that there is one common thing in all businesses either in public or pr ivate businesses To be successful, they must control their operations. This means hiring the right people, pay them the right amount of salaries, order and retrieve the right products and services, etc (Libby et al, 2009).To achieve this, it is important to establish and comply with specific procedures and policies which suck how the business should be run. These specific procedures and policies are controls which can be either internal or external. This theory is applied to the case under discussion.3.1. Internal controlsInternal controls are defined as set of methods an organisation puts in place in order to protect the theft of its assets, ensure the write up information is reliable, boost effective and efficient operations, and retard that applicable laws, regulations and codes of moral philosophy are complied with (Libby et al, 2009).For the case of Uganda, given the shortcomings that were identified, internal control mechanisms should be heighten and set to target them. The internal measures would include unfluctuating compliance audits these audits would ascertain that the specific procedures, rules or regulations-set out by Global Fund and as described in grant agreement-to ensure the good management of grants are observed at every level of the management.Regular operational audits these audits would register all operating procedures at all management levels in order to measure their performance in terms of effectiveness and efficiency. According to hay et al (2005), operational audits are not only limited to financial issues, they might also put more emphasis on opposite areas of the organisation structure, working approaches alike or other areas where evaluation is needed.Regular audits of financial statements these audits would analyse the financial statements to ensure that they are accurate and in accordance with set criteria.Involving stakeholders in decision making process and heighten communication The involvement of stakeholders and improved decision making process concerning the implementation of Global Fund programmes could have been a cornerstone in the barroom of grants mismanagement. It is argued that if legitimate and fair decision making process were used, the suspension of grants could have been averted (Kapiriri Martins (2006).Given that the poor communication between members of Country Coordinating Mechanism (CCM) was cited among the causes of grant mismanagement in Uganda, enhanced communication within CCM and with other stakeholders would be equally important in preventing such gross financial loss.3.2. External controlsTo minimise opportunities for grants mismanagement in the future, external control mechanisms should also be enhanced. These includeGlobal Fund should conduct regular and punctual audits and reviews to ensure that the set guidelines for the management of its grants are observed.Independent auditors should be appointive and conduct audits on different levels of grants management. It is recommended by the Global Fund Office of the inspector general that the external audit reports should be submitted to Global Fund not later than six months after the period to be audited ( Global Fund, 2009).Global Fund should update its guidelines regarding the management of grants to fill the gaps when they are identified.4. completionProper Global Fund grants management is crucial in rubbish against AIDS, Tuberculosis and Malaria whose mortality and morbidity rates are still unacceptably high in developing countries. Government of Global Fund-supported countries have the law to ensure that the grants are used in accordance with the set guidelines and the agreements sign-language(a) between them and the Global Fund. Thus, this will avoid grants mismanagement or embezzlement cases and consequently reduce mortality and morbidity rates due to the above mentioned diseases.