1. HEALTH SECTOR SERVICES FUND (HSSF)
PERFORMANCE
FYs

2. PRESENTATION OUTLINE
WHY HESSF ? HOW IT WORKS STATUS AS PER JUNE 2013 AUDIT OF FIRST 21 MONTHS OF OPERATION RESULTS CONCLUSIONS RECOMMENDATIONS

3. BEFORE HSSF Approved national budget
MoH requests ↔ Treasury authorizes
MoH Issues AIEs to P/D/SD Hospitals &P/DMOHS
DAs control funds
Resources spent according to items
Balances returned to Treasury
DAs Prepare reports for treasury with cc to account holders

4. WHY HEALTH SECTOR SERVICE FUND?
BOTTLE NECKS
TREASURY
$ ↘
DISTRICT ACCOUNTANT 
DMOH 
 HF 

5. HEALTH SECTOR SERVICES FUND
WHAT IS IT? A GoK FUND
$ APPROPRIATED BY PARLIAMENT
+ GRANTS & DONATIONS
+(USER CHARGES) AND OTHER INCOMES
FUNDS DISBURSED DIRECTLY TO UNITS
(based on approved plans)
POSITIVE BALANCES RETAINED BY THE FACILITY

6. PURPOSE Improve QUALITY of services
by increasing PREDICTABLE RESOURCES AVAILABILITY for:
Health supplies, equipment, & maintenance of recipient units
Increasing staff management capacity
Increasing community participation

8. STRUCTURES HF MANAGEMENT COMMITTEES NATIONAL HEALTH SERVICES COMMITTEE
HESSF SECRETARIATE

9. FLOW OF FUNDS ( GoK + DP funds) ↓ HSSF AC @ Central Bank
MOH Requests ↔ Treasury authorizes
( GoK + DP funds) ↓
HSSF Central Bank
↓ →Informs DA & DMOH
Credits directly each individual units bank ACs.

10. REPORTING ↑ NHSC for approval HSSF Secr. for checking and collating
Report to Treasury ↑
NHSC for approval
HSSF Secr. for checking and collating
↑ ↗ to DA for information → to DAUD for action
DMOH for checking
Committee approved HF quarterly financial reports

11. TOOLS
A simplified form of GoK official tools and Standard official tools where necessary and/or possible

12. THE FIRST 21 MONTHS (OCTOBER 2010 TO JUNE 2013)
Recipients: 3,362
How much: 2,110 Mio KShs
751 HCs: 1,104
262 DHMTs:
2,349 Disps:
1 HSSF Secr.:

13. HSSF AUDIT RESULTS 1 (October 2010 to June 2012)
Two audits were conducted by the Internal Auditor General and by Deloitte & Touche in 2013.
The first audit found a total of
296.6 Mio of questionable expenditures.
137.3 Mio of which were immediately justified by the MOH and cleared

14. AUDIT RESULTS 2 (October 2010 to June 2012)
Of the remaining
159.3 Mio the MOH provided adequate justifications for 63.1 Mio in April
The remaining questioned expenditures amounting to
128.6 Mio relating to 689 recipient units were investigated during the scheduled IIFRA audit in June 2014.
Independent Integrated Financial

15. AUDIT RESULTS 3 (October 2010 to June 2012)
Of the Mio 95.3 Mio were cleared.
Of the remaining 33 Mio and considering only amounts > 100, Mio are still questioned, of which:
4.73 Mio are clear theft in 9 units
14.45 Mio are probable theft/poor financial management in 33 units

16. AUDIT RESULTS 4 (October 2010 to June 2012)
2,100 millions disbursed to 3,362 units
297 million were questioned of which
264 million were cleared, of the remaining
33 million or 1.6%
of the total disbursement is still questioned in 247 units

17. HSSF CONCLUSIONS Is a viable funding mechanism
Its funding predictability is vital for FACILITIES continued functionality
Has demonstrably improved quality of care, staff motivation, and patient satisfaction
It stimulates community participation

18. RECOMMENDATIONS Maintain direct financing to facilities
2. Continue with the current approach while searching for, and testing user more friendly financial, reporting, and control mechanisms
3. Adjust it to the devolved landscape
4. Increase GoK funding to include 1,000 more facilities including FBO owned

19. ASANTE SANA