AUDIT HEALTH UNIT FINANCIAL RECORDS
Item
- Title
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AUDIT HEALTH UNIT
FINANCIAL RECORDS - extracted text
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Training for Health Committees and Health Staff at Health Unit Level
AUDIT HEALTH UNIT
FINANCIAL RECORDS
Financial Management
FACILITATOR GUIDE
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unicef
Training for Health Committees and Health Staff at Health Unit Level
AUDIT HEALTH UNIT
FINANCIAL RECORDS
Financial Management
FACILITATOR GUIDE
unicef
Financial Management: Audit Health Unit Financial Records
Facilitator Guide
FACILITATOR INTRODUCTION
MODULE OVERVIEW
Auditing health unit’s financial records is important so that the community can account for
all money going in and out of the health unit. Auditing should always be done by a person
outside the health unit and other than the treasurer. By regularly auditing the health unit’s
records, the community will have greater confidence that the health committee and health
staff are doing their functions responsibly.
Internal auditing can be performed monthly by a community member who has adequate
auditing skills. External auditing may occur less often. Auditors from the regional or district
office conduct external auditing.
In this module, participants learn how to conduct several auditing tasks. They learn how to
resolve discrepancies, prepare a report describing the results of the audit, and provide
constructive feedback to the person in charge of the health unit's financial records.
Training Audience
•
Auditor/community member responsible for auditing the health unit s financial
records
Treasurer/person responsible for managing the health unit’s revenue and expenditures
Chairperson of the health committee
Health unit head
Recommended Prerequisite Modules
Course Introduction
Community Participation: Organize and Support Health Committee
t-
Financial Management: Manage Revenue and Expenditures
Financial Management: Establish a Budget
Drug/Supply Management: Monitor Daily and Monthly Inventory
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Financial Management: Audit Health Unit Financial Records
Facilitator Guide
Estimated Length of Module
Entire module 1 day
MODULE PREPARATION
Thoroughly read the module to familiarize yourself with the content.
Modify the material to accurately reflect existing guidelines and procedures for
auditing health unit records in the participants' area.
Prepare the appropriate flipcharts that you will need for the module.
Prepare the following cash and bank book on a separate flipchart or blackboard.
Materials
Pencils - one for each participant
Notebooks - one for each participant
Participant Guides - one for each participant
' ; or one flipchart standjwith pad
Two flipchart stands with pads and colored markers
and colored markers and one blackboard with colored chalk
Calculators - one for each facilitator and participant, if possible
4
CASH AND BANK BOOK
Name of District:
Date
Month:
Sabgli
Name of responsible person:.
Ref
no.
Bamali
Name of Health Unit:.
URD
Description
(transaction)
Budget
Category
June
Year:.
Cash
Bank
Debit
(out)
Credit
(in)
1996
Balance
Debit
(out)
Credit
(in)
Balance
Total
Balance
1,925
155
2,080
1,665
155
1,820
10
165
1,830
25
190
1,855
190
1,830
15
205
1,845
35
240
1,880
15
225
1,865
1,790
150
75
1,865
FO
1,790
10
65
1,855
vehicle
maintenance
tire repair
V
1,790
50
15
1,805
consultation
receipts
0718-0722
U
1,790
18
35
1,825
105
140
1,930
140
1,930
1/6/96
Balance
brought
forward
101
3/6/96
payment for
drugs cheque
0012K
D
102
7/6/96
laboratory
receipts
0691-0695
U
1,665
103
7/6/96
drug receipts
1113-1117
D
1,665
104
9/6/96
office supplies
O
105
10/6/96
consultation
receipts
0701-0717
U
1,640
106
10/6/96
drug receipts
1118-1137
D
1,640
107
12/6/96 fuel for cold
chain
F
1,640
108
13/6/96
109
16/6/96 fuel for
outreach
110
16/6/96
111
17/6/96
260
1,640
25
150
bank deposit
Totals
Balance carried
forward
285
150
1,790
1,790
225
Financial Management: Audit Health Unit Financial Records
Facilitator Guide
HOW TO CONDUCT PERFORMANCE CHECKS AND
PRACTICE EXERCISES
Follow these guidelines when you conduct Performance Checks or Practice Exercises.
Before You Conduct a Performance Check/Practice Exercise
•
Thoroughly read the appropriate Module Preparation section and entire Performance
Check/Practice Exercise.
•
Modify the Performance Check/Practice Exercise to reflect local procedures and policies.
You also may need to adapt the Performance Check/Practice Exercises to fit the
availability of local resources.
•
Make all necessary preparations (e.g., make copies of forms).
•
Work through the Performance Check/Practice Exercise to make sure you understand
how to conduct the activity.
Prepare answers to the Performance Check/Practice Exercise.
Review the Performance Check/Practice Exercise the day before you teach the module.
During the Performance Check/Practice Exercise
•
Read all instructions to participants. Answer any questions they may have about the
instructions.
Circulate among the participants while they are working to answer any questions. Be
attentive so that you can correct any errors or misunderstandings.
Take notes on the common difficulties participants may be experiencing.
If a participant or group does not successfully complete the Performance Check/Practice
Exercise, explain what is incorrect. Ask the participant(s) to redo the work. If needed,
refer the participant(s) to someone who has fulfilled the objective.
If a participant or group fulfilled the objective, give positive feedback.
Listen carefully during group presentations. If you see any errors, first ask other
participants to provide feedback to the presenters. If the error is not corrected by the
participants themselves, explain what participants are doing incorrectly. Work through
an example, if needed.
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Financial Management: Audit Health Unit Financial Records
Facilitator Guide
FINANCIAL MANAGEMENT:
AUDIT HEALTH UNIT FINANCIAL RECORDS
Welcome Participants
Introduce yourself and welcome participants to the training.
Ask participants to introduce themselves if this is the first
time they are working together on a module.
Introduction
• The retention and use of money in the health unit makes
auditing health unit records essential.
• During auditing, financial records are checked for accuracy.
• Auditing should be done regularly
accountability to the community.
to
ensure
• Usually the Treasurer is responsible for managing the health
unit’s revenue and expenditures.
• Someone other than the Treasurer should make sure
that all the money going in and out of the health unit is
accounted for.
• The Treasurer will use the results of the audit to resolve
any discrepancies and to improve the way the health
unit manages money on a daily basis.
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Financial Management: Audit Health Unit Financial Records
Facilitator Guide
Learning Objectives
• The objectives for this module are:
Flipchart
Learning Objectives
At the end of the session, participants will be able to perform the
following auditing tasks:
1. Compare the cash and bank book balance with the actual
amount of money in the health unit and in the bank.
2. Check cash and bank book debit entries.
3. Check the cash and bank book credit entries.
4. Check the budget item expenditure forms for accuracy and to
determine whether expenditures have exceeded budgeted
amounts.
5. Cross-check the health unit receipts with the patient register.
6. Make sure inventory records match actual supply available.
7. Make recommendations for resolving any discrepancies
found.
Overview of Learning Process
• During this module, you will learn how to conduct an audit
of health unit records.
Before you teach the module contents, briefly review the
following financial records and accounting forms:
cash and bank book
(continued)
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Financial Management: Audit Health Unit Financial Records
Facilitator Guide
receipt books
exemptions and debtors books
cheque book
bank book and bank statement
budget item expenditure forms
purchase receipts
Refer participants to the Financial Management: Manage
Revenue and Expenditures module for more information, as
necessary.
Overview of Auditing
• What does "auditing" mean?
Solicit responses. Answer:
- Auditing is a formal examination and verification of
financial records. It should always be done by a person
outside the health unit.
• There are two types of audits: internal and external.
• During internal auditing, someone from the community
but other than the one in charge of the daily financial
management of the health unit checks the financial
records to make sure they are accurate and complete.
• Who can conduct internal auditing in your health unit?
Solicit responses. Answers may include:
(continued)
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Financial Management: Audit Health Unit Financial Records
Facilitator Guide
a community member trained in auditing
the health committee auditor
• Internal auditing can be done on a monthly basis.
• Discuss the results from internal auditing during health
committee meetings.
• During external auditing, someone from outside the
community formally examines the health unit’s financial
records to verify that money is accounted for.
• Auditors from the district or regional level can conduct
external audits.
• If you regularly perform internal auditing and if you resolve
discrepancies, the external auditor should find the health
unit’s financial records in order.
• During auditing, check your health unit's financial records
to:
know the actual amount of money in the health unit
and in the bank
make sure that all revenue and expenditures are
accounted for
make sure that expenditures have not exceeded the
amount budgeted
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Financial Management: Audit Health Unit Financial Records
Facilitator Guide
Select an Auditor
• Your health committee is responsible for selecting an
internal auditor.
• What qualities and skills should an auditor have?
Solicit responses. Possible answers:
Auditor's Skills and Qualities
excellent mathematical skills
excellent problem-solving skills
thoroughness
trustworthy
ability to provide constructive feedback
• Your health committee should select an auditor when it
establishes how it will manage its revenue and expenditures.
• Work with the District Management Team (DMT) to select
the auditor. Discuss the qualifications that the candidate
should have and if the candidate will need any specific
training.
Discuss with participants how to select an auditor in their
area. Ask participants to describe how they would:
inform the community about the available position
decide who will conduct interviews
(continued)
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Financial Management: Audit Health Unit Financial Records
Facilitator Guide
decide what information to collect from applicants
decide who will make the final selection decision
• After your health committee selects an internal auditor,
decide whether to give the auditor financial support (e.g.,
transportation costs).
• Your health committee should make sure that the
auditor is well-trained before taking on the job
responsibility.
• The auditor has five main tasks:
Review the following flipchart:
Auditor’s Tasks
1. Check accuracy of health unit financial records, making
appropriate cross-references.
2. Make sure inventory records match actual supply available.
3. Make sure salaries are going to real employees.
Flipchart
2
4. Determine how the Treasurer has maintained and organized
the financial records.
5. Make recommendations for resolving any discrepancies.
Explain to participants that they will learn how to perform
each task as they work through the module.
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Financial Management: Audit Health Unit Financial Records
Facilitator Guide
Step 1 - Check Accuracy of Health Unit
Financial Records, Making Appropriate CrossReferences
Ask participants what cross-reference means.
Explain that cross-reference or cross-checking is
comparing two or more financial records to make sure
records are correct and money is accounted for.
Discuss with participants which financial records they
should cross-check to make sure their records are accurate.
Refer to the following flipchart.
Flipchart
How to Check Accuracy of Information
in Health Unit Records
a. Compare the cash and bank book balance with the actual
amount of money in the health unit and in the bank
b. Check the cash and bank book debit entries
c. Check the cash and bank book credit entries
d. Check the balance columns in the cash and bank book for
accuracy
e. Check the budget item expenditure forms for accuracy and
determine whether expenditures have exceeded budgeted
amounts
f. Cross-check patient receipts, debtors and exemptions book
with patient registers
Explain to participants that they will use the cash and bank
book to complete most auditing tasks.
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Financial Management: Audit Health Unit Financial Records
Facilitator Guide
a. Compare the Cash and Bank Book Balance with
the Actual Amount of Money Kept in the Health
Unit and in the Bank
• Take the current balance of your cash and bank book at the
time of your audit.
• Count the money kept at the health unit.
• Compare this amount of money with the balance column in
the cash section of the cash and bank book.
• Identify any discrepancy. Find out the cause of any
discrepancy found (loan, mathematical errors in the cash
and bankbook, etc...).
Ask participants how they could find how much money is
kept in the bank.
Solicit responses. Possible answers:
- look at the ending balance of the most recent bank
statement
- look at the ending balance in the bank book
• Compare the ending balance of the bank statement or bank
book with the balance of the bank section of the cash and
bank book on the same date.
• Note any discrepancy.
Example: Ask participants to refer to the account statement
on the following pages.
On 8 July 1996, the ending balance is $2,000.00. The
balance column of the bank section in the cash and bank
book should indicate the same amount of money on the
same date.
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Financial Management: Audit Health Unit Financial Records
Fact litator Guide
b. Check Cash and Bank Book Debit Entries
• Why is it important to make sure that each debit entry in the
cash and bank book is correct?
Solicit responses. Possible answers:
to make sure records are accurate
to make sure all money is accounted for
to make sure money has been spent on actual
expenditures
• Verify entries in both Debit columns of the cash and bank
book.
Refer to the sample cash and bank book you prepared on
the flipchart or board before training.
Cash and
Bank
Book
Refer to the completed example on page 21, as needed.
• Check that debit entries are accurate by cross-checking
other health unit financial records, such as purchase
receipts, bank statements, cheque book.
(continued)
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Fmancial Management: Audit Health Una Financial Records
Facilitator Guide
• To audit Cash Debit entries in the cash and bank book:
Flipchart
How to Audit Debit Entries in the Cash Section
of the Cash and Bank Book
1. Refer to the pages in the cash and bank book for the period
you are auditing.
2. For each Cash Debit entry:
Find the corresponding purchase receipt and compare the
amounts. Note any discrepancies.
3. For each Cash Debit entry that is a bank deposit:
Check the bank statement and bank book to verify the
deposit. Note any discrepancies.
Make sure that the correct amount has been transferred
from the Cash section to the Bank section of the cash and
bank book. Note any discrepancies.
Emphasize that participants should always obtain a receipt
when they pay for something.
Exercise for Auditing Debit Entries in the
Cash Section of the Cash and Bank Book
Work with participants to cross-check the two Cash
section Debit entries below:
12/6/96
fuel for cold-chain
13/6/96
bank deposit
Use the sample cash and bank book, purchase receipt,
bank statement, and bank book on the following pages.
(continued)
16
Financial Management: Audit Health Unit Financial Records
Facilitator Guide
Follow the steps on Flipchart 4 to audit the entries. Note
any discrepancies.
Answer: There is a discrepancy between the cash and bank
book and the bank statement for the 13/6/96 bank
deposit. The bank statement and bank book both
show that $50 was deposited, not $150.
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Financial Management: Audit Health Unit Financial Records
Facilitator Guide
CASH AND BANK BOOK
Name of District:
Date
Month:
SabdH
Name of responsible person:.
Ref
no.
Bamali
Name of Health Unit:.
URD
Description
(transaction)
Budget
Category
June
Year:.
Cash
Bank
Debit
(out)
Credit
(in)
1996
Balance
Debit
(out)
Credit
(in)
Balance
Total
Balance
1,925
155
2,080
1,665
155
1,820
10
165
1,830
25
190
1,855
190
1,830
15
205
1,845
35
240
1,880
15
225
1,865
1,790
150
75
1,865
FO
1,790
10
65
1,855
vehicle
maintenance
tire repair
V
1,790
50
15
1,805
consultation
receipts
0718-0722
U
1,790
18
35
1,825
105
140
1,930
140
1,930
1/6/96
Balance
brought
forward
101
3/6/96
payment for
drugs cheque
0012K
D
102
7/6/96
laboratory
receipts
0691-0695
U
1,665
103
7/6/96
drug receipts
1113-1117
D
1,665
104
9/6/96
office supplies
O
105
10/6/96
consultation
receipts
0701-0717
U
1,640
106
10/6/96
drug receipts
1118-1137
D
1,640
107
12/6/96 fuel for cold
chain
F
1,640
108
13/6/96
109
16/6/96 fuel for
outreach
110
16/6/96
111
17/6/96
260
1,640
25
150
bank deposit
Totals
150
285
1,790
1,790
Balance carried
forward
18
225
Financial Management: Audit Health Unit Financial Records
Facilitator Guide
\2/6/96
Receipt No. 12860149
Elf Petrol
Saregambe, URD
5 litres fuel @ $3.00 per litre $15.00
Total amount due
$15.00
Total amount paid
$15.00
ACCOUNT STATEMENT
Statement Date: July 8,1996
Mr. Sabali Mbwoto
Bamali Health Committee
Bamali, URD
Standard Bank
Commerce Street
Tokama, URD
Summary for Account No. 23954-1294-82
$1,925.00
150.00
Beginning Balance
Total Deposits
Interest This Period
Total Withdrawals
Service Charges
Ending Balance
75.00
$2,000.00
Description of Account Transactions
Date
Transaction
Amount
Balance
$1,925.00
Beginning
Balance
1/6/96
Deposit
13/6/96
$50.00
$1,975.00
Withdrawal
22/6/96
$75.00
$1,900.00
Deposit
26/6/96
$100.00
$2,000.00
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Financial Management: Audit Health Unit Financial Records
Facili tator Guide
BANK BOOK
Bqmali
Health Unit
URD
District
Date
Description
No.
In
13/6/96
Deposit
DOS
$50
19/6/96
Withdrawal
W97
21/6/96
Deposit
D15
Out
Balance
$1,975
$75
$100
$1,900
$2,000
• To audit Bank Debit entries in the cash and bank book:
Flipchart
How to Audit Debit Entries in the Bank Section
of the Cash and Bank Book
1. Refer to the pages in the cash and bank book for the period
you are auditing.
2. For each debit entry in which a cheque was written:
Find the corresponding cheque book stub and receipt.
Compare the debit entry, the amount on the cheque book
stub, and the amount on the receipt.
Note any
discrepancies.
3. For each debit entry that is a cash withdrawal:
Find the corresponding withdrawal on the bank statement
■ and in the bank book.
Compare the debit entry, the amount on the bank
statement, and the amount in the bank book. Note any
discrepancies.
Explain to participants that most Bank Debit entries will be
cheques or cash withdrawals. Ask participants to identify
other types of Bank Debit entries, such as bank fees.
Discuss how to verify these types of Bank debit entries.
20
Financial Management: Audit Health Unit Financial Records
Facilitator Guide
Exercise for Auditing Debit Entries in the Bank
Section of the Cash and Bank Book
Work with participants to cross-check the following Bank
section Debit entry:
payment for drugs, cheque 0012K
3/6/96
Use the sample cash and bank book on page 18. Use the
purchase receipt, and cheque book stub on the following
pages.
Follow the steps on Flipchart 5 to audit the entry. Note any
discrepancies.
Answer: There is no discrepancy between the financial
records.
3/6/96
Receipt No. 4577488
Central Store
Bamali, URD
$260.00
Shipment of drugs
Total amount due
$260.00
Total amount paid
$260.00
i
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i
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0012K
Date
3/6/96
Amount $260,00
i
i
For Central Store
payment for drugs
and supplies____
•i
i
i
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Financial Management: Audit Health Unit Financial Records
Facilitator Guide
c. Check Cash and Bank Book Credit Entries
• Verify entries in both Credit columns of the cash and bank
book.
Refer to the sample cash and bank book you prepared on
the flipchart or board before training.
• Check that credit entries are accurate by cross-checking
other health unit financial records, such as patient receipts
for drugs, consultations, debtors book, and bank statements.
• To audit Cash Credit entries in the cash and bank book:
How to Audit Credit Entries in the Cash Section of
the Cash and Bank Book
Flipchart
6
1. Refer to the pages in the cash and bank book for the period you
are auditing.
2. For each Cash Credit entry:
- Find the corresponding patient receipt (drug receipt,
consultation receipt, laboratory receipt) and compare the
amounts. Note any discrepancies.
- If the amount of money on the receipt does not equal the
amount of money in the cash and bank book, check the
debtors book. Find out the reason for the discrepancy.
(continued)
22
Financial Management: Audit Health Unit Financial Records
Facilitator Guide
• To audit Bank Credit Entries in the cash and bank book:
Flipchart
7
How to Audit Credit Entries in the Bank Section of
the Cash and Bank Book
1. Refer to the pages in the cash and bank book for the period you
are auditing.
2. For each credit entry that is a bank deposit:
- Find the corresponding deposit on the bank statement and in
the bank book.
- Compare the credit entry, the amount on the bank statement
and in the bank book. Note any discrepancies.
d. Check the Balance Columns in the Cash and
Bank Book
Refer to the cash and bank book on the flipchart or board as
you discuss the following points.
• This auditing task is to make sure that the columns are
correctly added and/or subtracted.
• For each entry you audit, check:
- the Balance column in the Bank section,
- the Balance column in the Cash section, and
- the Total Balance.
• At the bottom of each cash and bank book page, check the
amounts in the Totals row of the:
- Debit, Credit, and Balance columns in the Bank section,
(continued)
23
Financial Management. Audit Health Unit Financial Records
Facilitator Guide
- Debit, Credit, and Balance columns in the Cash section,
and
- the Total Balance column.
• Also check that the amounts in the Balance carried
forward row for the Bank and Cash sections and the Total
Balance column are correct on the following cash and bank
book page.
Exercise for Checking the Balance Columns
in the Cash and Bank Book
Work with participants to check the Balance columns in the
sample cash and bank book on page 18. Check the Balance
columns for following entries:
3/6/96
payment for drugs, cheque 0012K
12/6/96
fuel for cold-chain
13/6/96
bank deposit
Also check the Balance columns at the bottom of the cash
and bank book page. Note any errors.
Answers:
The Balance columns for the 13/6/96 bank deposit entry
are incorrect because only $50 was deposited, not $150.
- As a result, all Balance column entries made after the
13/6/96 bank deposit entry need to be corrected.
(continued)
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Financial Management: Audit Health Unit Financial Records
Facilitator Guide
The entry in the Totals row for the Cash section Debit
column should be $125. The entry in the Credit
column should be $103.
The balance carried forward should be respectively
$1,690for the Bank section and $133 for the Cash
section, leading to a total balance of $1,823.
e. Check the Budget Item Expenditure Forms for
Accuracy and to Determine Whether
Expenditures Have Exceeded Budgeted
Amounts
• The purpose of the Budget Item Expenditure Form is to
make sure the health unit does not exceed the amount
budgeted for each category of expenditures.
• Each item on the budget has its own Budget Item
Expenditure Form.
• When you audit a budget item expenditure form, make sure:
- The item recorded is consistent with the category of
expenditure.
- All expenditures for a category have been identified and
correspond with the cash and bank book.
Calculations are correct.
- Expenditures have not exceeded budgeted amounts.
• What would happen if the health unit spent more money
than was budgeted?
Solicit responses. Possible answers:
(continued)
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Financial Management: Audit Health Unit Financial Records
Facilitator Guide
The health unit may run into debt.
Priorities may not be fulfilled.
The health unit may not have enough money for other
expenditures.
Refer participants to the sample budget item expenditure
form below. Quickly review the sections of the budget item
expenditure form.
Budget Item Expenditure Form
Budget Item
Expenditure
Form
ffi
Category:
Vehicle maintenance
Amount Budgeted:
$30
Date
Description
Amount
Spent
Total Amount
Spent to Date
Balance
2 Feb 96
oil change
$10
$10
$20
10 March 96
spark plugs
$3
$13
$17
• To conduct the audit, collect all of the health unit's budget
item expenditure forms. The health unit should maintain
one form for each category of expenditure in the budget.
Flipchart
8
• Take these steps to audit each budget item expenditure
form:
(continued)
26
Financial Management: Audit Health Unit Financial Records
Facilitator Guide
How to Audit Budget Item Expenditure Forms
1. Check that each item recorded in the description column is
consistent with the category of expenditure.
2. Find the corresponding purchase receipt and debit entry in the
cash and bank book.
3. Compare the amounts and note any discrepancies.
4. For each entry, check the calculations to make sure that the
Balance column is accurate.
5. Determine if the amount in the Balance column is a positive
or negative number.
6. If the amount in the Balance column is a positive number,
the amount spent has not exceeded the amount budgeted.
Continue auditing the next budget item expenditure form.
7. If the amount in the Balance column is a negative number,
the amount spent has exceeded the amount budgeted.
a. Circle amount in the Balance column. Place the budget
item expenditure form aside.
b. During your review of the audit report, find out from the
Treasurer why the amount spent exceeded the amount
budgeted.
Explain to participants that if they have a forecasting
budget, the auditor should:
7. Check the budget item revenue form to determine
whether the amount of money collected is progressing as
expected.
2. Check the calculations to make sure that the columns are
accurate.
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Financial Management: Audit Health Unit Financial Records
Facilitator Guide
Show participants a sample budget item revenue form.
Work through an example, as necessary’.
Budget
Item
Revenue
Form /
Budget Item Revenue Form
Category: Deliveries Expected Revenue for: / Jan - 30 Jung-PJ. is $300.
Date
Description
Amount
Collected
Total
Amount
Collected to
Date
Expected
Revenue - Total
Amount Collected
to Date
2 Feb 97
1 delivery'
$10
$10
$290
19 Feb 97
1 delivery
$10
$20
$280
03 Mar 97
1 delivery
$10
$30
$270
Exercise for Auditing Budget Item
Expenditure Forms
Work through auditing the following budget item
expenditure forms. Note any errors. Refer to the cash and
bank book and purchase receipts used in the previous
exercise.
(continued)
28
Financial Management: Audit Health Unit Financial Records
Facilitator Guide
Budget Item Expenditure Form
Fuel fof cold chain (Fl.
Category:
Amount Budgeted: $120
Date
Description
Amount
Spent
Total Amount
Spent to Date
Balance
2 Feb 96
fuel for cold
chain
$10
$20
$100
10 March 96
fuel for
sterilization
$20
$40
$80
15 April 96
fuel for cold
chain and
sterilization
$40
$80
$40
12 June 96
fuel for cold
chain
$15
$95
$25
Budget Item Expenditure Form
Amount Budgeted: $720
Category:
Resupply of Druss (D)
Date
Description
Amount
Spent
Total Amount
Spent to Date
Balance
2 Feb 96
purchase drugs
$100
$100
$620
10 March 96 purchase drugs
$200
$300
$420
15 April 96
purchase drugs
$220
$520
$200
3 June 96
purchase drugs
$260
$780
-$60
Items recorded on each form are consistent with the
budget category.
For each item, there is a corresponding entry in the cash
and bank book and a purchase receipt.
Balance columns are accurate.
(continued)
29
Financial Management: Audit Health Unit Financial Records
Facilitator Guide
The auditor should ask the Treasurer why the health unit
has spent $60 more on the resupply of drugs than was
budgeted.
f. Cross-Check the Patient Receipts, Debtors and
Exemptions Book With Patient Registers
• Why should you compare the patient receipts with the
patient registers?
Possible answers:
to make sure revenue recorded in the receipts is
consistent with the prescriptions.
to identify and resolve any discrepancies or errors.
(continued)
30
Financial Management: Audit Health Unit Financial Records
Facilitator Guide
How to Compare the Amount of Money Recorded in
Patient Registers and Receipt, Debtors, and
Exemptions Books
Flipchart
1. Refer to the day’s entries in the patient register.
2. For each entry:
a. Refer to the column in the register which contains the
amount of money the patient was charged for the health
service.
b. Locate the corresponding receipt in the appropriate
receipt book.
c. Compare the amount of money recorded in the register
and on the receipt.
d. If the amount of money on the receipt equals the amount
of money in the register, repeat steps a. - d. until all
entries for the day are checked.
If the amount of money on the receipt does not equal
the amount of money in the register, check the debtors
book.
If there is no corresponding receipt for an entry, check
the exemptions book.
Find the reason for the discrepancy. Then continue
checking the rest of the entries in the health unit register.
• Identify possible causes of any discrepancies, such as:
recording errors
mathematical errors
debts and exemptions recorded incorrectly
04-82-1
31
v
O
a
V
*■
J..J
»o /Z
Financial Management: Audit Health Unit Financial Records
Facilitator Guide
Exercise for Cross-Checking the Patient
Receipts With Patient Registers
Work with participants to cross-check the 7/6/96 entry for
patient receipts 1113 -1117 from the sample cash and bank
book on page 18.
Use the sample receipts and patient register on the
following pages.
Follow the steps on Flipchart 8. Note any discrepancies.
Answers:
-
Receipts 1113 and 1114 match the patient register.
-
Receipts 1115, 1116, and 1117 do not match the patient
register because the patients owe money, but they are
recorded in the debtors book.
There is a discrepancy between receipt 1115 and the
entry in the Debtors book. The patient paid $1.50 and
owes $1.00 according to the receipt.
Three patients are exempt. They have been correctly
identified in the Exemptions book.
32
PATIENT REGISTER
Number of Reattendances = 0
7-6-96
Village
Age
M/F
106
Myriam Ngwete Bawada
42
F
107
Gizi Dobola
108
Lizenge Embale Koulouro
109
Sukato
Manzomba
110
Serial
No.
Patient Name
Sabar
4m
Diagnosis
Drugs/Treatment
Acetylsalicylic Acid 500 mg 1 tab x 3 x 5
days_________________
convulsions, severe malaria Diazepam 5mg 1ml inj 1/2 amp 1R
Paracetamol 1 OOmg 1 tab x 4
Quinine 150 mg/ml inj 1/2 amp IM
Refer urgently to hospital____________
backache
Price
(USD)
0.10
3.35
20
F
anemia
Fer 60 mg 2 tab x 3 x 30 days
Folic Acid 5 mg, 2 tab x 1 x 30 days
exempt
Yatawa
12
M
scabies
Benzylbenzoate lotion 25%
exempt
Ngoi Lintak
Goujia
14m
M
persistent cough, difficulty
breathing____________
Amoxycillin 250 mg, 1 tab x 3 x 5 days
2.50
111
Patrick Saboya
Nafouta
31
M
wound right hand
Chlorhexidine, bandage
TT vaccination___________
1.50
112
Magbo
Mazebele
Nafouta
33
M
hookworm
exempt
113
Aicha SyIla
Tokama
51
F
dysentery, no dehydration
Mebendazole 500 mg, 2 tabs
Wash hands, cut nails_______________
Nalidixic acid 500 mg, 1 tab x4x 5 days
_
fluid, food
L
Referral
No.
1.50
28
Financial Management: Audit Health Unit Financial Records
Facilitator Guide
Receipt No. 1113
District: ORD
Health Unit:,
Bamgli
___
Name:_____ Myrigm Nzwete______ ____
For: Acetylsalicylic 500 ms 1 tab x 3 x 5
Amount:___________ $0, IQ.---------------Dollars
____________ ten cents______
Date:
7 June 96
Signed: Omar Dibba
Receipt No. 1114
District: URD
Health Unit:,
Bamgli
Name:
Giz.i Dobola
For: Diazepam inj 1/2 amip. paracetamol 1 tab 4. quinine 150 mz/rnl ini
1/2 gmp IM____________
Amount:.
$3,35________
Dollars
three dollars and thirty’ five cents
Date:
7 June 96
Signed: Omar Dibba
Receipt No. 1115
District: URD
Health Unit:
Egmali
Name:_____ Nsoi Lintgk____________
For: amoxycillin 250 me, 1 tab x 3 x 5
Amount:
$1,50________
one dollar and fifty cents
Date
7 June 96
Signed: Omar Dibba
Dollars
(continued)
34
Financial Management: Audit Health Unit Financial Records
Facilitator Guide
Receipt No. 1116
District: URD
_____________
Health Unit:
Bamali
—
Name:
Patrick Saboya
For: chlorhexidine, bandage, TT vaccination.
Amount:
$PQQ----Dollars
one dollar and no cents
Date:
7 June 96
Signed: Omar Dibba
Receipt No. 1117
District: URD_
Health Unit:,
Bamali-------------------Name:
Aicha SyIla
For: nalidixic acid 500 mgt I tab x 4 x 5.
Amount:.
$L0Q.--------------_________ one dollar and no cents_____
Date:
7 June 96
____________
Signed: Omar Dibba
Dollars
(continued)
35
Financial Management: Audit Health Unit Financial Records
Facilitator Guide
DEBTORS BOOK
Name of District:
Name of responsible person:.
Bamqli
Name of Health Unit:.
URD
Sabqli
Month:
1996
Year:
June
Serial
No.
Date
Patient Name
Service Provided
Amount
Paid
Receipt
No.
Amount
Due
21
1/6/96
Ekombe Mongwa
drugs
$1.00
1084
$2.50
22
1/6/96 Myriam Embale
drugs
$0.50
1085
$1.25
23
7/6/96 Ngoi Lintak
drugs
$1.00
1115
$1.50
24
7/6/96
drugs
$1.00
1116
$0.50
25
7/6/96 Aicha Scylla
drugs
$1.00
1117
$0.50
Patrick Saboya
Debt
Recovery
pd$1.25
18/6/96
receipt no.
1193
EXEMPTIONS BOOK
Name of District:
Name of responsible person:.
Bamali
Name of Health Unit:.
URD
Sabqli
Month:
June
Year:
1996
Reason for
Exemption
Amount of
Exemption
60 Folic acid tablets, 5 mg
indigent
$1.20
Per 60 mg 2 tab x 3 x 60
Folic acid 5 mg, 2 tab x 1 x 30
indigent
$0.20
mentally ill
$0.50
handicapped
$0.45
Service Provided
Serial
No.
Date
Patient Name
1
1/6/96
Sophie Lokela
2
7/6/96 Lizenge Embale
3
7/6/96 Sukato Manzomba Benzylbenzoate lotion 25%
4
7/6/96 Magbo Mazebele
Mebendazole 500 mg, 2 tabs
36
Financial Management: Audit Health Unit Financial Records
Facilitator Guide
Step 2 - Make Sure Inventory Records Match
Actual Supply Available
• The auditor should count all drug and supply items in the
health unit each month to make sure inventory records
match actual supply available.
• Count each drug and supply item in the main stock.
• When counting inventory items, identify items that are:
expired or near expiration
damaged or spoiled
• Deduct from your count all expired, damaged and spoiled
items.
• Record your inventory count of each drug and supply item
in the stock balance column of the corresponding stock
inventory card.
• Identify any discrepancies with the quantity in the stock
balance recorded by health staff.
Refer to the sample stock inventory card on the following
page.
37
Financial Management: Audit Health Unit Financial Records
Fact Iitator Guide
Stock Inventory Card
Health Unit Name:
Stock Inventory Card No.2
Bamali
Acetylsalicylic Acid tablets, 300 mg.
Stock Item:
Tins of 1,000 tablets
Unit of Issue:
2.000 tablets
Minimum Required Stock Level:
Date
From/To
Quantity
In
3/1/96
Central
Store
3,000
1/2/96
Daily
stock OPD
2/4/96
Daily
stock maternity
5/6/96
Central
Store
15/6/96
Daily
stock OPD
30/6/96
Stock
inventory
7/7/96
Daily
stock OPD
8/7/96
Stock
inventory
Quantity
Out
Stock
Balance
Unit
Price
Stock
Value
Batch No./
Expiration Date
Initials
W7945
8/97
SLM
5,000
$2.67 $13.35
per tin
of 1,000
tablets
1,000
4,000
$10.68
SLM
1,000
3,000
$8.01
RFT
6,000
$2.67 $16.02
per tin
of 1,000
tablets
5,000
$13.35
RFT
5,000
$13.35
RFT
4,000
$10.68
SLM
3,000
1,000
1,000
4,000
38
W4759
8/98
SLM
auditor
Financial Management: Audit Health Unit Financial Records
Facilitator Guide
Step 3 - Make Sure Salaries Are Going to Real
Employees
• Why should you visually identify each health unit staff
person who is being paid a salary?
Possible answers:
to account for revenue spent on salaries.
to make sure that only those who work at the health unit
are receiving salaries.
• Refer to the budget item expenditure form on salaries to
identify the number/names of the health staff who receive
salaries.
• Do a physical check to make sure that these health
professionals are working at the health unit.
Step 4 - Determine How the Treasurer Has
Maintained and Organized the Financial
Records
• When you audit health unit financial records, note how
the Treasurer has maintained and organized his/her
records.
• Answer these questions:
Are the financial records completely and accurately
filled out?
-
Are the purchase receipts, budget item expenditure
forms, and requisition forms filed in a logical way?
(continued)
39
Financial Management: Audit Health Unit Financial Records
Facilitator Guide
• What other things should you note about how records are
maintained and organized?
Solicit responses. Possible answers:
Can you quickly find what you need?
Are records missing?
Are records damaged?
• It is important to file budget item expenditure forms,
purchase receipts, and requisition forms in a practical
way (e.g., alphabetically, by date, by serial number) so
that they can be found easily during an audit.
• How should a Treasurer maintain and organize the health
unit's financial records?
Solicit responses. Answers should include:
The cash and bank book should be continuously updated
with transactions of money going in and out of the health
unit.
Cheque numbers should be recorded next to the
appropriate expenditure in the cash and bank book.
Receipt numbers should be entered in the cash and bank
book, e.g., “Drug receipts 0701-0702. ”
All budget item expenditure forms should be filed in a
box or cabinet in alphabetical order, with categories of
expenditures beginning with "A " at the front of the box
and those beginning with "Z" at the back.
(continued)
40
Financial Management: Audit Health Unit Financial Records
Focilitator Guide
Each file box or cabinet should be labeled.
Purchase receipts and requisition forms should be
stapled or clipped together and filed in date order, with
the most recent invoice and receiptfiled in front for easy
access.
Step 5 - Make Recommendations for
Resolving Any Discrepancies
• For each discrepancy you identify during the internal audit,
describe how the Treasurer can resolve the discrepancy.
• Why should you make recommendations for resolving
discrepancies?
Solicit responses. Possible answers:
to make sure that the discrepancy is resolved correctly
and quickly
to provide the person responsible for the day-to-day
finances with guidance on how to better manage the
health unit's financial records
Explain to participants that if they list recommendations for
resolving discrepancies, it is easier to verify that the
financial records have been corrected.
41
Financial Management: Audit Health Unit Financial Records
Facilitator Guide
Prepare a Report on Audit Results
• After you complete the audit, prepare a report that
describes your findings.
Refer to the sample audit report on the following page.
Review what participants should include in the internal
audit report, such as:
auditor's name
date of audit
summary of results on auditing (actual amount of money
at the health unit and in the bank compared to financial
records, amount of expenditures compared to budgeted
amounts, stock inventory records compared to actual
supply)
discrepancies found
-
explanations of discrepancies found
suggestions for improvement
general comments on how financial records are
maintained and organized
(continued)
42
Financial Management: Audit Health Unit Financial Records
Facilitator Guide
Report on Internal Auditing Results
Internal
Auditing
Report
Auditor; Joseph Odele
Date of Audit: 9 July 1996
Results:
- actual amount of money at the health unit = $176 (9 July 96).
actual amount of money in the bank = $2,000 (9 July 96).
Total bank deposits in June = $150
Total bank withdrawals in June = $75
drug expenditures exceed budgeted amounts by $40.
stock inventory records match actual supply.
Discrepancies:
Recording error in the cash and bank book for bank deposit on
13/6/96. Change the deposit to $50 and correct the Balance
columns for all subsequent entries.
Recording error on Debtors book for Serial No. 23.
Suggestions for improvement:
Cross-check cash and bank book with bank statements.
General comments:
- Financial records are organized well. It is easy to retrieve budget
item expenditure forms and receipts from health unit files.
• Give a copy of the auditing report to:
the person responsible for the day-to-day finances
the health unit head
the Chairperson of the health committee
43
Financial Management: Audit Health Unit Financial Records
Facilitator Guide
Provide Feedback
• After the person responsible for the day-to-day finances
receives your report, schedule a time to meet to review
the report and resolve any discrepancies.
• When the auditor provides feedback to the Treasurer, the
auditor should take the opportunity to train the Treasurer on
the job.
• The role of the auditor is to make sure all money is
accounted for and to improve the financial management
at the health unit.
• Discuss the behavior that you recommend the Treasurer
change. For example, if the Treasurer has loaned money to
someone, discuss with him or her the problems it creates.
• Praise the person responsible for the day-to-day
finances for good things he or she has done. Reinforce
positive behaviors.
• Ask the person responsible for the day-to-day finances if he
or she has any questions or concerns about what is written
on the report.
Resolve Discrepancies
• Work with the person responsible for financial management
to resolve discrepancies due to recording errors, calculation
errors, money loaned, theft...
• Make sure each financial record is corrected as quickly
as possible. Future decisions, such as establishing the next
budget, will be based on the health unit's financial records.
(continued)
44
Financial Management: Audit Health Unit Financial Records
Facilitator Guide
• Notify the health committee if you and your colleague
cannot resolve a discrepancy.
• The health committee will decide if it wants to refer the
discrepancy to a higher level, such as the District
Management Team.
45
Financial Management: Audit Health Unit Financial Records
Facilitator Guide
PERFORMANCE CHECK
Facilitator Instructions
Read the following instructions to participants. Write or
draw any instructions on the flipchart or board, as needed.
• For the Performance Check, you will work individually to
audit health unit financial records using information from a
short case-scenario.
• You will prepare a report on the results of your audit.
• When you have completed the Performance Check, let a
facilitator know.
• When everyone has completed the exercise, we will discuss
the Performance Check.
After all participants have completed the Performance
Check, reconvene them for the plenary discussion.
Refer to the following pages which show the Performance
Check exercise in the Participant Guide.
46
Financial Management: Audit Health Unit Financial Records
Facilitator Guide
PERFORMANCE CHECK
STOP
Do not begin the Performance Check until the facilitator has given you the instructions!
You will work individually to complete the Performance Check. Use the sample forms on the
following pages to complete the Performance Check:
-
cash and bank book
purchase receipts
cheque book stub
■
-
bank book statement
budget item expenditure forms
• patient receipts
On 19 June 1996 you audit the financial records of the Cumba health unit. Upon arrival, you count
the amount of money at the health unit and find $153.5 (i.e. $42 less than what is indicated in the
cash and bank book).
You check the debit and credit entries of the cash and bank book, balance columns and budget item
expenditure forms.
Prepare a report on the results of your audit. Note any discrepancies found and possible reasons for
the discrepancies.
1. Use the table on the following page to record your observations.
2. Let a facilitator know when you have completed the Performance Check.
47
Financial Management: Audit Health Unit Financial Records
Facilitator Guide
Report on Internal Auditing Results
Auditor: participant's name
Date of Audit: 19/6/96
Results:
Actual amount at the health unit =
Cash and bank book: cash balance =
Actual amount in the bank =
Cash and bank book: bank balance =
Discrepancies:
Cash and bank book debit entries
Cash and bank book credit entries
Balance columns
- Budget item expenditure forms
Reasons for discrepancies:
Suggestions for Improvements:
48
Financial Management: Audit Health Unit Financial Records
Facilitator Guide
CASH AND BANK BOOK
Name of District:
Name of responsible person:.
Ref
no.
Date
Cumba
Name of Health Unit:.
URD
Month:
Sabali
Description Budget
(transaction) Category
June
Year:.
Cash
Bank
Debit
(out)
Credit
(in)
7996
Balance
Debit
(out)
Credit
(in)
2,550.00
1/6/96
Balance
brought
forward
101
3/6/96
Drug
receipts
0711-0716
D
102
7/6/96
Purchase of
office
supplies
O
103
10/6/96 Drug
receipts
0717-0720
D
2,537.50
104
11/6/96 Purchase of
cleaning
supplies
O
2,537.50
105
19/6/96 Payment of
drugs
cheque
0012K
D
10.00
2,550.00
2,537.50
12.50
2,037.50
500.00
Totals
Balance carried forward
49
6.50
11.00
Balance
Total
Balance
190.00
$2,740.00
200.00
2,750.00
200.00
2,737.50
206.50
2,744.00
195.50
2,733.00
195.50
2,233.00
Financial Management: Audit Health Unit Financial Records
Facilitator Guide
Customer Receipt No. 45780
Vendor
Shopmart
Date
7 June 96
Description
notebooks, paper clips,
pencils
Amount
$12.50
Customer Receipt No. 45802
Vendor
Shopmart
Date
11 June 96
Description
ammonia, mops
Amount
$1.00
Central Drug Store Receipt No. 5378399
Date
19 June 1996
Description
Amoxycillin 500 mg, tablets - 10 tins @ $30/tin = $300
Acetylsalicylic acid 300 mg, tablets - 10 tins @ $2.50/tin = $25
Dextran 70 injectable 6% -10 sets @ 4$/set = $40
Metronidazole 250 mg, tablets - 10 tins @ $8/tin = $80
Benzylpenicillin 3g injectable, 2 boxes @ $27.5/box = $55
Total Amount $500.00
Cheque
Book Stub
0012 ]
i
i
i
i
i
i
i
i
i
i
Date 19 June 96
To
Maria Obwetp
Amount $500
For
Purchase Drugs
(continued)
50
Financial Management: Audit Health Unit Financial Records
Facilitator Guide
BANK BOOK
District
Cumba
Health Unit
URD
Date
Description
No.
In
18/5/96
Deposit
DOS
$50
19/5/96
Withdrawal
V/97
15/6/96
Deposit
D15
19/6/96
Withdrawal
W106
Balance
Out
$2,612.50
$2,537.50
$75
$2,587.50
$50
$2,087.50
$500
Budget Item Expenditure Form
Amount Budgeted:
Category:,,, Office Supplies (01
Date
Description
Amount
Spent
Total Amount
Spent to Date
Balance
7/2/96
pens, pencils, notebook
paper_______
$12.50
$12.50
$27.50
11/4/96
notebook paper, paper clips
$10
$22.50
$17.50
21/5/96
pencils, tape
$6
$28.50
$11.50
7/6/96
notebooks, paper clips,
pencils_____________
$12.50
$41
-$1
Budget Item Expenditure Form
Amount Budgeted: $4,000.
Category: Resupply of druzs and supplies (D)
Date
Description
Amount
Spent
Total Amount
Spent to Date
Balance
12/1/96
purchase drugs
$900
$900
$3,100
4/4/96
purchase drugs
$350
$1,250
$2,750
19/6/96
purchase drugs
$500
$1,750
$2,350
TH - HO
51
-^5
(continued)
/A J 1
1 r jj
/
j/
Financial Management: Audit Health Unit Financial Records
Facilitator Guide
(receipt pages from drug receipt book)
Receipt No. 0712
Receipt No. 0711
District:
Health Unit:
URD____________
Cumba
Name: Jane Kataw
For: 15 tablets of Paracetamol 100 m2
URD____________
Cumba
District:
Health Unit:
Name: Nelson Margka
For: 20 tablets of Nalidixic acid 500 m2
Amount:______$1_____________
Amount:
Date: 3 June 1996
Signed: Omar Dibba___________ _
Signed:
$1.50
Date: 3 June 1996
Omar Dibba__________ _
Receipt No. 0714
Receipt No. 0713
District:___ URD____________
Health Unit:.
Cumba_________
Name: Ella Kunay______
For:__ 180 tablets of Per 60 mg and
60 tablets of Folic Acid 5 m2
Amount:
^2________
Date: 3 June 1996
Signed:
Omar Dibba
URD____________
Cumba
District:
Health Unit:
Name: Joseph Ranayo
_
For: 6 tablets of Chloroquine 150 me and
9 tablets ofAcetylsalicylic acid 500 me
Amount: $1,50
Date: 3 June 1996
Signed: Omar Dibba____________
Receipt No. 0716
Receipt No. 0715
District:
URD
Health Unit:
Cumba
Name: Ana Kinor
URD____________
Cumba
District:
Health Unit:
For: 15 tablets of Acetylsalicylic acid 500 m2
Name: Micala Gasoriwi
For: 2 capsules of Vit A 200,0001U
Am ou nt:_____ $1_____________
Amount:
Date: 3 June 1996
Signed: Omar Dibba____________
Date: 3 June 1996
$1
_
Signed:_ Omar Dibba__________
Receipt No. 0718
Receipt No. 0717
URD____________
Cumba
District:
URD
Health Unit:
Cumba
District:
Health Unit:
Name: Angelica Bambelo
For: 3 vials of Chloramphenicol inj 500 m2
Name: John Mnengowo
For: 75 tablets ofAmoxycillin 250 m2
Amount:
$1.50________
Date: 10 June 1996
Signed: Omar Dibba
Amount:
$2.00
Date: 10 June 1996
Signed:
Omar Dibba
(continued)
52
Financial Management: Audit Health Unit Financial Records
Facilitator Guide
Receipt No. 0720
Receipt No. 0719
District:
Health Unit:
URD____________
Cumbd___________
Name: Moses Rwome
For: 15 tablets of Paracetamol 100 mg
Amount:
________
Date: 10 June 1996
Signed:
Omar Dibba____________
District:
Health Unit:
URD____________
Cumba__________
Name: Winifred Mashoka
For: 20 tablets of Amoxycillin 500 mg and
8 tablets ofAcetylsalicylic acid 500 ms
Amount:
$2,00.
Date: 10 June 1996
Signed:
53
Omar Dibba
Financial Management: Audit Health Unit Financial Records
Facilitator Guide
Answer Key to Performance Check
Date of Audit: 19/6/96
Results:
Actual amount at the health unit = $153.5
Cash and bank book: cash balance = $195.5
Actual amount in the bank = $2087.5
Cash and bank book: bank balance = $2037.5
Discrepancies:
Cash and bank Book debit entries
The $50 bank deposit on 15/6/96 does not appear in the
cash section of the cash and bank book.
The cleaning supplies expenditures was $1 instead of $11.
Cash and bank book credit entries
The drug receipts on 3/6/96 equal $8, not $10.
The $50 bank deposit on 15/6/96 does not appear in the
bank section of the cash and bank book.
Balance columns
The balance on 19/6/96 should be respectively $2087.5 in
the bank section and $153.5 in the cash section, leading to
a total balance of $2241.
(continued)
54
Financial Management: Audit Health Unit Financial Records
Facilitator Guide
Budget item expenditure forms
The office supplies expenditures has exceeded the amount
budgeted by $1.
The resupply of drugs and supplies has not exceeded the
amount budgeted; however, the balance on 19/6/96 should
be $2,250 instead of $2,350.
Reasons for discrepancies:
The discrepancy between the actual amount of money at the
health unit and in the bank and the cash and bank book is only
due to recording errors.
On 15/6/96, the treasurer deposited $50 in the bank, but did not
record the deposit in the cash and bank book.
The cash and bank book should be changed to reflect the
deposit as well as the correct amount of revenue for drug
receipts on 3/6/96 and the expenditure for cleaning supplies on
11/6/96.
Suggestions for improvement:
Cross-check cash and bank book with bank statements.
Record all bank deposits in the cash and bank book.
Avoid recording and calculations errors.
55
Financial Management: Audit Health Unit Financial Records
Facilitator Guide
Plenary Discussion
When the participants reconvene, encourage them to ask
any questions, share any observations, problems, or
concerns they experienced in completing the Performance
Check.
Discuss the difficulties that you noted participants
experienced during the Performance Check.
Ask participants the following questions:
• What are some common discrepancies an auditor may find?
How can you prevent or reduce these discrepancies?
• How can you use the information from an audit to improve
the way your health unit manages its money?
• What are some additional audits that you conduct on your
health unit’s financial records that we did not discuss in this
module? Why are they important?
Conclude the module with positive comments about how
participants performed. Summarize the major points of the
activity.
• Someone other than the Treasurer should make sure that all
the money going in and out of the health unit is accounted
for.
• During internal auditing, someone from the community
checks the health unit records to make sure they are accurate
and complete.
• Internal auditing can be done on a monthly basis.
(continued)
56
Financial Management: Audit Health Unit Financial Records
Facilitator Guide
• The health committee is responsible for selecting an auditor,
who has appropriate auditing skills.
• To conduct an internal audit, perform these tasks:
Flipchart
2
Auditor’s Tasks
1
Check accuracy of health unit financial records, making
appropriate cross-references.
2. Make sure inventory records match actual supply available.
3. Make sure salaries are going to real employees.
4. Determine how the Treasurer has maintained and organized
the financial records.
5. Make recommendations for resolving any discrepancies.
• After you complete the audit, prepare a report that describes
your findings.
• Use the results of the audit to improve the way your health
unit manages its money on a daily basis.
Discuss any plans you have for following up with
participants after training.
57
*
Health Systems Development Unit
UNICEF House
3 United Nations Plaza
New York, NY 10017 - USA
Fax: 212-824-6462
Community
participation
Monitoring and
service delivery
Management of staff
and equipment
Drug/supply
management
Financial management
1. Apply basic communication
skills
2. Conduct commumry
diagnosis
3. Organize and suppon health
committee
4. Establish relationships with
community leaders, local
organizations, and authorities
5. Conduct participatory
planning
1. Monitor and evaluate at the
health unit level
2. Monitor and evaluate at the
community level
3. Organize delivery of
services
1. Hire and manage support
staff
2. Ensure training of health
unit personnel
3. Maintain equipment and
health unit facility
1. Store supply and establish
inventory procedures
2. Order and procure
3. Receive and inspect
4. Monitor daily and monthly
inventory
1. Establish prices and exemptions
systems
2. Manage revenue and
expenditures
3. Establish a budget
4. Audit health unit financial
records
I
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