MANAGE REVENUE AND EXPENDITURES Financial Management

Item

Title
MANAGE REVENUE AND
EXPENDITURES
Financial Management
extracted text
Training for Health Committees and Health Staff at Health Unit Level

MANAGE REVENUE AND
EXPENDITURES
Financial Management

2
PARTICIPANT GUIDE

unicef

Training for Health Committees and Health Staff at Health Unit Level

MANAGE REVENUE AND

EXPENDITURES
Financial Management

2
PARTICIPANT GUIDE

unicef

Copyright © 1996
United Nations Children’s Fund
3 UN Plaza
New York, NY 10017
USA

The purpose of this training course is to improve the management of resources at health unit level
and to build the capacity of health committee members and health staff to work with communities.
The training course was developed by Dr Kasa Pangu and Dr Helene Gaumerais of the Health
Systems Development Unit with the technical collaboration of the Center For Effective Performance
(Atlanta, Georgia) and with the inputs from all the Unit’s programme staff. The Health Systems
Development Unit wishes to express its gratitude to the colleagues from other sections who gave
comments on the draft.

The design and content of the training course benefited greatly from the work undertaken by
participants from panel review meetings held in New York, including E. Alihonou, M. Bah, G.
Bukenya, B. Criel, K. Drame, J. Eshuis, H. Gorgen, M. Kader Konde, H. M. Kahssay, R.
Knippenberg, B. McPake, L. Mpande, K. Mukelabai, M. Murro, V. Oketcho-Oketh, I. Rizzo and A.
B. Touray.

The designations employed in this publication do not imply on the part of UNICEF the expression
of any opinion whatsoever concerning the legal status of any country or territory. Furthermore, the
training modules are intended to be practical tools for adaptation to country local situation and as
such have not been edited to the official publication standards of UNICEF, nor do they necessarily
reflect the policies or views of UNICEF.

All correspondence should be addressed to :
Dr Kasa Pangu
Senior Advisor
Health Section, TA-24A
UNICEF
3 UN Plaza
New York, NY 10017, USA

Phone:
Facsimile:
Internet:

TIA-WO

^6

212-824-6339
212-824-6462
kpangu @ unicef.org

V

----

Financial Management: Manage Revenue and Expenditures

Participant Guide

FINANCIAL MANAGEMENT: MANAGE REVENUE AND
EXPENDITURES
Introduction ..............................................
Overview of Revenue and Expenditures

4
5

Activity 1 - Manage Revenue .................................................................
Introduction to Activity 1...................................................................
Overview of Managing Revenue.......................................................
Step 1 - Collect Money and Issue Receipts......................................
Step 2 - Record Debtors and Exemptions ........................................
Practice Exercise for Issuing a Receipt and
Recording Exemptions and Debtors ..........................................
Step 3 - Keep Money at the Bank and at the Health Unit ................
Step 4 - Record in the Cash and Bank Book Money Deposited
in the Bank and Money Received in Hand........................................
Practice Exercise for Recording Money Received in Hand
and Bank Deposits in the Cash and Bank Book..........................
Step 5 - Verify Bank Statements and Bank Book ............................
Practice Exercise for Verifying Bank Statements and Bank Book
Step 6 - Make Sure that Money Recorded in
Health Unit Registers Equals the Amount of Money in
Receipt, Debtors, and Exemptions Books........................................
Performance Check 1.........................................................................

.7
.7
.8
.8
12

Activity 2 - Manage Expenditures..............................................
Introduction to Activity 2......................................................
Approval of Expenditures ....................................................
Overview of How to Manage Expenditures..........................
Step 1 - Determine if Money is Available for a
Purchase or Expenditure ......................................................
Practice Exercise for Determining if Money is Available
Using a Budget Item Expenditure Form ........................
Step 2 - Record Expenditures in the Cash and Bank Book . .
Practice Exercise for Recording Expenditures in the
Cash and Bank Book................................................
Step 3 - Record Expenditures on the Budget Item
Expenditure Form .................................................................
Practice Exercise for Completing the Budget Item
Expenditure Form ...........................................................

16
20
22

26
28
31

33
36
42
42
42
43
46

48
49
51
53
54

(continued)

2

Financial Management: Manage Revenue and Expenditures

Participant Guide

Step 4 - Write a Cheque......................................
Practice Exercise for Writing a Cheque........
Step 5 - Make a Requisition For Large Purchases
Practice Exercise for Making a Requisition ..
Performance Check 2..........................................
Performance Check 3..........................................

55
56
57
60
61
67

Activity 3 - Prepare a Financial Report.......... i..............
Introduction to Activity 3..........................................
Prepare Budgeted versus Actual Expenditures Report
Practice Exercise for Preparing Budgeted versus
Actual Expenditures Report................................
Performance Check 4.............................. J

73
73
73

3

77
84

o

Financial Management: Manage Revenue and Expenditures

Participant Guide

FINANCIAL MANAGEMENT:
MANAGE REVENUE AND EXPENDITURES
Introduction
Regular and proper financial management is essential in
health units.
The health staff and health committee must work
together to effectively manage revenue and expenditures.

A health unit that manages revenue and expenditures
successfully does not run out of money and keeps to its
budget.
Proper financial management of health unit money
ensures accountability to the community.
In this module, you will learn how to manage revenue
and expenditures.
In the first activity, you will learn how to manage
revenue using the cash and bank book and receipts.
In the second activity, you will learn how to manage
expenditures using Budget Item Expenditure Forms,
requisitions, and cheques.

In the third activity, you will learn how to prepare and
use a financial report.

4

Participant Notes

Financial Management: Manage Revenue and Expenditures

Participant Guide

Overview of Revenue and Expenditures
Participant Notes

Revenue is:
money received from patients
money received from donors or the
government

• Revenue is money coming in. It is also referred to
as credit on many financial management forms, such
as the cash and bank book.
Expenditures are:

expenses

payments
examples;
drugs

supplies

incentive payments (allowances)
• Expenditure is money going out It is also referred
to as debit on many financial management forms,
such as the cash and bank book.
• It is important to manage revenue and expenditures:
to make sure money is available for high-priority
purchases, such as drugs and supplies

(continued)

5

Financial Management: Manage Revenue and Expenditures

Participant Guide

to make sure the health unit does not run out of
money

Participant Notes
so that the health unit knows how much money
it is spending on certain items
so that the health unit can determine how much
money it has at any given time

to make sure the health unit follows the
approved budget

6

Financial Management: Manage Revenue and Expenditures

Participant Guide

ACTIVITY 1 - MANAGE REVENUE
Introduction to Activity 1
• Managing revenue is a process.

Managing Revenue
Collect
money

Record
money

Keep money
at health unit
or in the bank
Verify health unit
and bank
financial records

• It is important to properly manage revenue:

to make sure money is not lost, misplaced, unaccounted for, or
stolen
to make sure money is available for high priority purchases, such
as the resupply of drugs

7

Financial Management: Manage Revenue and Expenditures

Participant Guide

Overview of Managing Revenue
Participant Notes

• There are six steps to managing revenue:

Main Steps in Managing Revenue

1. Collect money and issue receipts.

2. Record exemptions and debtors.
3. Keep money at the bank and at the
health unit.

4. Record in the cash and bank book
money deposited in the bank and money
received in hand.
5. Verify bank statements and bank book.
6. Make sure that money recorded in
health unit registers equals the amount
of money in receipt, debtors, and
exemptions books.

Step 1 - Collect Money and Issue
Receipts
• A receipt is a formal record of the transfer of money
from one person to another.
• Receipts confirm that money has been paid for a
service or a product.
• Receipts confirm the amount of money that was paid
for a service or product.
• Receipts are used during audits to make sure
financial records are accurate.

(continued)

8

Financial Management: Manage Revenue and Expenditures

Participant Guide

• The cashier issues a receipt to patients when they pay
for a service such as consultation, delivery,
laboratory etc.

• The Treasurer issues a receipt to the health staff
when he collects money from the health unit.

Receipts
Issue a receipt whenever you receive or
collect money.
Obtain a receipt whenever you pay
money.

• Make sure there is a receipt book at each place
money is received or collected at your health unit
• The Treasurer should have a separate receipt book.
• Whenever the Treasurer collects money from the
health unit, he or she should issue the health unit
a receipt.
• Issue a receipt for the amount of money collected.
• Write on the receipt:
a description of what the money is collected for

the total amount of money paid by the patient in
figures and in words
the date on which you issue the receipt

(continued)

9

Participant Notes

Participant Guide

Financial Management: Manage Revenue and Expenditures

Receipt No. 0702
Participant Notes

District:.

URD

Health Unit:.

Name:.
For:

Bamali
Mary Ruwasha

chlorhexidine, bandage, TT vaccination

Amount:.

$1,50

One dollar and fifty cents
Date:.

Dollars

13 April 96

Signed: Omar Dibba

Mary Ruwasha

• If a patient pays for drugs and supplies, write the
name, strength, and quantity issued for each
purchased drug and supply item on the receipt.
• The person receiving the money should sign the
receipt.
• The person giving the money may sometimes also
sign the receipt.

• It is important to indicate on the receipt the quantity
of money received and what the money was received
for:
to keep an accurate record of revenue

to keep an accurate record of purchased drugs
and supplies

(continued)

io

Financial Management: Manage Revenue and Expenditures

Participant Guide

• Information on the receipts is used to complete the
cash and bank book.
• Receipts are also used to verify other health unit
records, such as the drug register, patient register,
and debtors book.
• The person receiving the money should sign the
receipt:

to ensure accountability
to identify who issued the receipt if there is a
discrepancy or error

• If you make a mistake when you write a receipt,
cancel the receipt and issue another receipt.
Make sure you leave the incorrect receipt in the
receipt book.
• Keep a copy of each receipt issued.
• At the end of the day, you will use copies of the
receipts to:
Record revenue in the cash and bank book.

Identify discrepancies between the drug
register, the patient register, and the receipts.

11

Participant Notes

Financial Management: Manage Revenue and Expenditures

Participant Guide

Step 2 - Record Debtors and
Exemptions
Participant Notes

• Patients who are unable to pay are either debtors or
exempt patients.
• Patients who have to repay the health unit are
debtors.

• Patients who are exempt do not have to repay the
health unit.
• To make sure that your health unit does not lose
track of patients who owe money, record debtors in
a debtors book.
Refer to the sample debtors book on the following
page. Create your own debtors book to fit local
procedures.

12

Financial Management: Manage Revenue and Expenditures

Participant Guide

DEBTORS BOOK

Name of District:

Name of responsible person:.

Bamali

Name of Health Unit:.

URD

Sabqli

Month:

April

Year:

1996

Serial
No.

Date

Patient Name

Service Provided

Amount
Paid

Receipt
No.

Amount
Due

1

3/4/96

Ekombe Mongwa

drugs

$1.00

0678

$2.50

2

3/4/96

Myriam Embale

drugs

$0.50

0681

$1.25

3

7/4/96 Beatrice Dibba

prenatal care fee

$2.00

0686

$8.00

4

10/4/96 Solomon Saboya

lab fee

5

11/4/96 Euza Dombe

consultation

6

7
8

9

10
11

13

$2.50

$1.00

0693

$1.00

Debt
Recovery

$1.25 pd
10/4/96
^0689

Financial Management: Manage Revenue and Expenditures

Participant Guide

• Patients who are exempt are relieved from paying
for health services.

Participant Notes
• Record exempted patients in an exemptions book.
Refer to the sample exemptions book on the
following page. Create your own exemptions book
to fit local procedures.

• Keep a record of exempt patients to monitor the cost
of the exemption system.

14

Financial Management: Manage Revenue and Expenditures

Participant Guide

EXEMPTIONS BOOK

Name of District:

Name of responsible person:.

Serial
No.

Date

Bamqli

Name of Health Unit:.

URD

Sabali

Patient Name

Month:

April

Service Provided

Year:

1996

Reason for
Exemption

Amount of
Exemption

1

3/4/96 Sophie Lokela

60 Folic acid tablets, 5 mg

chronic
disease

$1.20

2

10/4/96 Amane Ngwoto

consultation

prisoner

$2.00

3
4
5

6
7

8
9

10

11

75

Participant Guide

Financial Management: Manage Revenue and Expenditures

Practice Exercise for Issuing a Receipt and Recording Exemptions
and Debtors
Complete a receipt for the following case scenarios. Record exemptions and debtors on the
appropriate forms on page 19, as necessary.
1. On 21 March 1996, Micala Womba paid $1.50 for 15 packets of oral rehydration salts.

Receipt No. 0709
District:

Health Unit:.
Name:.

For:

Amount:

Dolla

Date:.

Signed:

(continued)

16

Financial Management: Manage Revenue and Expenditures

Participant Guide

2. John Mwabe paid $2 for a consultation on 10 March 1996.

Receipt No. 1102
District:.

Health Unit:.

Name:.
For:

Amount:.

Dol

Date:
Signed:.

3. On 15 March 1996, Amina Traore received 15 tablets of Amoxycillin 250 mg and 18
Paracetamol 100 mg tablets for her baby's ear infection. The drugs cost $2.00, but Amina
could only pay $1.00.

Receipt No. 1119
District:.

Health Unit:
Name:.

For:.
Amount:

Dol

Date:.
Signed:.

(continued)

17

Financial Management: Manage Revenue and Expenditures

Participant Guide

4. On 15 March 1996, Sekou Sangare was exempt from paying $1.00 for 40 Aluminum
hydroxide 500 mg tablets. He is a prisoner.
Receipt No. 3112
District:.

Health Unit:.
Name:.

For:.
Amount:.

Dolla

Date:.
Signed:.

(continued)

18

Financial Management: Manage Revenue and Expenditures

Participant Guide

DEBTORS BOOK
Name of Health Unit:.

Name of District:
Name of responsible person:.
Serial
No.

Date

Patient Name

Year: 1996

Month:

Service Provided

Amount
Paid

Receipt
No.

Amount
Due

Debt
Recovery

1

2

3

EXEMPTIONS BOOK
Name of Health Unit:.

Name of District:
Name of responsible person:.

Serial
No.

Date

Patient Name

Month:

Service Provided

1

2

3

The facilitator will review this exercise during training.

19

Year: 1996

Reason for
Exemption

Amount of
Exemption

Financial Management: Manage Revenue and Expenditures

Participant Guide

Step 3 - Keep Money at the Bank and at
the Health Unit
• Your health unit may collect money from patients on
a daily basis.
• Your health unit might keep most of the money it
collects:
in a bank savings account
in a credit union

at a post office

• It is not wise to keep large amounts of money at the
health unit because of the possibility of theft.

• The health staff and health committee should decide
when and how often to deposit money in the bank.
• It may be convenient to deposit money once or twice
a week. Or, you may decide to deposit money when
the health unit has collected a certain amount.

(continued)

20

Participant Notes

Financial Management: Manage Revenue and Expenditures

Participant Guide



To deposit money in the bank, complete a deposit slip.
Standard Bank

Notes

$95.00

Coins

$5.00

Cash

Date:.

21 March 96

Account No..

Total in words One hundred dollars
Paid in by.

$100.00

Subtotal Cash

018475456

Cheques

Subtotal Cheques

Omar Dibba

CASHIER cashier's signature and
stamp

TOTAL DEPOSIT

$100.00



After verifying the amount of money being deposited, the bank
cashier will sign and stamp your deposit slip.



If your bank uses a bank book, the cashier will update your bank book
to reflect the deposit.
BANK BOOK

District

URD

Health Unit

Date

Description

No.

7/3/96

Withdrawal

W34

18/3/96

Deposit

DOS

19/3/96

Withdrawal

W97

21/3/96

Deposit

D15

Bamali
In

Out

Balance

$25

$1,075
$1,125

$50

$75
$100

$1,050

$1,150



Keep a certain amount of money at the health unit for emergency
expenditures.



Identify the amount of money that you can safely keep at the health
unit.



Identify where you can safely and securely store money in your health
unit.

(continued)

21

Financial Management: Manage Revenue and Expenditures

Participant Guide

• Money should be securely stored in a safe or lock
box.
• Withdraw money for other expenditures from the
health unit's bank account.

Step 4 - Record in the Cash and Bank
Book Money Deposited in the Bank and
Money Received in Hand
This module assumes that the health committee
keeps the cash and bank book.

• Use a cash and bank book to:

Keep track of your revenue and expenditures.
Record money received in hand during the day.
Record amount of money deposited in the bank.

• At the end of the day, add up the receipts and record
the total amount of cash received in hand, in the cash
and bank book.

• Whenever you receive cash in hand, issue a receipt.
• At the end of the day, calculate the total revenue for
each receipt book separately.
• For example, add up all drug receipts and write the
total in the cash and bank book. Then add up all
OPD consultation receipts and record that total as a
separate entry in the cash and bank book.
The following steps for recording cash in hand are
the same whether the cash is receivedfrom patients
for services or if the cash is received by the
Treasurer from the health unit.
(continued)

22

Participant Notes

Financial Management: Manage Revenue and Expenditures

Participant Guide

Refer to the sample cash and bank book on page 24,
as needed.
Participant Notes
• To record money received in hand during the day
or receipts from each receipt book:
1. Collect all copies of receipts issued during the
day.

2. Write the date of the entry in the Date column.
3. Describe the entry in the Description column.
Include the numbers of the receipts issued. For
example, 0702-0713.

4. Write the budget category code in the Budget
Category column. For example, write "D" for
money received from drug sales. Write "U" for
money collected for user fees.
5. Add up the total amount of money collected
during the day from the copies of receipts.
6. Count the money that was received in hand.
7. Make sure that the amount of money received in
hand equals the quantity on the receipts.

8. Write the total quantity of money collected in
Credit column of the Cash section of the cash
and bank book.
9. Add the amount in the Credit column to the
amount in the Balance column of the previous
entry in the Cash section. Write the total in the
current entry's Balance column.
10. Add the amounts in the Bank Balance and Cash
Balance columns. Write the sum in the Total
Balance column.

11. Store the money in the health unit safe until it
can be deposited in the bank.

23

Financial Management: Manage Revenue and Expenditures

Participant Guide

CASH AND BANK BOOK

Name of District:

Name of responsible person:.

Ref
no.

Date

Bamgli

Name of Health Unit:.

URD

Month:

Sabali

Description Budget
(transaction) Category

Year:.

March

Cash

Bank
Debit
(out)

Credit
(in)

1/3/96 Balance
brought
forward

1996

Balance

Debit
(out)

Credit
(in)

Balance

Total
Balance

1,500

400

1,900

001

3/3/96 Payment of
drugs
chq 0009

D

400

1,100

400

1,500

002

7/3/96 Purchase of
office
supplies

O

25

1,075

400

1,475

003

15/3/96 OPD
consultation
receipts
291-316

U

450

1,525

004

18/3/96 Bank deposit

400

1,525

005

19/3/96 Purchase of
cleaning
supplies

400

1,450

006

21/3/96 Bank deposit

300

lf450

007

25/3/96 Drug receipts
126-144

345

1,495

1,125

50

O

50

1,075

50

1,050

75

1,150

100

1,150

D

Totals
Balance carried
forward

24

100

45

Financial Management: Manage Revenue and Expenditures

Participant Guide

• To record money deposited in the bank:
1. Write the date of the deposit in the Date column.

2. Describe the entry in the Description column.
3. Write the amount of money deposited in the
bank in the Credit column of the Bank section.

4. Add the amount in the Credit column to the
amount in the Balance column of the previous
entry in the Bank section. Write the total in the
current entry's Balance column.
5. Write the amount of money deposited in the
bank in the Debit column of the Cash section.
6. Subtract the amount in the Debit column from
the Balance column of the previous entry in the
Cash section. Write the total in the current
entry's Balance column.
7. Add the amounts in the Bank Balance and Cash
Balance columns. Write the sum in the Total
Balance column.

• The Total Balance should be the same as in the
previous entry. There is no loss or gain because
money is being moved from one location to
another.

25

Participant Notes

Financial Management: Manage Revenue and Expenditures

Participant Guide

Practice Exercise for Recording Money Received in Hand and Bank
Deposits in the Cash and Bank Book
Complete the cash and bank book for each case scenario:

1. On 25 April 1996, the Treasurer deposited $100 in the bank from the cash box.
2. On 29 April 1996, the Treasurer collected $15 in cash from the health unit for lab fee receipts
0500-0507.

3. Add the amount of money collected from the receipts listed below and write the total in the
cash and bank book.
Drugs Receipts for 30 April 1996

Receipt
Number

Name and Quantity of Item Issued and Fee
Collected

0711

20 tablets of acetyl salicylic acid, 300 mg"$0.40

0712

30 tablets of folic acid, 5 mg - $0.60

0713

40 tablets of aluminum hydroxide 500 mg--$1.00

0714

20 tablets of cotrimoxazole — $1.00

0715

20 tablets of acetyl salicylic acid, 300 mg—$0.40

0716

30 tablets of folic acid, 5 mg - $0.60

The facilitator will review this exercise during training.

26

Financial Management: Manage Revenue and Expenditures

Participant Guide

CASH AND BANK BOOK

Name of District:

Name of responsible person:.

Ref
no.

Date

Bamali

Name of Health Unit:.

URD

Sabqli

Description Budget
(transaction) Category

Month:

Year:.

April

Cash

Bank
Debit
(out)

Credit
(in)

1/4/96 Balance
brought
forward

Balance

2,940.00

300.00

3,240.00

311.50

3,251.50

305.50

3,245.50

312.60

3,252.60

002

7/4/96 Delivery fee
receipts
0291-0300

U

2,940.00

003

8/4/96 Purchase of
office
supplies

O

2,940.00

004 21/4/96 OPD
consultation
receipts
0801-0802

U

2,940.00

007

Totals
Balance carried
forward

27

Balance

$3,300.00

D

006

Credit
(in)

300.00

3/4/96 Payment of
drugs
chq 0009

005

Debit
(out)

Total
Balance

3,000.00

001

60.00

1996

11.50

6.00

7.10

Financial Management: Manage Revenue and Expenditures

Participant Guide

Step 5 - Verify Bank Statements and Bank Book
• The bank provides you with a bank book for each account.
• The bank book is completed by the bank, not by the health unit.
BANK BOOK
District

Health Unit

URD

Date

Description

No.

7/3/96

Withdrawal

W34

18/3/96

Deposit

DOS

19/3/96

Withdrawal

W97

21/3/96

Deposit

D15

Bamali

In

Out

Balance

$25

$1,075
$1,125

$50
$75
$100

$1,050
$1,150

• Each time you deposit or withdraw money, the bank either gives you
a receipt or updates your bank book.
(continued)

28

Participant Guide

Financial Management: Manage Revenue and Expenditures

• At the end of the month, the bank should send you a statement of your
transactions.
ACCOUNT STATEMENT
Statement Date: April 8, 1996
Standard Bank
Commerce Street
Tokama, URD

Mr. Sabali Mbwoto
Bamali Health Committee
Bamali, URD

Summary for Account No. 23954-1294-82

Beginning Balance
Total Deposits
Interest This Period
Total Withdrawals
Service Charges
Ending Balance

$1,100.00
150.00

100.00
$1,150.00

Description of Account Transactions

Transaction

Date

Amount

Balance
$1,100.00

Beginning
Balance

1/3/96

Withdrawal

7/3/96

$25.00

$1,075.00

Deposit

18/3/96

$50.00

$1,125.00

Withdrawal

19/3/96

$75.00

$1,050.00

Deposit

21/3/96

$100.00

$1,150.00

• Make sure that the bank statement, bank book, and your cash and
bank book match.
• Verify your bank statement:

to make sure that all money is accounted for
to identify and resolve and discrepancies

(continued)

29

Financial Management: Manage Revenue and Expenditures

Participant Guide

• To verify your bank statement:
Participant Notes

1. Verify all bank deposits:

a. Total all bank deposits for the month in your
cash and bank book.

b. Total all deposits recorded for the month by
the bank cashier in your bank book.

c. Find the total amount of bank deposits on
your bank statement. Compare the amount
with the totals from the bank book and the
cash and bank book.
Identify any
discrepancies.
2. Verify all bank withdrawals:

a. Total all bank withdrawals for the month in
your cash and bank book.

b. Total all withdrawals recorded for the month
by the bank cashier in your bank book.

c. Find the total amount of bank withdrawals
on your bank statement. Compare the
amount with the totals from the bank book
and the cash and bank book. Identify any
discrepancies.

30

Financial Management: Manage Revenue and Expenditures

Participant Guide

Practice Exercise for Verifying Bank Statements and Bank Book
Verify the sample bank statement and bank book using the information below.
Answer the following questions:

A

1. Are there any discrepancies between the cash and bank book, the bank book, and the bank
statement?
2. How would you resolve the discrepancy?

April 1996 Bank Deposit Entries and Withdrawals
Recorded in the Cash and Bank Book
Withdrawals

Deposits

9/4/96

$80

2/4/96

$130

18/4/96

$120

30/4/96

$100

26/4/96

$80

BANK BOOK
District

URD

Health Unit

Bamali

In

Out

Balance

$75

$1,050

Date

Description

No.

19/3/96

Withdrawal

W97

21/3/96

Deposit

D15

2/4/96

Withdrawal

Wil

9/4/96

Deposit

D28

$80

$1,100

18/4/96

Deposit

D42

$120

$1,220

26/4/96

Deposit

D71

$80

$1,300

30/4/96

Withdrawal

W37

$1,150

$100
$130

$100

$1,020

$1,200

(continued)

31

Financial Management: Manage Revenue and Expenditures

Participant Guide

ACCOUNT STATEMENT
Statement Date: May 8, 1996
Mr. Sabali Mbwoto
Bamali Health Committee
Bamali, URD

Standard Bank
Commerce Street
Tokama, URD

Summary for Account No. 23954-1294-82

Beginning Balance
Total Deposits
Interest This Period
Total Withdrawals 230.00
Service Charges
Ending Balance

$1,150.00
260.00

$1,180.00

Description of Account Transactions

Transaction

Beginning
Balance
Withdrawal
Deposit
Deposit
Deposit
Withdrawal

Date

Amount

$1,150.00

1/4/96

2/4/96
9/4/96
18/4/96
26/4/96
30/4/96

Balance

$130.00
$80.00
$100.00
$80.00
$100.00

$1,020.00
$1,100.00
$1,200.00
$1,280.00
$1,180.00

The facilitator will review this exercise during training.

> -fl

01^62.
32



Financial Management: Manage Revenue and Expenditures

Participant Guide

Step 6 - Make Sure that Money
Recorded in Patient Registers Matches
the Amount of Money in Receipt,
Debtors, and Exemptions Books
This step assumes that the cash and bank book is
being used at the health unit to record revenue
collected directly from patients.

• At the end of the day, compare the health unit
registers, receipt books, exemptions book, and
debtors book to make sure records match.
• Compare the health unit registers to the receipt
books, exemptions book, and debtors book:
to make sure all money is accounted for

to make sure records are accurate
to identify and resolve any discrepancies or
errors

to make sure patients are paying the correct
amount
to make sure the correct amount of money is
recorded in the cash and bank book

This activity assumes that the health unit keeps
separate receipt books for different services, such as
consultations, prescriptions, and lab fees.
• The health staff record in the appropriate health unit
register the health service that each patient receives.

• For example, if a patient has a consultation, the
health staff record the price of the consultation in the
patient register.

(continued)

33

Participant Notes

Financial Management: Manage Revenue and Expenditures

Participant Guide

• When a patient pays for the health service, the health
staff issue a receipt from the appropriate receipt
book.
• If a patient is unable to pay the full fee or is exempt,
the health staff complete either the debtors or
exemptions book, as appropriate.

• The amount of money recorded in each health unit
register should equal the amount of money recorded
in the appropriate receipt book, debtors book, and
exemptions book.

Equation for Comparing Health Unit
Records to Make Sure All Money Is
Accounted For
Amount of money in Patient Register =
Amount of money in Appropriate Receipt
Book + Debtors Book 4- Exemptions Book

Example:

Five patients have consultations. Each consultation
costs $1. One patient is exempt and another pays
only half the fee. The cost ofproviding the service to
all five patients is recorded in the patient register.
The entries in the health unit records are as follows:
Patient Register = $5.00
Receipt Book = $3.50
Debtors Book = $0.50
Exemption Book - $1.00

Use the equation to compare the health unit records
and to make sure all money is accounted for:
Amount of money in Patient Register =
Amount of money in Appropriate Receipt Book
+ Debtors Book + Exemption Book
$5.00 = $3.50 + $0.50 + $1.00

(continued)
34

Participant Notes

Financial Management: Manage Revenue and Expenditures

Participant Guide

How to Compare the Amount of Money Recorded in Patient
Register(s) and Receipt, Debtors, and Exemptions Books
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 patient register.

• If you find discrepancies, identify possible causes, such as:

recording errors

mathematical errors
debtors and exemptions recorded incorrectly
deferred payment

35

Financial Management: Manage Revenue and Expenditures

Participant Guide

ACTIVITY 1 - MANAGE REVENUE
PERFORMANCE CHECK 1

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 following sample forms
to complete the Performance Check:
receipts
debtors book
exemptions book

cash and bank book
deposit slips

1. Read the case scenario below. Complete receipts for money received and record information in
the debtors and exemptions books, as appropriate.
On 5 June 1996, Mongone Acheje paid $2 for 50 tablets of cotrimoxazole 400 mg + 80 mg.

On 6 June 1996, Alia Serote came in for some lab tests. She had only $1 to pay the $4 fee,
but promised to return with her rest of the money at the end of the week.
On 8 June 1996, Mary Mbwaje had her first prenatal care examination. The health unit
charges a flat fee of $8 for prenatal care services. Because Mary is very poor, the health
committee and community agreed that she is exempt from paying health services.

You are the Treasurer. On 10 June 1996, the health unit nurse, Sala Marika, gave you $75.50
collected from consultation receipts 0767-0780. Write a receipt for the money you received
from the health unit nurse.
2. You are unable to go to the bank on 10 June 1996 to deposit the money you received from the

health unit nurse. You keep the money in your safe box. Update the cash and bank book.

(continued)

36

Financial Management: Manage Revenue and Expenditures

Participant Guide

3. Add the following receipts and record the revenue in the cash and bank book on page 42.

Drugs Receipts for 11 June 1996

Receipt
Number

Name and Quantity of Item Issued and Fee Collected

0571

20 tablets of nalidixic acid, 500 mg

$1.00

0572

30 packets of oral rehydration salts

$3.00

0573

90 tablets of folic acid, 5 mg

$1.80

0574

25 tablets of acetyl salicylic acid, 300 mg

$0.50

0575

40 tablets of acetyl salicylic acid, 300 mg

$0.80

0576

2 tablets of mebendazole, 500 mg

$0.25

0577

30 tablets of folic acid, 5 mg

$0.60

0578

40 tablets of aluminum hydroxide, 500 mg $1.00

4. Read the case scenario below and complete the appropriate forms.

You want to deposit the $75.50 you received from the health unit nurse in the bank on 15
June 1996. You will deposit $70 in notes and $5.50 in coins. Complete a deposit slip.
Record the $75.50 you deposited in the bank on 15 June 1996 in the cash and bank book.
(continued)

37

Financial Management: Manage Revenue and Expenditures

Participant Guide

5. Use the information below to make sure that money recorded in the patient register equals the
amount of money in the receipt, debtors and exemptions books.

Ten patients have consultations. Each consultation costs $1. Two patients are exempt, one
patient will pay the fee at the end of the week, and another pays only half the fee. The entries
in the health unit records are as follows:

Patient Register = $10.00
Receipt Book = $6.50
Debtors Book = $ 1.00
Exemptions Book = $2.00
Answer the following questions:

a. Does the amount of money recorded in the patient register equal the amount of money in the
receipt, debtors and exemptions books?

b. If the records do not match, where is the discrepancy?

6. Use the following information to verify the bank statement and bank book. Identify any
discrepancies. Describe how you would resolve the discrepancy.

May 1996 Bank Deposit Entries and Withdrawals
Recorded in the Cash and Bank Book
Withdrawals

Deposits
9/5/96

$50

2/5/96

$100

18/5/96

$100

30/5/96

$150

26/5/96

$150
(continued)

38

Financial Management: Manage Revenue and Expenditures

Participant Guide

BANK BOOK
District

URD

Health Unit

Bamali
Balance

Out

Date

Description

No.

In

29/4/96

Deposit

D15

$100

2/5/96

Withdrawal

Wil

9/5/96

Deposit

D28

$50

$1,100

18/5/96

Deposit

D42

$100

$1,200

26/5/96

Deposit

D71

$150

$1,350

30/5/96

Withdrawal

W37

$1,150
$1,050

$100

$1,200

$150

ACCOUNT STATEMENT
Statement Date: June 8, 1996

Mr. Sabali Mbwoto
Bamali Health Committee
Bamali, URD

Standard Bank
Commerce Street
Tokama, URD

Summary for Account No. 23954-1294-82
Beginning Balance
Total Deposits
Interest This Period
Total Withdrawals 200.00
Service Charges
Ending Balance

$1,150.00
250.00

$1,200.00

Description of Account Transactions

Transaction

Beginning
Balance
Withdrawal
Deposit
Deposit
Deposit
Withdrawal

Date

Amount

$1,150.00

1/5/96

2/5/96
9/5/96
18/5/96
26/5/96
30/5/96

Balance

$100.00
$50.00
$100.00
$100.00
$100.00

$1,050.00
$1,100.00
$1,200.00
$1,300.00
$1,200.00

7. Let a facilitator know when you have completed the Performance Check.

39

Financial Management: Manage Revenue and Expenditures

Participant Guide

CASH AND BANK BOOK
Name of District:

URD

Sabali

Month:

Description Budget
(transaction) Category

Bank

Name of responsible person:.

Ref
no.

Date

Bamqli

Name of Health Unit:.

Debit
(out)

Credit
(in)

June

Year:.

J996

Cash

Balance

Debit
(out)

Credit
(in)

2,500.00

1/6/96

Balance
brought
forward

001

3/6/96

Drug
receipts
0555-0570

D

002

7/6/96

Purchase of
office
supplies

O

2,500.00

2,481.50

18.50

003

004
005

006
007
Totals
Balance carried forward

40

25.00

Balance

Total
Balance

150.00

2,650.00

175.00

2,675.00

175.00

2,656.50

Participant Guide

Financial Management: Manage Revenue and Expenditures

PLENARY DISCUSSION 1

While you are waiting for the plenary discussion, think about the following
questions:
How soon after you receive money should you update the cash and bank
book?
What benefits are there to issuing receipts from different receipt books?
What information does it provide?
What benefits are there to keeping a record of exemptions? What
information does it provide?
What would you do if you discover that the bank made a mistake in
updating your bank book after a deposit?

What can you do to improve how your health unit and health committee
manage revenue?

41

Financial Management: Manage Revenue and Expenditures

Participant Guide

ACTIVITY 2 - MANAGE EXPENDITURES
Introduction to Activity 2


It is important to properly manage expenditures:
to make sure that the health unit does not spend
more money than it has
to make sure that the health unit keeps to its
budget
to make sure the health unit does not run out of
money

Approval of Expenditures


Your health unit may decide that some expenditures
need to be approved.



The persons authorized to approve expenditures
may include:

Chairperson of the health committee
Treasurer
Health unit head


Obtain approval for large purchases:

to prevent one person from making large
purchases without consulting other health
committee members

to make sure other health committee members
agree that the purchase is reasonable and
necessary
to make sure that the purchase is consistent with
the health unit's budget and activities

42

Participant Notes

Participant Guide

Financial Management: Manage Revenue and Expenditures

Overview of How to Manage Expenditures


Use the following forms to manage expenditures:
cash and bank book

budget
cheques
requisition forms

Main Steps in Managing
Expenditures

1.

Determine if money is available for a
purchase or expenditure.

2.

Record expenditures in the cash and
bank book.

3.

Record expenditures in the Budget Item
Expenditure Form.

4.

Write a cheque.

5.

Make a requisition for large purchases.

Before you learn how to complete these steps, you
will learn what a budget is and how you can use it to
manage expenditures.


A budget is a financial plan for revenue and
expenditures for a given period.



A budget is a tool for coordinating revenues and
expenditures to meet workplan objectives.

(continued)

43

Participant Notes >

Financial Management: Manage Revenue and Expenditures

Participant Guide



A budget helps the health unit effectively manage
revenue and expenditures.
Participant Notes



The budget enables the health unit and health
committee to plan how it will spend its money.



A budget helps the health unit and health committee
make sure that money is available for the most
important expenses, such as drugs and supply
purchases.

Refer to the sample budget on the following page.


Use a budget:

to monitor expenses and make sure the health
unit does not spend more money than it has
to approve purchases and other expenses



Use the budget regularly to approve expenses and
ensure that the expenses do not exceed the amount
budgeted.

44

Participant Guide

Financial Management: Manage Revenue and Expenditures

BUDGET FORM
Health Unit:.

Bamali

District:

Budget for the Period: 01 / January / 96

To:

URD

30 I June / 96

1) Total Amount to be Budgeted

Cash and Bank Book

$5.900

Date 75 December 1995

Expected Revenue

$5,900

Total

$295

2) Reserve funds
3) High priority costs

3.1

Essential Drugs/Supplies (D)

3.2

Information Tools (I)

3.3

Fuel for cold-chain and sterilization (F)

3.4

Fuel for outreach activities (FO)

3.5

Workplan activities
3.5.1
3.5.2
3.5.3

Storage of drugs

$120

3.6

Electricity (E)

$20

3.7

Water (W)

$10

3.8

Salaries (S)

$1,320

Total high priority costs

4) Low priority costs

4.1

Workplan activities
4.1.1 Outreach

4.2

Allowances (A)

4.3

Office supplies (O)

4.4

Vehicle maintenance (V)

4.5

Cleaning supplies (C)

4.6

Building maintenance (M)

4.7

Furniture (FU)

4.8

Replacement cost (RC)

4.9

Miscellaneous (MS)

$20

$875

Total Low priority costs
5) Total high plus low priority costs
Signature
Signature
Committee Chairperson
Health Unit Head
Conchetta
Panala
Date Budget Approved: 18/ Jan 196

Signature
Committee Treasurer
Mkqmwe

45

Signature
District Medical Officer

Taluli

Financial Management: Manage Revenue and Expenditures

Participant Guide

Step 1 - Determine if Money is Available
for a Purchase or Expenditure

Participant Notes

• Before you spend money, make sure money is
available.
• Look at the current balance in the cash and bank
book, if available.
• Check the cash and bank book balance to make sure
there is money either in the bank or on hand to pay
for the expenditure.

• Do not spend more money than was budgeted.
• Use the Budget Item Expenditure Form to determine
if money is available for a given purchase or
expense.
• The Budget Item Expenditure Form relates to the
allocation of funds within the budget.

Budget Item Expenditure Form

$30

Category:

Vehicle maintenance (V) Amount Budgeted:

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

• The Budget Item Expenditure Form is known in some countries as the
vote book.

• 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.

(continued)

46

V.

Participant Guide

Financial Management: Manage Revenue and Expenditures

• Each item on the budget has its own Budget Item
Expenditure Form.

• Check the amount in the Balance column of the
Budget Item Expenditure Form to determine if funds
are available for a purchase.
Refer to the sample form on the previous page.
$17 is available for vehicle maintenance expenses.

47

Participant Notes \

Financial Management: Manage Revenue and Expenditures

Participant Guide

Practice Exercise for Determining if Money is Available Using a
Budget Item Expenditure Form
Read the case scenarios and use the sample Budget Item Expenditure Forms to determine if
funds are available for the expenditure.

Assume that you have looked in the cash and bank book and found that money is available. Now
you need to check the Budget Item Expenditure Form to determine if money is available for that
particular expenditure budget category.
1. The cashier requests $5 to purchase a notepad and some erasers. Is money available? How
much money can you give the cashier?
Budget Item Expenditure Form
Category:

Office supplies (0)

Amount Budgeted:

$20

Date

Description

Amount
Spent

Total Amount
Spent to Date

Balance

15 Feb 96

pens, paper

$5

$5

$15

30 March 96 pencils, paper

$7

$12

$8

2. The pharmacist requests $15 to replace a broken chair. Is money available? How much
money can you give the pharmacist?
Budget Item Expenditure Form
Category:

Amount Budgeted:

Furniture (FU)

$25

Date

Description

Amount
Spent

Total Amount
Spent to Date

Balance

15 Jan 96

stool for
delivery room

$9

$9

$16

17 March 96

small
consultation

$12

$21

$4

table

The facilitator will review this exercise during training.

48

Financial Management: Manage Revenue and Expenditures

Participant Guide

Step 2 - Record Expenditures in the Cash
and Bank Book
• Use the cash and bank book to record all
expenditures.

Refer to the completed form on page 52, as needed.
• For each expenditure, update the cash and bank
book:

1. Write the date of the payment in the Date
column.
2. Describe the entry in the Description column.
Include the cheque number if the purchase was
paid by cheque.

3. Write the budget category code in the Budget
Category column. For example, write "D" for
the purchase of drugs and supplies. Write "F"
for money paid for fuel for cold-chain and
sterilization.

4. Write the amount of money withdrawn in the
Debit column of the appropriate section.
If a cheque was written or money was
withdrawn from the bank, write the amount
in the Debit column of the Bank section.
If money was withdrawn from cash box,
write the amount in the Debit column of the
Cash section.

Add the amount in the Debit column from
the amount in the Balance column of the
previous entry in the appropriate section.
Write the total in the current entry’s Balance
column.
Add the amounts in the Bank Balance and
Cash Balance columns. Write the sum in
the Total Balance column.

49

Participant Notes

Financial Management: Manage Revenue and Expenditures

Participant Guide

CASH AND BANK BOOK

Name of responsible person:.

Ref
no.

Date

Bamali

Name of Health Unit:.

URD

Name of District:

Month:

Sabali

Description Budget
(transaction) Category

Year:.

March

Cash

Bank
Debit
(out)

Credit
(in)

1/3/96 Balance
brought
forward

1996

Balance

Debit
(out)

Credit
(in)

Balance

Total
Balance

1,500

400

1,900

001

3/3/96 Payment of
drugs
chq 0009

D

400

1,100

400

1,500

002

7/3/96 Purchase of

O

25

1,075

400

1,475

450

1,525

400

1,525

400

1,450

300

1,450

345

1,495

345

lf470

335

1,460

office
supplies

003

15/3/96 OPD
consultation
receipts
291-316

004

18/3/96 Bank deposit

005

19/3/96 Purchase of
cleaning
supplies

006 21/3/96

1,125

50
O

1,150

100

25/3/96 Drug receipts
126-144

D

008

25/3/96 Cold-chain
fuel
chq 0010

F

009

26/3/96 Fuel for
outreach

FO

50

1,050

75

Bank deposit

007

50

1,075

U

100

45

1,150

lf125

25

1,125

Totals
Balance carried
forward

50

10

Participant Guide

Financial Management: Manage Revenue and Expenditures

Practice Exercise for Recording Expenditures in the Cash and Bank
Book
Complete the cash and bank book for each case scenario:
1. On 29 April 1996, the Treasurer paid $12 in cash for office supplies.
2. On 29 April 1996, the Treasurer wrote a $1,000 cheque for the purchase of drugs and
supplies. The cheque number is 0010.

51

Financial Management: Manage Revenue and Expenditures

Participant Guide

CASH AND BANK BOOK
Name of District:

Sabali

Name of responsible person:.

Ref
no.

Date

Bamali

Name of Health Unit:.

URD

Description Budget
(transaction) Category

Month:

Cash

Bank
Debit
(out)

Balance

Credit
(in)

1/4/96 Balance
brought
forward

Balance
300.00

$3,300.00

2,940.00

300.00

3,240.00

311.50

3,251.50

305.50

3,245.50

312.60

3,252.60

212.60

3,252.60

3/4/96 Payment of
drugs
chq 0009

D

002

7/4/96 Delivery fee
receipts
0291-0300

U

2,940.00

003

8/4/96 Purchase of
office
supplies

O

2,940.00

004 21/4/96 OPD
consultation
receipts
0801-0802

U

2,940.00

60.00

Credit
(in)

Debit
(out)

Total
Balance

3,000.00

001

100.00 3,040.00

005 25/4/96 Bank deposit

1996

Year:

April

11.50

6.00

7.10

100.00

006 29/4/96 Lab fee
receipts
0500-0507

L

3,040.00

15.00

227.60

3,267.60

007 29/4/96 Drug
receipts
0711-0716

D

3,040.00

4.00

231.60

3,271.60

008

009

Totals
Balance carried
forward

-r I M - I I O

)' J

0^82-252

l


V O0'

V

Financial Management: Manage Revenue and Expenditures

Participant Guide

Step 3 - Record Expenditures on the Budget Item
Expenditure Form
• Use the purchase receipt and the cash and bank book to update the
Budget Item Expenditure Form.
Budget Item Expenditure Form

$30

Category: Vehicle maintenance (V) Amount Budgeted:
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

15 March 96

tires

$10

$23

$7

• To complete the form:
1. Identify all expenditures made during the day in the cash and
bank book.

2. For each expenditure type:

a. Find the appropriate Budget Item Expenditure Form.
b. Write the Date and Description of the expenditure.

c. Write the amount of money spent in the Amount Spent
column.

d. Calculate the Total Amount Spent to Date using one of the
following methods:
i.

Amount Spent + Total Amount Spent to Date of the
previous entry

ii. Total all the amounts in the Amount Spent column
iii. Subtract the Balance from the Amount Budgeted

e. Use the following equation to complete the Balance column:

Balance = Amount Budgeted - Total Amount Spent to
Date
53

Financial Management: Manage Revenue and Expenditures

Participant Guide

Practice Exercise for Completing the Budget Item Expenditure Form
Complete the Budget Item Expenditure Form for the following purchases.
1. The cashier paid $5 to purchase a notepad and some erasers on 12 April 1996.
Budget Item Expenditure Form
Category:

Office supplies (O)

Amount Budgeted:

$20

Date

Description

Amount
Spent

Total Amount
Spent to Date

Balance

15 Feb 96

pens, paper

$5

$5

$15

30 March 96 pencils, paper

$7

$12

$8

2. The pharmacist paid $15 to replace a broken chair on 15 April 96.
Budget Item Expenditure Form
Category:

Amount Budgeted:

Furniture (FU}

$25

Date

Description

Amount
Spent

Total Amount
Spent to Date

Balance

15 Jan 96

stool for
delivery room

$9

$9

$16

17 March 96

small
consultation
table

$12

$21

$4

54

Financial Management: Manage Revenue and Expenditures

Participant Guide

Step 4 - Write a Cheque
Participant Notes

• If funds are available and the purchase does not
require approval, pay in cash or write a cheque.
• Write a cheque when you need to buy something
expensive.
• There are three types of cheques:
Bearer cheque: anyone can cash it or endorse it

Order cheque: can only be cashed or endorsed
by the person to whom the cheque is addressed
Crossed cheque: can only be deposited to an
account. Provides additional protection against
theft or loss

275

Date 26/5/96
Amount $25,50

| Standard Bank
i
i
275
i
i
i
i
i
i
i
i

26 March

I Pay to the
| order of _ Maria Obweto

For —
Maria Obweto
— - I(
Allowance '

$

19 96

25.50

Twenty1 five dollars and 50/100 Dollars

i

Sal Mirazi

i

I 051401865 958372

• To write a cheque:

Write the name of the person who will receive the cheque in the
Pay to the order of line.

Write the amount of the cheque in numbers and letters.
Always sign and date the cheque.
Record the amount of each cheque on the counterfoil or cheque
book stub.

55

Financial Management: Manage Revenue and Expenditures

Participant Guide

Practice Exercise for Writing a Cheque
Write a cheque for the following case scenario:

The pharmacist, John Wasalo, requested $20.30 for motorcycle parts. You checked the
appropriate Budget Item Expenditure Form and found that $25 dollars are available. Write
a cheque for the amount requested.
725

725

| Standard Bank

Date

i
i
i
i
i
i
i

Amount

I Pay to the
| order of

19

i
i
i
i

Dollars

For

I 1948 35779 3950103

The facilitator will review this exercise during training.

56

Financial Management: Manage Revenue and Expenditures

Participant Guide

Step 5 - Make a Requisition for Large
Purchases
• For most expenditures, approval is given beforehand
because most items are not expensive.
• When expenditures reach a certain amount, it is
necessary to get approval.
• Health committee members should discuss the
amount above which a requisition should be made
and who will approve it.

• For large expenditures that require approval:
Obtain price quotations.

Make a requisition.
Obtain approval from authorized persons.

• Obtain price quotations:
to have a more accurate estimate of the cost of
the purchase or expenditure
to compare prices between competitors

to make sure you are not paying more for a
purchase than you should

• In some places, there may be preprinted requisition
forms.
• If preprinted requisition forms are not available, you
can easily make your own.

(continued)

57

Participant Notes

Financial Management: Manage Revenue and Expenditures

Participant Guide

• Complete a requisition form:

to inform the authorized persons of the amount of money that you
expect to spend on a purchase
to have a record that shows the expenditure was approved before
the purchase was made

Requisition No:

Date:

36

17 April 1996

Amount in numbers:

$250

Paid to: Anwar Humba
For the amount of (in letters): Two hundred fifty dollars
For: a new motorbike
Signature of applicant:

Anwar Humba

Signature of approval: Nelson Faluli

• To complete the requisition form:

a. Write a sequential requisition form number.

b. Write the date you complete the form.
c. Write the name of the person requesting the money in the Paid to
line.
d. Write the amount of money requested in numbers and in letters.

e. Describe the expenditure in the For line.

f.

Ask the authorized person(s) to approve and sign the requisition
form on the Signature of approval line.

g. Give the person requesting the money either cash or a cheque for
the approved amount.

h. Ask the person to sign his or her name in the Signature of
applicant line.
(continued)

58

Financial Management: Manage Revenue and Expenditures

Participant Guide

• After the purchase is made, the person who
requested the money should give you a purchase
receipt and any remaining funds.

• The money given should be accounted for.
• If funds remain from the purchase, update the cash
and bank book.
• If the requisition, receipt, and remaining funds do
not match, ask the person who requested the money
to explain what happened.
• Attach the purchase receipt to the requisition and file
it.

• If the purchase was not made:
Obtain the full amount of money that was given
to the person requesting the funds and issue a
receipt.

Update the cash and bank book.

59

Participant Notes

Financial Management: Manage Revenue and Expenditures

Participant Guide

Practice Exercise for Making a Requisition
Make a requisition for the following case scenario:
-

The pharmacist, John Wasalo, requested $170.00 to repair the leaking health unit roof.
He asked two contractors to estimate the cost and $170.00 was the best quote. Make a
requisition for the amount requested.

The facilitator will review this exercise during training.

60

Participant Guide

Financial Management: Manage Revenue and Expenditures

ACTIVITY 2 - MANAGE EXPENDITURES
PERFORMANCE CHECK 2

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 following sample forms
to complete the Performance Check:

Budget Item Expenditure Form
requisition form

cash and bank book
sample cheque

1. The nurse requests $25 for an office chair. Use the Budget Item Expenditure Form to determine
if money is available. Is money available for the purchase? Explain your answer.

Budget Item Expenditure Form
Category:

Amount Budgeted:

Furniture (FU)

$45

Date

Description

Amount Spent

Total Amount
Spent to Date

Balance

15 Jan 96

lamp

$10

$10

$35

(continued)

61

Financial Management: Manage Revenue and Expenditures

Participant Guide

2. The health unit head needs $1,000 to purchase drugs and supplies. Use the Budget Item
Expenditure Form to determine if money is available. Is money available for the purchase?
Explain your answer.

Budget Item Expenditure Form
Amount Budgeted:

$2,500

Category:

Resupply of (trues and supplies (D)

Date

Description

Amount Spent

Total Amount
Spent to Date

Balance

14/3/96

purchase drugs

$1,000

$1,000

$1,500

3. The nurse, Joseph Mendali, requests $500 to have the stock room door and windows secured and
to purchase a lock box for money kept at the health unit. Complete requisition form number 56.
Use today’s date.

Requisition No:

Date:.
Amount in numbers:.

Paid to:
For the amount of (in letters):.

For:.

Signature of approval:
Signature of receipt:.

(continued)

62

Financial Management: Manage Revenue and Expenditures

Participant Guide

4. The health committee and health staff approved the $500 requested to secure the stock room door
and windows and to purchase a lock box for money kept at the health unit. Sebo Dombe has
done the work and would like to be paid by cheque. Complete the following cheque for the full
amount using today's date.
534

534

; Standard Bank
i

Date

Amount

For

i
i
i

I Pay to the
| order of

$.

i
i
i
i
i ------------------------------------------------i
i
i

Dollars

I 1948 35779 3950103

5. Use the cash and bank book on the following page to record the following expenditures for
today's date.
$25 for an office chair was paid in cash

$ 1,000 to purchase drugs and supplies was paid by cheque 0025

$500 requested to secure the stock room door and windows and to purchase a lock box was
paid by cheque 0026

63

Financial Management: Manage Revenue and Expenditures

Participant Guide

CASH AND BANK BOOK

Sabali

Month:

Description Budget
(transaction) Category

Bank

Name of responsible person:.

Ref
no.

Date

Bamali

Name of Health Unit:.

Name of District:

Debit
(out)

Credit
(in)

June

Year:

1996

Cash

Balance

Debit
(out)

Credit
(in)

150.00

2,650.00

175.00

2,675.00

175.00

2,656.50

75.50

250.50

2,732.00

8.95

259.45

2,740.95

183.95

2,740.95

2,500.00

1/6/96

Balance
brought
forward

001

3/6/96

Drug
receipts
0555-0570

D

002

7/6/96

Purchase of
office
supplies

O

003

10/6/96

Consultation
receipts
0767-0780

U

2,481.50

004

11/6/96

Drug
receipts
0571-0578

D

2,481.50

005

15/6/96

Bank deposit

25.00

2,500.00

2,481.50

18.50

75.50

006
007
008

Totals
Balance carried forward

64

2,557.00

75.50

Balance

Total
Balance

Financial Management: Manage Revenue and Expenditures

Participant Guide

6. Update the Budget Item Expenditure Forms for the following expenditures for today's date.

$25 for an office chair was paid in cash
$ 1,000 to purchase drugs and supplies was paid by cheque 0025

$500 requested to secure the stock room door and windows and to purchase a lock box was
paid by cheque 0026
Budget Item Expenditure Form

Category:

Amount Budgeted:

Furniture (FU)

$45

Date

Description

Amount Spent

Total Amount
Spent to Date

Balance

15 Jan 96

lamp

$10

$10

$35

Budget Item Expenditure Form

Category:

Resupply of drug$ and supplies (D)

Amount Budgeted:

$2.500

Date

Description

Amount Spent

Total Amount
Spent to Date

Balance

14/3/96

purchase drugs

$1,000

$1,000

$1,500

Budget Item Expenditure Form

Category:

Amount Budgeted:

Building maintenance (M)

$850

Date

Description

Amount Spent

Total Amount
Spent to Date

Balance

1/2/96

repair broken
window pane

$8

$8

$842

7. Let a facilitator know when you have completed the Performance Check.

65

Financial Management: Manage Revenue and Expenditures

Participant Guide

PLENARY DISCUSSION 2

While you are waiting for the plenary discussion, think about the following
questions:
What is the most difficult part of managing expenditures?
For what amount do you need to complete a requisition form? How did
you determine that amount?

How do you manage emergency expenditures that would normally require
approval?

66

Financial Management: Manage Revenue and Expenditures

Participant Guide

ACTIVITIES 1 AND 2
PERFORMANCE CHECK 3

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 following sample forms
to complete the Performance Check:
cash and bank book

deposit slip
receipt

Budget Item Expenditure Form
requisition form

cheque

1. Read the case scenario on the following page. Complete the appropriate financial form for each
transaction.
2. Update the cash and bank book.

3. Let a facilitator know when you have completed the Performance Check.

(continued)

67

Financial Management: Manage Revenue and Expenditures

Participant Guide

Case Scenario
You are the Treasurer of your health committee. It is 18 June 1996 and you have many financial
tasks to complete today:
1. Collect $48 from the health unit cashier for drug receipts 0789-0800. Issue the cashier a
receipt.

Receipt No. 112
District:
Health Unit:.

Name:.

For:.
Amount:.

Dollar

Date:.
Signed:

2. The Secretary of the health committee needs some pencils and paper for the next health
committee meeting. He asks you for $5 in cash. Check the Budget Item Expenditure Form.
If funds are available, give him the money.
Budget Item Expenditure Form

Category:

Amount Budgeted:

Office supplies (O)

$20

Date

Description

Amount Spent

Total Amount
Spent to Date

Balance

15 Feb 96

pens, paper

$5

$5

$15

30 March 96

pencils, paper

$7

$12

$8

12 April 96

notepad, erasers

$5

$17

$3

(continued)

68

Financial Management: Manage Revenue and Expenditures

Participant Guide

3. The health unit head requests money for an operating table. She has checked with three
stores and cannot fmd a table for less than $125. Complete requisition form number 19.

Requisition No:
Date:.
Amount in numbers:.

Paid to:.
For the amount of (in letters):.
For:
Signature of approval:.

Signature of receipt:

4. Total the following drug receipts and update the cash and bank book.

Drugs Receipts for 18 June 1996
Receipt
Number

Name and Quantity of Item Issued and Fee Collected

0801

20 tablets of acetyl salicylic acid, 300 mg

$0.40

0802

20 packets of oral rehydration salts

$2.00

0803

30 tablets of folic acid, 5 mg

0804

25 tablets of acetyl salicylic acid, 300 mg

$0.50

0805

40 tablets of acetyl salicylic acid, 300 mg

$0.80

0806

50 tablets of cotrimoxazole 400 mg + 80 mg

0807

30 tablets of folic acid, 5 mg

0808

50 tablets of cotrimoxazole 400 mg + 80 mg

$0.60

$2.00
$0.60
$2.00
A

(continued)
69

Financial Management: Manage Revenue and Expenditures

Participant Guide

It is 19 June 1996. Complete the following:
5. There is too much cash at the health unit. Deposit $150 in the bank. Complete the deposit
slip below. Update the cash and bank book.
Notes

Standard Bank

Cash

Coins

Date:.

Account No..

Subtotal Cash

018475456

Total in words.

Cheques

Paid in by.

Subtotal Cheques

CASHIER
and stamp

Cashier's signature

TOTAL DEPOSIT

6. The operating table was approved. Write cheque 143 for $125 to your health unit head.
143

| Standard Bank

Date

i
i
i
i
i
8

Amount

| Pay to the
I order of

For

143

$.

i
i
i
i
i
i
i
i
i

Dollars

I 1948 35779 3950103

(continued)

70

Financial Management: Manage Revenue and Expenditures

Participant Guide

CASH AND BANK BOOK
Name of District:

Name of responsible person:.

Sabali

Month:

Description
(transaction)

Budget
Category

Bank

Ref
no.

Date

Barnali

Name of Health Unit:.

URD

Debit
(out)

Credit
(in)

June

Year:

J 996

Cash

Balance

Debit
(out)

Credit
(in)

2,500.00

1/6/96 Balance
brought
forward
001

3/6/96 Drug
receipts
0755-0766

D

002

7/6/96 Purchase fuel
for cold-chain

F

2,500.00

2,481.50

18.50

003
004

005

006

007
008
Totals
Balance carried
forward

71

25.00

Balance

Total
Balance

150.00

2,650.00

175.00

2,675.00

175.00

2,656.50

Financial Management: Manage Revenue and Expenditures

Participant Guide

PLENARY DISCUSSION 3

While you are waiting for the plenary discussion, think about questions that you
would like to ask the facilitator, or any observations you would like to share with
other participants.

72

Financial Management: Manage Revenue and Expenditures

Participant Guide

ACTIVITY 3 - PREPARE FINANCIAL REPORT
Introduction to Activity 3
• There are four main reasons why you should prepare
and use financial reports:

Use Financial Reports to:
Identify if your health unit is going
bankrupt.
Determine if your health unit can improve
activities.

Determine if your health unit is wasting
resources.
Ensure accountability.

Prepare Budgeted versus Actual
Expenditures Report
• At the end of the budgeting period, prepare a report
that compares the amount budgeted and the amount
spent for each expenditure.
• Compare budgeted and actual expenditures:

to determine if you spent more or less on each
category of expenditure than what was budgeted
to determine what you spent most of your money
on
• Use the budgeted and actual expenditures report in
the following ways:
If the amount spent exceeded the budgeted
amount, examine the possible causes.

(continued)

73

Participant Notes

Financial Management: Manage Revenue and Expenditures

Participant Guide

Identify how to adjust the amount budgeted for
the next budgeting period.

Participant Notes
• Use a form to help you complete the report.
Refer to the sample form on the following page.

• To complete the report:
1. Write the name of the district and health unit.

2. Write the date of the report.
3. Refer to the budget for the reporting period.

Write the name of each expenditure in the
Category of Expenditure column.
For each item in the Category of
Expenditure column, write the amount
budgeted in the Amount Budgeted line on
the report form.

4. Obtain the Budget Item Expenditure Forms. For
each category of expenditure, record the Total
Amount Spent to Date in the Amount Spent
column on the report form.

(continued)

74

Participant Guide

Financial Management: Manage Revenue and Expenditures

Report on Budgeted versus Actual Expenditures
District:

Health Unit:

Date:

Category of Expenditure

Amount
Budgeted

TOTAL

Observations:

Signatures:

75

Amount Spent

Difference

Financial Management: Manage Revenue and Expenditures

Participant Guide

5. For each item in the Category of Expenditure
column:

Participant Notes
Subtract the amount in the Amount Spent
line from the quantity in the Amount
Budgeted line.

Write the result in the Difference column.
6. Total the amount in the Amount Budgeted,
Amount Spent, and Difference columns. Write
the totals at the bottom of each respective
column in the Total row.

7. Check your calculations by subtracting the total
amount spent from the total amount budgeted.
The result should equal the total in the
Difference column.
8. Review the report and note any findings in the
Observations line. For example, include an
explanation of why the budget was not met.

9. Ask the appropriate people to sign the report.
• A difference that is negative between the amount
budgeted and the amount spent means a debt or an
overexpenditure.

• When you have a debt or an overexpenditure, do not
try to reallocate money from another item. This is
not possible or useful because it is already the end of
the budgeting period.
• During the next budgeting period, you should
increase the amount allocated to this item.
• When the amount budgeted minus the amount spent
is a large, positive amount, question the usefulness
of the budget item since very little money has been
spent.

76

Participant Guide

Financial Management: Manage Revenue and Expenditures

Practice Exercise for Preparing Budgeted versus Actual Expenditures
Report
Use the sample budget and sample information on the following pages to complete the blank
report form on page 79.

Amount Spent During January - June 1996
resupply of essential drugs and supplies

3,240

resupply of information tools

110

fuel for cold-chain and sterilization

115

workplan activities

140

fuel for outreach activities

38

salaries

1,320

office supplies

40

furniture

20

allowances

720

vehicle maintenance

40

cleaning supplies

20

building maintenance

18

replacement cost

25

water

10

electricity

15

miscellaneous

15

(continued)

77

Financial Management: Manage Revenue and Expenditures

Participant Guide

BUDGET FORM
District:

Bqmali

Health Unit:,

Budget for the Period: 01 / January / 96

To:

URD

30 I June I 96

1) Total Amount to be Budgeted
Cash and Bank Book

$5,900

Date 75 December 1995

Expected Revenue
$5,900

Total

$295

2) Reserve funds
3) High priority costs

3.1

Essential Drugs/Supplies (D)

3.2

Information Tools (1)

3.3

Fuel for cold-chain and sterilization (F)

3.4

Fuel for outreach activities (FO)

3.5

Workplan activities
3.5.1
3.5.2
3.5.3

Storage of drugs

_ $120

3.6

Electricity (E)

$20

3.7

Water (W)

$10

3.8

Salaries (S)

$1,320

Total high priority costs

4) Low priority costs

4.1

Workplan activities
4.1.1 Outreach

4.2

Allowances (A)

4.3

Office supplies (O)

4.4

Vehicle maintenance (V)

4.5

Cleaning supplies (C)

4.6

Building maintenance (M)

4.7

Furniture (FU)

4.8

Replacement cost (RC)

4.9

Miscellaneous (MS)

$20

$875

Total Low priority costs

5) Total high plus low priority costs

Signature
Committee Chairperson
Panala_____
Conchetta____
Date Budget Approved: 18/ Jan 196
Signature
Health Unit Head

Signature
Committee Treasurer
Mkamwe____

78

Signature
District Medical Officer
Taluli

Financial Management: Manage Revenue and Expenditures

Participant Guide

Report on Budgeted versus Actual Expenditures
Health Unit:

Date:

Category of Expenditure

Amount
Budgeted

District:

TOTAL

Observations:
Signatures:

79

Amount Spent

Difference

Financial Management: Manage Revenue and Expenditures

Participant Guide

Answer to the Practice Exercise

Report on Budgeted versus Actual Expenditures
URD

District:

Health Unit:

Date:

Bamqli

1 July 1996

Amount
Budgeted

Amount Spent

Difference

resupply of essential drugs and supplies

3,000

3,240

-240

resupply of information tools

100

110

-10

fuel for cold-chain and sterilization

120

115

5

fuel for outreach activities

40

38

2

salaries

1,320

1,320

0

water

10

10

0

electricity

20

15

5

workplan activities

140

140

0

office supplies

20

40

-20

furniture

25

20

5

allowances

720

720

0

vehicle maintenance

30

40

-10

cleaning supplies

5

20

-15

building maintenance

10

18

-8

replacement cost

25

25

0

miscellaneous

20

15

5

5,605

5,886

-281

Category of Expenditure

TOTAL

Observations: Amount of money spent on drugs exceeded budgeted amounts by $240 because a large quantity
of drugs was spoiled during the rainy season. $10 excess in resupply of information tools due to MOH price
increase. $20 excess in office supplies due to price increase. Excess in cleaning supplies and building
maintenance due to flooding of health unit facility. Excess in vehicle maintenance due partly to price increase.

Signatures:

Your signature

Other signatures

80

Financial Management: Manage Revenue and Expenditures

Participant Guide

If your health unit is doing forecast budgeting, read the following
section.
• You will also use budget item revenue forms to regularly monitor
revenue collected during the budgeting period.

Budget Item Revenue Form
Category: Deliveries Expected Revenue for: J Jan - 30 June 97 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

• You will create a budget item revenue form for each health unit
service that generates money.
• You will create new forms for each new budgeting period.
• Use the budget item revenue forms after you establish your budget.
• When you determine expected revenue, you should know the user
fees for each health unit service.

• By looking at these forms, you can quickly determine whether the
amount of revenue is progressing as expected.
• You can consider how health unit services are being implemented and
identify problems with the services if revenue is not progressing as
expected.

(continued)

81

Financial Management: Manage Revenue and Expenditures

Participant Guide

• At the end of the budgeting period, use the budget
item revenue forms to prepare a report that compares
expected revenue with actual revenue.
Refer to the sample report form on the following
page.

• This report form will help you to quickly compare
expected revenue with actual revenue. Develop your
own report to fit your local needs.

• The report will help you determine:
if you collected more or less for each category of
revenue than was estimated

which service generated the most money
• Use the report to adjust the expected revenue for the
upcoming budget, if necessary.
• For example, if you estimated that the health unit
expects $300 in delivery fees for a budgeting period,
and you collected only $200, identify the possible
reasons for the discrepancy.

• Determine whether you have made a calculation
error when estimating the expected revenue.
• Or, there may have been other reasons for the
discrepancy, for example, a decrease in the number
of expected patients.

82

Participant Notes

Participant Guide

Financial Management: Manage Revenue and Expenditures

Report on Expected versus Actual Revenue
Health Unit:

Date:

Category of Revenue

Amount
Expected

District:

TOTAL

Observations:
Signatures:

83

Amount
Collected

Difference

Financial Management: Manage Revenue and Expenditures

Participant Guide

ACTIVITY 3 - PREPARE FINANCIAL REPORT
PERFORMANCE CHECK 4

STOP
Do not begin the Performance Check until the facilitator has given you the instructions!

You will work individually to complete the Performance Check.

1. Use the following sample forms in the back of your Participant Guide to prepare a report on
budgeted versus actual expenditures:

a blank Budgeted versus Actual Expenditures Report form
a sample budget
information about money spent during July - December 1996
2. Discuss whether you should adjust the amount budgeted for the next budgeting period and how
you would do it, if needed.

3. Let a facilitator know when you have completed the Performance Check.

84

Participant Guide

Financial Management: Manage Revenue and Expenditures

Report on Budgeted versus Actual Expenditures
District:

Health Unit:

Date:

Category of Expenditure

Amount
Budgeted

TOTAL

Observations:

Signatures:

85

Amount Spent

Difference

Financial Management: Manage Revenue and Expenditures

Participant Guide

Amount Spent During July - December 1996

resupply of essential drugs and supplies

3,300

resupply of information tools

90

fuel for cold-chain and sterilization

130

workplan activities

140

fuel for outreach activities

45

salaries

1,320

office supplies

25

furniture

15

allowances

720

vehicle maintenance

240

cleaning supplies

5

building maintenance

15

replacement cost

25

water

10

electricity

30

miscellaneous

20

86

Participant Guide

Financial Management: Manage Revenue and Expenditures

BUDGET FORM

Bamali

Health Unit:.

District:

Budget for the Period: 01 I July / 96

URD

31 / January / 97

To:

1) Total Amount to be Budgeted
Cash and Bank Book

$5.900

Date 75 June 1996

Expected Revenue
$5.900

Total

$295

2) Reserve funds
3) High priority costs
3.1

Essential Drugs/Supplies (D)

3.2

Information Tools (I)

3.3

Fuel for cold-chain and sterilization (F)

3.4

Fuel for outreach activities (FO)

3.5

Workplan activities

3.5.1
3.5.2
3.5.3

Storage of drugs

$120

3.6

Electricity (E)

$20

3.7

Water (W)

$10

3.8

Salaries (S)

$1.320

Total high priority costs
4) Low priority costs
4.1

Workplan activities
4.1.1 Outreach

4.2

Allowances (A)

4.3

Office supplies (O)

4.4

Vehicle maintenance (V)

4.5

Cleaning supplies (C)

4.6

Building maintenance (M)

4.7

Furniture (FU)

4.8

Replacement cost (RC)

4.9

Miscellaneous (MS)

$20

$875

Total Low priority costs

5) Total high plus low priority costs
Signature
Signature
Committee Chairperson
Health Unit Head
Conchetta____
Panala____
Date Budget Approved: 18/ July 196

Signature
Committee Treasurer
Mkamwe____

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Signature
District Medical Officer

Taluli___

Financial Management: Manage Revenue and Expenditures

Participant Guide

PLENARY DISCUSSION 4

While you are waiting for the plenary discussion, think about the following
questions:

What is the most difficult part of preparing the report?
Who is most likely to use the report at your health unit?
Would you share the results of the report with the community? If yes,
what information do you think they should know?

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Media
4822.pdf

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