A 2024 audit of the Ministry of Health has uncovered serious lapses in contract management, financial accountability and asset control, with millions of leones paid out for projects that remain unfinished years after contracts were awarded.
The findings are contained in the Auditor General’s Detailed Observations and Recommendations for the Ministry of Health for the 2024 financial year, raising concerns over the management of public funds in the health sector.
The audit revealed that in 2021 the Ministry awarded contracts worth NLe75,493,118 to 15 contractors for the rehabilitation of 12 government hospitals and the construction of three District Health Medical Team offices across the country. Fourteen of the contractors received 30 percent advance payments amounting to NLe21,342,544 after signing their agreements. However, as of the time of the audit, four years later, none of the projects had been completed.
Auditors recommended that the Ministry’s Procurement Committee urgently engage the contractors to ensure the timely completion of the stalled projects, warning that continued delays undermine service delivery in affected districts.
Concerns were also raised over an addendum contract for the construction of the Lumley Government Hospital. The Ministry signed the original contract with Fajaha Construction Company on 29 July 2014 and later entered into an addendum on 5 April 2024 for additional works valued at US$679,053.33, funded through the Strengthening Tertiary Service Project under the Kuwait Fund. Less than three months after the addendum was signed, the Ministry had disbursed 100 percent of the contract value without verification of completed work or any third-party validation. A site visit by auditors showed that key components of the project remained incomplete despite full payment.
The audit recommended that the Senior Permanent Secretary engage the contractor to complete the outstanding works or ensure that the full amount paid is refunded to the government.
The report also highlighted irregularities in payments for overseas medical treatment. A total of NLe3,468,406.80 was paid directly to 13 patients for medical bills instead of being paid to hospitals abroad or Sierra Leone’s embassies in the countries where treatment was to be received. Auditors noted that no justification was provided for making the payments directly to patients.
They recommended that the Director of Financial Resources provide documentary evidence of travel and treatment and justification for bypassing standard payment procedures.
Significant weaknesses were also identified in the Ministry’s asset management systems. Assets valued at NLe1,224,000, procured in 2024 for various departments, were not made available for physical verification and were not recorded in the Ministry’s asset register, exposing government property to potential loss or misuse.
In addition, 37 vehicles and 32 motorbikes listed in the asset register were not presented for audit inspection and ownership documents were not submitted. The audit further found that 194 vehicles recorded as Ministry assets were unroadworthy, with no immediate plan for repair or disposal. Some of the vehicles were reportedly abandoned in private garages, even as the Ministry struggled with insufficient transport for its operations.
Seven vehicles donated to the Ministry in 2024 by the World Health Organisation, valued at US$199,492.34, were also found to be unregistered and unlicensed.
In its official response, the Ministry said some vehicles were unavailable during verification due to emergency deployment for surveillance activities during the Monkeypox outbreak and that arrangements had been made for the assets to be presented to Audit Service Sierra Leone. Management also indicated that a memorandum had been forwarded to the Ministry of Works and Public Assets, with copies to the Assets Commission and the Ministry of Transport and Aviation.
However, the Auditor General noted that most of the issues remain unresolved, stating that assets worth NLe1,151,000 were still not presented for verification, 17 vehicles and all 32 motorbikes remained unverified and recommendations concerning unroadworthy vehicles had not been implemented.
The audit warns that failure to address these issues could result in significant financial losses to the state and further weaken healthcare service delivery across the country.
