Published on 17/07/2025
Members of Parliament on the Public Accounts Committee (PAC) have demanded answers from the management of Mulago National Referral Hospital regarding delays in implementing an ICT project worth UGX11.269 billion, aimed at digitizing patient care and management. The project is funded by the Korea International Cooperation Agency (KOICA).
The issue came up during a PAC meeting held on July 9, 2025, to review the Auditor General’s December 2024 report, which faulted the hospital for failing to implement several key initiatives, including the digitization project. According to the report, the project was not prioritized in the hospital’s work plans or budgets.
Mulago’s Executive Director, Dr. Rosemary Byanyima, attributed the delay to late disbursement of funds from KOICA.
“We developed the project and secured a grant from KOICA to digitize our processes. The financing protocol has been completed, but not everything could be concluded in the last financial year. We hope to begin implementation this financial year. Over five years, the grant will support the full digitization of both clinical and non-clinical operations,” Byanyima explained.
However, PAC member Silas Aogon (Kumi Municipality) expressed skepticism about the hospital’s readiness to execute the project.
“What gives you confidence that this will finally take off? Is there any formal communication from KOICA? What indicators can you point to that show this is actually moving forward?” Aogon asked.
PAC Chairperson Hon. Muwanga Kivumbi (Butambala County) pressed further, questioning whether Mulago had adhered to KOICA’s funding protocols.
“You failed to utilize the funds because you didn’t follow the required protocols. The Auditor General indicates that the funds were warranted to you. KOICA did not fail to provide the money—you failed to access it,” Kivumbi stated.
In response, Mulago Hospital Administrator David Nuwamanya clarified that while the funds were included in the budget and warrants were raised, the money was never actually received because KOICA had not yet disbursed it.
“Yes, it was in the budget, but there were no actual funds at the time of expenditure. KOICA had not released the money. Nothing was swapped back,” Nuwamanya said.
Asked for a project status update, Nuwamanya admitted the project was still at the feasibility study stage.
“We recently held a meeting with the Ministries of Health and Finance. KOICA has now agreed to resource the project and finalized the protocols. Although we had initially planned to start in the current financial year, we had to extend the timeline. The final feasibility study was just concluded two weeks ago with KOICA’s team,” he said.
This revelation angered PAC Chair Kivumbi.
“This is the problem. Agencies present rosy pictures by budgeting for projects before even conducting feasibility studies. How can funds be accessed under such circumstances?” he asked.
Dr. Byanyima explained that the digitization component was initially included during the hospital’s renovation and was meant to scale up existing systems. However, following a directive from the Ministry of Health requiring all referral hospitals to use a unified digital system, the hospital had to revise its plans.
“That’s why we had to conduct a fresh feasibility study. KOICA sent consultants, and we have now submitted the report and developed a work plan for implementation,” she said.
Domestic Arrears
Mulago Hospital also came under scrutiny for a sharp increase in domestic arrears, which rose by UGX4.96 billion—from UGX7.71 billion in June 2023 to UGX12.67 billion by June 2024—representing a 64% increase. According to the Auditor General, the arrears mainly comprise utility bills, with water bills accounting for UGX6.063 billion and electricity for UGX1.69 billion.
“The increase in payables affects sustainability of service delivery and could result in costly legal battles. The Accounting Officer blamed the surge in arrears on inadequate budget provisions, exacerbated by increased patient volumes and medical equipment,” the report noted.
Staffing Shortages
The hospital also faces severe understaffing. While the approved staff structure as of March 2024 provides for 2,351 personnel, the actual staff count as of April 2024 stood at only 1,369—representing 58% staffing and leaving a gap of 983 positions.
“Understaffing overstretches available personnel, causes job-related stress, and undermines service delivery. The Accounting Officer attributed this to insufficient wage allocations despite repeated requests for additional funding. The most affected departments include critical care, emergency, neurosurgery, transplant medicine, theatre, and geriatrics,” the report highlighted.
PAC also raised concerns about the underutilization of Mulago’s adult Intensive Care Unit (ICU). Despite a capacity of 44 beds, only 20 are currently in use—representing just 45% utilization. The committee called for urgent measures to improve efficiency and ensure that public resources are not wasted.
