Academic literature on the topic 'Management audit – Rwanda'

Abstract Objectives We investigated the quality system performance in Rwandan referral laboratories to determine their progress toward accreditation. Methods We conducted audits across five laboratories in 2017, using the Stepwise Laboratory Quality Improvement Process Towards Accreditation checklist. Laboratories were scored based on the World Health Organization grading scale (0-5 stars scale) and compared with earlier audits. Results Between 2012 and 2017, only one laboratory progressed (from four to five stars). Four of the five laboratories decreased to one (three laboratories) and zero (one laboratory) stars from four and three stars. Management reviews, evaluation, audits, documents, records, and identification of nonconformities showed a low performance. Conclusions Four of five laboratories are not moving toward accreditation. However, this target is still achievable by energizing responsibilities of stakeholders and monitoring and evaluation. This would be possible because of the ability that laboratories showed in earlier audits, coupled with existing health policy that enables sustainable quality health care in Rwanda.

Background and Objective: The Newborn Survival Case study in Rwanda provides an analysis of the newborn health and survival situation in the country. It reviews evidence-based interventions and coverage levels already implemented in the country; identifies key issues and bottlenecks in service delivery and uptake of services by community/beneficiaries, and provides key recommendations aimed at faster reduction in newborn mortality rate.Methods: This study utilized mixed method research including qualitative and quantitative analyses of various maternal and newborn health programs implemented in the country. This included interviewing key stakeholders at each level, field visits and also interviewing beneficiaries for assessment of uptake of services. Monitoring systems such as Health Management Information Systems (HMIS), maternal and newborn death audits were reviewed and data analyzed to aid these analyses.Results: Policies, protocols, various guidelines and tools for monitoring are already in place however, implementation of these remains a challenge e.g. infection control practices to reduce deaths due to sepsis. Although existing staff are quite knowledgeable and are highly motivated, however, shortage of health personnel especially doctors in an issue. New facilities are being operationalized e.g. at Gisenyi, however, the existing facilities needs expansion.Conclusion and Global Health Implications: It is essential to implement high impact evidence based interventions but coverage levels need to be significantly high in order to achieve higher reduction in newborn mortality rate. Equity approach should be considered in planning so that the services are better implemented and the poor and needy can get the benefits of public health programs.Key words: Bottleneck Analysis • Lives Saved Tool • Rwanda • Maternal and Newborn Health • Neonatal MortalityCopyright © 2017 Khurmi et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background: In 2009, to improve the performance of laboratories and strengthen healthcare systems, the World Health Organization Regional Office for Africa (WHO AFRO) and partners launched two initiatives: a laboratory quality improvement programme called Strengthening Laboratory Management Toward Accreditation (SLMTA), and what is now called the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA).Objectives: This study describes the achievements of Rwandan laboratories four years after the introduction of SLMTA in the country, using the SLIPTA scoring system to measure laboratory progress.Methods: Three cohorts of five laboratories each were enrolled in the SLMTA programme in 2010, 2011 and 2013. The cohorts used SLMTA workshops, improvement projects, mentorship and quarterly performance-based financing incentives to accelerate laboratory quality improvement. Baseline, exit and follow-up audits were conducted over a two-year period from the time of enrolment. Audit scores were used to categorise laboratory quality on a scale of zero (< 55%) to five (95% – 100%) stars.Results: At baseline, 14 of the 15 laboratories received zero stars with the remaining laboratory receiving a two-star rating. At exit, five laboratories received one star, six received two stars and four received three stars. At the follow-up audit conducted in the first two cohorts approximately one year after exit, one laboratory scored two stars, five laboratories earned three stars and four laboratories, including the National Reference Laboratory, achieved four stars.Conclusion: Rwandan laboratories enrolled in SLMTA showed improvement in quality management systems. Sustaining the gains and further expansion of the SLMTA programme to meet country targets will require continued programme strengthening.


 
 
 Risk management practices are currently a subject of interest and a novel impression beneath research and application by diverse organizations. Nevertheless, there seems much to be debated on this subject in terms of a general strategic risk management practices statement. There is uncertainty like, when there should be a declaration for each principal risk category the organization experiences or should exist a general risk management practices for the organization. A risk management practice is about achieving corporate goals. For many financial institutions (FIs), dual goals exist such as the social and economic perspectives. This study sought to analyze the effect of strategic risk management practices on corporate investment of selected financial institutions in Rwanda. The study aimed at establishing the effect of operational risk management practices, market risk management practices, compliance risk management practices and governance risk management practices on corporate investment in selected commercial banks in Rwanda. The study adopted descriptive research design. The study targeted 95 managers from finance, internal audit, risk compliance and operations departments. The sample size was 77 respondents. The research was conducted using primary and secondary data, which includes survey forms (questionnaires), interviews as well as reports of the targeted institutions. Information for the research were gathered utilizing organized surveys forms that were distributed to the targeted respondents. Narrative information obtained from interviews and open-ended questions in the questionnaire were analyzed using qualitative approaches. Validity and reliability of the instruments were tested using the Cronbach Alpha test retest methods. With the aid of Statistical Package for Social Science version 21.0, both descriptive statistics such as the means, modes, standard deviation, variances and inferential statistics were analyzed. The research revealed that management of operational risk has a constructive effect financial outcomes performance of financial institutions in Rwanda. The study found that there is a correlation between both operational risk management and market risk management and performance of the financial institutions. The research findings revealed that operational risk management (r=0.096, p<0.01), market risk management (r=0.506, p<0.01) and compliance risk (r=0.612, p<0.01) on corporate investments.
 
 

The Rio+20 outcomes document, the Future We Want, enshrines green economy as one of the platforms to attain sustainable development and calls for measures that seek to address climate change and biodiversity management. This paper audits climate change policies from selected east and southern African countries to determine the extent to which climate change legislation mainstreams biodiversity and wildlife management. A scan of international, continental, regional and national climate change policies was conducted to assess whether they include biodiversity and/or wildlife management issues. The key finding is that many climate change policy–related documents, particularly the National Adaptation Programme of Actions (NAPAs), address threats to biodiversity and wildlife resources. However, international policies like the United Nations Framework Convention on Climate Change and Kyoto Protocol do not address the matter under deliberation. Regional climate change policies such as the East African Community, Common Market for Eastern and Southern Africa and African Union address biodiversity and/or wildlife issues whilst the Southern African Development Community region does not have a stand-alone policy for climate change. Progressive countries like Rwanda, Uganda, Tanzania and Zambia have recently put in place detailed NAPAs which are mainstream responsive strategies intended to address climate change adaptation in the wildlife sector.Keywords: mainstreaming, biodiversity, wildlife, climate change policy, east and southern Africa

Abstract Background Neonatal mortality contributes to nearly half of child deaths globally and the majority of these deaths are preventable. Poor quality of care is a major driver of neonatal mortality in low- and middle-income countries. The All Babies Count (ABC) intervention was designed to reduce neonatal mortality through provision of equipment and supplies, training, mentorship, and data-driven quality improvement (QI) with peer-to-peer learning through learning collaborative sessions (LCS). We aim to describe the ABC scale-up in seven rural district hospitals from 2017 to 2019 focusing on the QI strategies implemented in hospital neonatal care units (NCUs) and the resultant neonatal care outcomes. Methods A pre-post quasi experimental study was conducted in 7 rural hospitals in Rwanda in two phases. The baseline periods were April-June 2017 for Phase I and July-September 2017 for Phase II; with end-line data collected during the same periods in 2019. Data included facility audits of supplies and staffing, LCS surveys of QI skills, and reports of implemented QI change ideas. Data on NCU admissions and deaths were extracted from Health Management Information System (HMIS). Facility-reported change ideas were coded into common themes. Changes in post-post neonatal mortality were measured using Chi-squared tests. Results NCUs were run by a median of 1 nurse [interquartile range (IQR):1–2] at baseline and endline. Median NCU admissions increased from 121 [IQR: 77–155] to 137 [IQR: 79–184]. Availability of advanced equipment improved (syringe pumps: 57–100 %, vital sign monitors: 51–100 % and CPAP machine: 14–100 %). There were significant improvements in QI skills among NCU staff. All 7 NCUs (100 %) addressed non-adherence to protocol as a priority gap, 5 NCUs (86 %) also improved communication with families. NCU case fatality rate declined from 12.4 to 7.8 % (p = 0.001). Conclusions The ABC package of interventions combining the provision of essential equipment to NCU, clinical training and strong mentorship, QI coaching, and the LCS approach for peer-to-peer learning was associated with significant neonatal mortality reduction and services utilization in the intervention hospitals.

Thesis (MTech. in Internal Auditing)<br>This study provides an analysis of the role of internal auditing in the organizational performance of the Rwanda Revenue Authority, and aim to show th importance of internal auditing within the organization.

Abstract in English, Xhosa and Southern Sotho<br>This study was about the lack of uniform financial reporting guidelines to be used by South African School Governing Bodies (SGBs) in preparing their financial statements and financial records, which resulted in the inconsistencies and the lack of comparability in the financial statements of section 21 schools. The researcher aimed to develop recommended practice guidelines to be used by SGBs of public schools in South Africa when preparing their financial statements. The research was conducted through a qualitative approach using document analysis, supplemented by individual interviews. Provincial guidelines and selected schools’ financial statements were analysed. Schools’ principals, finance officers, auditors, School Governing Body treasurers, as well as districts officials were interviewed. The participants were selected using a purposive sampling method. Without generalising, the findings revealed that the existing provincial guidelines as well as the financial statements of the selected schools, are not consistent. The inconsistencies affect the comparability of the financial information negatively and that may also have negative impact on the reliability of financial information. The findings from the interviews, supported by the literature review, revealed that there is a need for uniform guidelines in terms of preparation of schools’ financial statements. The findings also revealed that the majority of SGBs opt for the examination of accounting records and financial statements instead of the audit thereof. Recommended practice guidelines were developed using information acquired through the literature review and the data acquired through document analysis and interviews. The study recommended amongst others that a further study be conducted on the effectiveness of financial management training in addressing the financial reporting challenges of South African public schools and whether the examination (instead of audit) of schools’ financial records and financial statements should still be acceptable.<br>Thutopatlisiso eno e batlisisitse go tlhokagala ga kaedi e e tshwanang ya dipegelo tsa ditšhelete e e ka dirisiwang ke Makgotlataolo a Dikolo tsa Aforikaborwa (diSGB) fa a baakanya dikanego tsa ona tsa ditšhelete mmogo le direkoto tsa ditšhelete, e leng se se bakileng gore go se nne le go tsamaelana le tlhaelo mo ntlheng ya tshwantshanyego ya dikanego tsa ditšhelete tsa dikolo tsa Karolo 21. Maikaelelo a mmatlisisi e ne e le go tlhama kaedi e e tlaa atlenegisiwang ya tiriso e e tlaa dirisiwang ke diSGB tsa dikolo tsa setšhaba mo Aforikaborwa fa di baakanya dikanego tsa tsona tsa ditšhelete. Thutopatlisiso e dirilwe ka mokgwatebo o o lebelelang mabaka go dirisiwa tshekatsheko ya dikwalo, e tshegediwa ke dipotsolotso tsa batho bongwe ka bongwe. Go sekasekilwe kaedi ya porofense le dikanego tsa ditšhelete tsa dikolo tse di tlhophilweng. Go botsoloditswe bagokgo ba dikolo, batlhankedi ba ditšhelete, baruni, batshwaratlotlo ba Makgotlataolo a Dikolo, gammogo le batlhankedi ba dikgaolo. Bannileseabe ba tlhophilwe ka go dirisa mokgwa wa go tlhopha sampole ka maikaelelo. Kwa ntle ga go akaretsa, diphitlhelelo di bontshitse gore kaedi ya ga jaana ya porofense gammogo le dikanego tsa ditšhelete tsa dikolo tse di tlhophilweng, ga di tsamaelane. Go tlhoka go tsamaelana go ama go tshwantshanyega ga tshedimosetso ya ditšhelete ka tsela e e bosula mme seo se ka ama go ikanyega ga tshedimosetso ya ditšhelete. Diphitlhelelo go tswa mo dipotsolotsong, di tshegediwa ke tshekatsheko ya dikwalo, di senotse gore go na le tlhokego ya gore go nne le kaedi e e tshwanang malebana le go baakanngwa ga dikanego tsa ditšhelete tsa dikolo. Gape bontsi jwa diSGB bo itlhophela gore go tlhatlhobiwe direkoto tsa palotlotlo le dikanego tsa ditšhelete go na le gore di runiwe. Go tlhamilwe kaedi ya tiro e e atlenegisiwang go dirisiwa tshedimosetso e e bonweng ka tshekatsheko ya dikwalo le data e e bonweng mo tshekatshekong ya dikwalo le dipotsolotso. Thutopatlisiso e atlenegisitse, gareng ga tse dingwe, gore go nne le thutopatlisiso e nngwe ya nonofo ya katiso ya botsamaisi jwa ditšhelete malebana le go samagana le dikgwetlho tsa dipegelo tsa ditšhelete mo dikolong tsa setšhaba tsa Aforikaborwa gammogo le go bona gore a tlhatlhobo (go na le boruni) ya direkoto tsa ditšhelete le dikanego tsa ditšhelete tsa sekolo e sa ntse e tshwanetse go amogelesega<br>Ndzavisiso lowu wu lavisise hi makombandlela ya ndlela yo fanana yo endla xiviko xa swa timali leswi swi faneleke ku tirhisiwa hi va Tihuvo ta Vufambisi bya Swikolo eAfrika Dzonga ku nga South African School Governing Bodies (SGBs) ku lulamisela switatimende swa timali na tirhekhodo ta timali, leswi nga vangela leswaku ku va na mafambiselo yo ka ya nga fanani na ku va swilo swi nga pimanyiseki kahle eka switatimende swa timali eka swikolo swa Xiyenge 21. Muendli wa ndzavisiso u ve na xikongomelo xa ku endla xibumabumelo hi maendlelo na makombandlela lama ya faneleke ku tirhisiwa hi ti-SGB ta swikolo swa mfumo eAfrika Dzonga, loko swi lulamisa switatimende swa timali. Ndzavisiso wu endliwe hi ku landza fambiselo ra qualitative hi ku xopaxopa tidokumente, ku tlhela ku endliwa na mimburisano ya ti-interview na vanhu hi wun'we-wun'we. Makombandlela ya xifundzhankulu na switatimende swa timali swa swikolo swi xopaxopiwile. Ku endliwe mimburisano ya ti-interview na tinhloko ta swikolo (vaprinsipala), vaofisara va swa timali, vakamberi va swa timali (ti-odithara), vatameri va minkwama ya Tihuvo ta Vufambisi bya Swikolo (School Governing Body treasurers) xikan'we na vaofisara va tidistriki na vona ku endliwe mimburisano ya ti-interview na vona. Vokhoma-xiave va hlawuriwe hi ku tirhisa fambiselo ra sampuli ya xikongomelo ku nga purposive sampling method. Handle ko navisa vuyelo eka hinkwavo, vuyelo byi kume leswo makombandlela ya xifundzhankulu na switatimende swa timali eka swikolo swo karhi, a swi fanani. Ku hambana swi endla leswo ku nga vi na ku fambelana na ku pimanyiseka ka vutivi bya swa timali, na swona swi na vuyelo byo ka byi nga ri kahle na ku tshembeka eka vutivi bya swa timali. Vuyelo eka mimburisano ya ti-interview, hi ku seketeriwa hi ku hlayiwa ka matsalwa, swi kombise leswo ku na xilaveko xa makombandlela ya ku fanana hi ku landza ku lulamisiwa ka switatimende swa ta timali lomu swikoleni. Vunyingi bya ti-SGB byi endla na nkambelo kunene wa tirhekhodi ta timali na switatimende swa timali ku tlula ku lava leswo ku endliwa nxopanxopo lowu fambisanaka na ku xopaxopa vumbhoni bya swa matirhiselo ya timali ku nga auditing ya tibuku ta timali. Makombandlela lama ya bumabumeriwaka ya endliwe hi ku tirhisa vutivi lebyi nga kumeka eka ku hlayiwa ka matsalwa na data leyi nga kumeka hi ku xopaxopa tidokumente na mimburisano ya ti-interview. Ndzavisiso wu bumabumela, exikarhi ka swin'wana leswo ku endliwa ndzavisiso wun'wana hi ku tirheka ka vuleteri bya mafambiselo ya swa timali eka ku langutana na mintlhontlho leyi nga kona hi ku vika hi swa timali eswikolweni swa mfumo eAfrika Dzonga, no kumisisa leswo xana nkambelo kunene (ku nga ri nxopanxopo lowu xopaxopaku na vumbhoni ku nga auditing) ya tirhekhodo ta timali na switatimende swa timali swa ha fanela ku amukeriwa xana<br>College of Accounting Sciences<br>D. Phil. (Accounting Sciences)