Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1698928071368.pdf (Uganda)
I STATEMENT TO PARLIAMENT OF UGANDA FROM THE HON.

MIMSTER OF HEALTH, DR.JANE RUTH ACENG ON THE STATUS OF MEDICAL EQIIIPMENT PROCURED UNDER THE UGANDA HEALTH SYSTEMS STRENGTHENING PROJECT, FINANCED BY THE WORLD BANK The Rt.

Hon.

Speaker and colleagues The Government of Uganda received a Credit from International Development Association (IDA) of the World Bank amounting to USD 130 million towards the cost of implementation of UHSSP.
Out of the total funding of US$ 130 million, US$ 13.7 million was used to procure medical equipment.

The breakdown is as follows: Emergency Obstetric and Neonatal Care equipment (US$ 4.3 million) was distributed to 65 Hospitals and 165 HCIVs countrywide.

19 Hospitals and 27 HCIVs supported by the Project received general equipment (US$ 4.14 million), medical instruments (US$ 1.11 million); specialized equipment (1.13 million); and medical furniture (US$ 1.78 million).
Procurement for the above equipment started rn 2012 and was completed in 2014.

The 19 Hospitals future received x-rays (US$ 2.89 million), dental equipment (US$ 0.56 million) and laundry equipment (US$ 1.94 million).

This equipment required pre-installation works and its procurement started in 2015 and its installation was completed between March 2017 and June 2017.
Some of the medical equipment and furniture procured under the Project worth US$ 1.95 million was rejected by the National Advisory Committee on Medical Equipment (NACME) because it failed to meet the specifications that were provided by Ministry of Health.

The supplier was requested to withdraw the equipment from the health facilities in March 2014 and after protracted discussions, the suppliers accepted to withdraw the substandard equipment from our health facilities in September 2015.
The withdrawn equipment included but is not limited to: patient beds and mattresses; operating tables, bowl stands, cupboards, examination couches, filing cabinets, instrument trolleys, patients screens and delivery beds.

It should be noted that Government did not lose any money from this transaction since we still part of the contract value (25%) had been retained and was payable t upon installation and acceptance of the equipment.
When the equipment was rejected these funds were available to us to cover costs of replacement.

In rejecting the equipment my Ministry consulted and informed the relevant departments of Govemment including: the Solicitor General, Public Procurement and Disposal of Public Assets Authority (PPDA), and Ministry of Finance Planning and Economic Development (MoFPED).

The Solicitor General approved our request to reject and replace the equipment.
In January 2016, the World Bank approved our request to start a new procurement to replace the equipment.

Adverts were placed in the newspapers in April2016 and bidding closed in June 2016 and evaluation cornmenced immediately.

Samples were delivered to Uganda National Bureau of Standards (LINBS) for testing in July 2016 and the results were released in September 2016.

The bid evaluation report for supply of medical equipment was approved by the World Bank in November 2016.
The Solicitor provided clearance to enter into contracts with the best evaluated bidders in January 2017 and the contracts were signed in the same month.

Suppliers were then requested to fumish performance and advance payment guarantees in accordance with the contracts and these were received between February and March 2017.

The Bank of Uganda confirmed the authenticity of the guarantees in April 2017 and the letters of credit were opened on May 05, 20t7.
The suppliers are now expected to deliver the equipment to the health facilities by end of August 2017.

Allow me to add, that we have experienced delays, because we had to take much more caution and had to request UNBS to test and confirm samples and have also scheduled to carry out pre-shipment inspections to confirm that the quality standards agreed upon are adhered to.

I am confident that we are scheduled to receive equipment of high quality.
This notwithstanding, all delays in replacing this equipment are highly regretted.

On the use of the equipment, several of our partners in Government have taken keen interest in the procurement and use of the equipment including the Auditor General of Government and the Internal Auditor General and several reports have previously highlighted that some of the equipment we procured has not been put 2 to effective use.
Other reports cited that some of the equipment was missing or that some of the parts were missing.

The World Bank was also equally concerned and they recently conducted an independent and very comprehensive review and count of the equipment supplied.

They have produced a report which confirms that the equipment procured under this project was delivered and is available in health facilities.

They however also noted that some of the equipment is not in use.
Well aware of the non-use of some of the equipment in health facilities, we commissioned a review to establish which equipment are not in use and a plan to redistribute the equipment.

The teams have preparcd a report, which we are subjecting to a secondary review and approval so that we can redistribute some of this very critical equipment.

The key categories of equipment affected include: ventilators, defibrillators and Anesthesia machines.
The main reasons for some equipment not being put to effective use include: absence of Anaesthetic Officers in some health facilities, lack of reliable supply of oxygen for the ventilators, general lack of skilled personnel to operate the equipment, lack of adequate user training and intermittent power connectivity.

Future Plans to Avoid Supply of Substandard Equipment and Utilisation of Medical Equipment 1.
Starting with the replacement of the above medical equipment, we now require UNBS to test samples for quality and carry out pre-shipment inspections from the Country of Manufacture before the equipment is shipped and also carry out pre-acceptance inspections when the equipment is delivered to health facilities.

2.
2.

The Ministry has prioritized the training of Anesthetic Officers and Biomedical Engineers to make sure that we have adequate skills and competences to use the equipment and to provide routine maintenance.

3 3.

Robust needs assessment will be carried out for all new equipment to confirm that health facilities intending to receive the equipment have space, staff and the required skills to use the equipment.

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4.

The Ministry will hence forth sign maintenance contracts with suppliers of high value equipment for a period of 3 years and these will carry out preventive maintenance and repairs in case such equipment breaks down.

5.

The Ministry has carried out a comprehensive review of all equipment distributed under the Project and we are soon redistributing equipment not in use.

We will soon carry out a review of use of equipment in all health facilities countrywide focusing on high value equipment.
We will redistribute equipment from where it is not used to facilities that are ready to put it to immediate use.

I beg to move.

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