By: Mahamood Fofana
The 2024 Auditor General’s Report has revealed alarming gaps in the management and operations of the Makeni Regional Hospital, raising serious concerns about the quality of healthcare delivery in the Northern Region of Sierra Leone. The report highlights multiple issues ranging from poor procurement practices to the presence of ghost staff, underscoring systemic weaknesses in hospital administration.
According to the Auditor General, the hospital faced a short supply of dietary items amounting to NLe 503,115 for the period between 1st January and 30th September 2024. The contractor responsible for the supply failed to fulfill their obligations, and despite repeated follow-ups, the issue remained unresolved at the time of the audit. The Auditor General warned both the Permanent Secretary and the Assistant Director of Procurement at the Ministry of Health to ensure immediate supply, otherwise the full amount should be recovered and returned to the state treasury. The hospital’s Medical Superintendent and Hospital Secretary were noted to have only supervised the process but did not resolve the shortfall.
The report further exposed significant deficiencies in the Free Healthcare scheme, which is meant to provide essential drugs at no cost to under-5 children, lactating mothers, and persons with disabilities. Except for the maternity unit, which received 27% of the required drugs in 2024, the rest of the hospital departments went without supplies for three quarters of the year, forcing vulnerable patients to pay out-of-pocket in contravention of government policy.
Staffing issues were also highlighted, with only three staff operating the Free Healthcare pharmacy and a single staff member managing the Public Private Partnership pharmacy, preventing 24-hour operations. Shockingly, the hospital listed 36 staff members on its payroll, but only 10 were physically present during verification, while 26 ghost staff received salaries totaling NLe 1,012,200 in 2024.
Infrastructure and equipment at the hospital were described as “significantly deficient,” with the Auditor General noting inadequate medical equipment, poor infrastructure, and shortages of essential drugs across multiple wards and departments. These findings paint a worrying picture of a health facility struggling to meet the basic needs of the community it serves.
The report calls for urgent action from the Ministry of Health to address the mismanagement, recover funds from ghost staff, and ensure proper supply of dietary items and essential drugs, to restore the credibility and functionality of the Makeni Regional Hospital.
