This is according to the findings from Due Diligence which was conducted by URC in the middle of the compact development.
Results of the Due Diligence exercise were disseminated on Tuesday during the stakeholder workshop which also included the Ministry of Health.
The MCC awarded URC the five-year project in 2018 to work on Lesotho compact in collaboration with other stakeholders – the project ends in 2023.
The project supports MCC’s development of a compact for Lesotho to improve economic growth and reduce poverty through increasing the effectiveness and accountability of policy planning, coordination and execution.
MCC re-selected Lesotho as eligible for a second compact back in 2017. Signing of the compact is expected to take place in 2022 and implemented in 2023 and run until 2028.
The second compact is focused on improving capital investment as well as Health Systems Strengthening (HSS).
Through its Due Diligence findings, URC found quite a number of key weaknesses that need to be addressed. Challenges that are in line with financial management however are at the forefront and may threaten success of the second compact.
URC revealed that improvements are needed in the National System for accounting and budgeting as well as its implementation skills.
Particularly, weak systems in accounting for funding at the district level, including revenue accounting and the Integrated Financial Management Information System (IFMIS) should also be dealt with.
The URC findings further revealed that delays in funding warrant for district level work leads to delays in implementation.
Acting in his capacity as URC consultant, John Nkonyana explained among other things that IFMIS should be expanded at the district level to improve transactions.
“These are only proposed interventions. So we suggest that IFMIS be extended to the District level and hospitals. We also propose that block funding should be implemented because it will provide flexibility in the utilisation of funding at the district level so that we avoid a situation where money has to be returned from the district level even though they had needs.
“With the District Health Management Teams (DHMTs), we have seen the weaknesses around accountability and transparency. So we suggest that the DHMTs be capacitated with management skills. This is a wide range of helping them so that they can manage at a district level and the utilisation of funding,” Mr Nkonyana said during his deliberations on Tuesday.
He further recommended that quarterly reviews, which have been practiced in the past, should be reviewed and be properly organised this time around.
“There have been quarterly reviews made in the past, but they seem to have died a natural death. We propose that they be revived and properly organised so that they provide benchmarking, and provide progress monitoring as well as a situation where districts can compare performance,” the URC consultant added.
The Principal Secretary in the Ministry of Health, Khothatso Tšooana said the Health System Strengthening (HSS) is a framework for action that supports countries to scale up health systems and services.
He said Lesotho has benefited a lot from the United States government support in major areas, which include among others, the first compact development implementation which saw the country’s health facilities being renovated and new ones constructed.