DECLARATION

 

I MISAGO Jean Pierre hereby declare that this internship report

conducted from 1st July to 31st July 2014 in Kabutare Hospital

under the supervision of the Director of Finance, Mr. Jean Claude

SEBUSHUMBA. This is my original work and has never been presented

elsewhere in any form for a word of academic qualification.

 

Date: ……………………………………

Signature: …………………………….

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DEDICATION

To:

The Almighty God

My Brothers and

Sisters

ACKNOWLEDGEMENT

Great thanks go to the Almighty God. It is under his mercy I have

been able to complete my internship and make this internship

report. I praise him for enabling me on my academic journey and

carry out this academic training in particular.

I thank the Authorities of the UR Huye Campus and the College of

Business and Economics (CBE) in conjunction with the Finance

Department that accorded me this period to conduct an internship

for the purpose of transforming the theoretical knowledge

acquired in class into the practical part of it.

Special thanks go to Director of Hospital Dr. Saleh, Director of

Finance Mr. Jean Claude SEBUSHUMBA, and the accountants Mr.

MUREKEZI Venant and Mrs. MUKASHEMA Alice, for according me the

training in that internship that modeled me with a lot of

experience in the institution.

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Thanks also go to the Government of the Republic of Rwanda, in

collaboration with FARG for their financial support. Without

funding, it would not have been possible for me to complete this

Bachelor’s degree.

Great appreciation is extended to my family for his valuable

support both moral and financial which made me fully compile my

internship.

Thank you for all your effort that directly or indirectly had a

positive impact on this work.

PREFACE

The internship that was conducted at the Director of Finance

lasted for four weeks from 1st July to 31st July 2014, allowed me

to reconcile the class theory with practice in order to introduce

myself to a professional life. I carried out my internship in

Finance department. The objective of this internship was to

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familiarize myself to the operations carried out in this

institution.

I realized that a good Financing has a great impact on the

economy of the country due to powerful commitment whereby the

preparation of efficient financial arrangements and improvement

in implementation of the conducted activities.

This internship report provides information on the background,

mission, vision, objectives and location of the Kabutare

Hospital. Therefore this internship report can act as a source of

information for anybody who wants to get information concerning

Kabutare Hospital.

In conducting this training, the trainee used scientific methods

acquired from Class to collect information about the institution.

These include participatory approach, observation, direct

interviews and documentation as methods to achieve the stated

objectives. It is upon these methods and data collected, that

conclusions and recommendations were based.

 Thus, this report is made up of four chapters:

Chapter one comprises of the general introduction, objectives,

methods of data collection and time schedule.

Chapter two represents the profile of the Kabutare Hospital,

location, historical background, mission, vision, objectives,

core strategic values and administrative structure of the

Kabutare Hospital.

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Chapter three comprises the factory organizational functions and

administration,

Chapter four comprises of SWOT (Strength, Weakness, Opportunities

and Threats) analysis, recommendations and conclusion

LIST OF ABREVIATION

ARV: Anti Retro Viral

CBE: College of Business and Economic

CHUB: centre hospitaliere universitaire de Butare

CS: Centre de Sante

FARG: Fonds de soutien et d’assistance aux rescapés du génocide

FIFO: First In First Out

FOSA: Formation Sanitaire

HIV: Human immunodeficiency virus infection

ICT: Information Communication Technology

PCA: Paquet Complémentaire des Activités

RRA: Rwanda Revenue Authority

SIS: Système d’Information Sanitaire

SWOT: Strength, Weakness, Opportunities and Threats

TBMR:

UR: University of Rwanda

VAT: value added tax

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CHAPTER I: INTRODUCTION

1.1 General introduction

Practical training is a field attachment course, which must be

carried out by all students at the University level in the final

year fulfillment of their Honors degree.

The course helps the students to have some practical knowledge

and experience of how different organizations function and how

different tasks are executed on the field.

Internship is one of the University courses scheduled in its

academic program to be undertaken by finishing students in their

academic cycle. It is a practical course intended to equip the

student acquainted with practical knowledge in his respective

field of study. The training is set to prepare the final year

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students to have the global picture of how practical work is done

from the view point of the field.

I carried my training course at the Kabutare Hospital in the

Department of Finance and Accounting. During the course of my

training, I was allocated to different divisions every week and

that gave the chance to understand how the Kabutare Hospital is

functioning as well as Financial and Accounting Department. I

learnt on the impact that different Department play on economy of

Kabutare.

The training took a period of four weeks from 1st July to 31st July

2014

This training is of vital importance in accordance with real and

professional applications of Finance and Accounting, principles

and techniques applied for the effectiveness of the Kabutare

Hospital.

It addresses to the concerned student the way how theories

studied in classes are feasibly applied on the field, and hence

offering him a conclusive orientation on how to practically do 

things thus  preparing for future employment.

In the due course, the internee makes an assessment on the

organization under study. In addition, the study and ultimate

report by the student help in more advantage towards the

accomplishment of his University and thus, the award of a

bachelor’s degree in the resultant end.

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1.2 Objectives of the internship course

The objectives of this study are divided into: general objective

and specific objectives

1.2. 1 General objective

The main objective of the internship is to provide students to

relevancy of the theoretical knowledge acquired in class with a

practical professional skills and experience about what and how

things are done on the professional field.

1.2. 2 Specific objectives

To put into practice what is theoretically taught in class;

To acquire skills needed to become practically oriented

professionals;

To give a chance to students of relating with the outside work

before graduating;

To prepare students for the tasks ahead;

To make students get acclimatized to the external environment;

To acquire practical knowledge and skills that I gained in theory

and linking them with the functioning of Kabutare Hospital

Finance unit;

To identify problems that affected accounting and debt recovery

department in CHUB;

To suggest possible solutions faced by accounting and debt

recovery department;

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1.3 Significance of the internship

The internship is very important as it helps the internee to

capture the knowledge from the field which is helpful for his/her

future employment opportunities. It is also a stepping stone in

the fulfillment of the academic requirement for the award of a

Bachelor’s degree in Economics. It adds to the existing

literature and guides for future practices and orientations to

the researchers as well as the improvements of the organization

where the training was done from.

1.4 Methodology

Methodology is the overall approach used to gather and

disseminate data from different parties. It includes methods and

techniques used by the trainee to arrive at information obtained.

It is therefore vital to mention the following modes utilized to

come up with significant data.

1.4. 1 Observation

The trainee also managed to observe how some activities were

performed. This also helped the internee to have knowledge on

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various sections like finance, accounting and development which

are linked together.

1.4. 2 Interviews

Data was also collected by use of interviews. The trainee carried

out interviews with different employees who were felt to have the

necessary data. Questions were asked to various workers and the

heads of different departments and sections and answers could be

noted down which proved significant for the study.

1.4.3 Participation

For better understanding of the function of the Kabutare

Hospital, the trainee actively participated in daily activities

carried out in the institution especially in the department of

Finance. This is useful to the internee because it developed the

team working spirit and increase in friendship which is very

important in organization development.

1.4.4 Documentation

This is a research technique used to collect data from the

existing literature for better understanding of a given

phenomenon under study. The internee managed to acquire herself

with the finance’s statistics department and duplicates with

other documents found in the Kabutare Hospital and Finance were

so useful.

1.5 Time schedule

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 After the admission of the internee to carry out her practical

training in the Kabutare Hospital, the time schedule was as

follows:

The trainee spent his first week in the documentation about the

institution and self introduction.

In the second week, the internee actively participated in some

activities carried out in the institution especially department

of Finance.

In the third, the internee has been shown how to prepare the

strategic of finance, resources used and employee’s management.

In the fourth week, the internee has been shown to prepare a

monthly and annual report.

1.6 Problems encountered in the training

In spite of the knowledge obtained which seemed interesting and

the collaboration with the employees, the trainee was faced with

some problems which had an effect on the quality of the knowledge

acquired. Those problems are as follows:

The financial problem affected the internee in terms of lack of

transport…

Time accorded to this training by the University was limited to

have sufficient knowledge. If the time could be increased, the

quality of knowledge would have been increased to a substantial

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level.  The scope to be covered was wide and therefore was hardly

possible to cover the scope of the study.

1.7 Organization of the Report

This work is organized into four chapters and arranged as

follows:

Chapter one comprises of the General introduction, Objectives,

Methods of data collection and Time schedule.

Chapter two represents the Profile of KABUTARE HOSPITAL in

general Its Localization, Historical background, Mission, Vision

Objectives, and Core functions.

Chapter three comprises the Kabutare Hospital’s organizational

functions and Administrative structure.

Chapter four comprises of SWOT analysis, Recommendations and

Conclusion.

CHAPTER II: HISTORICAL BACKGROUND OF KABUTARE HOSPITAL

2.1. Localization of District Hospital

Kabutare District hospital is located in the Southern Province,

Huye Distict, Ngoma Sector, and Kabutare Village. It is located

next to the Groupe Scolaire Officiel de Butare, opposite of

Gatagara High School and Kamena stadium.

2.2 History of Kabutare hospital

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Kabutare hospital has started its activities in 1957 as a center

for medical application of students. Those students were for

medical assistants section at Groupe Scolaire de Butare under the

initiative of frères de la charité, but it has become after a

Hospital of district.

It has been recognized officially as a Hospital in 1982, after

the beginning of the frères de la charité in 1994, and it has

become a public hospital.

It is located in Southern Province, Huye District, Ngoma Sector

preciously in Butare Cellule nearly the public road via Huye-

Gisagara Districts nearly Groupe Scolaire Officiel de Butare. It

is on 2 km from centre Hospitalien Universitaire de Butare and on

1 km from Butare center.

Kabutare Hospital serves the entire population of Huye District

which is 328 605 inhabitants on an area of 581.5 km2. Its density

is 510.3 inhabitants per km2. The growth rate is 2.6% but the

hospital serves the population of CS Save Gisagara District, CS

Ngera and Ngoma District Nyaruguru an estimated (40, 000)

population forty thousand inhabitants.

Kabutare Hospital has all the services of a district hospital

except Ophthalmology service. There is also a specialized

treatment of the remaining multi tuberculosis.

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2 3 MISSION, VISION AND VALUES OF KABUTARE HOSPITAL

2 3 1 VISION

The vision of Kabutare Hospital is to promote the health of the

population through the provision of quality health services

2.3. 2 MISSION

The primary mission of the hospital is to provide quality care to

the reference population. Customer satisfaction with the quality

of services received was 59% in the hospital Kabutare, this

percentage is very basic.

2.3.3 VALUES

Integrity: We act openly and honestly in all that we do.

Collaboration: we work together in cooperation, recognizing that

our combined efforts beyond what we can accomplish individually.

Interview: we treat those we serve with concern, kindness and

respect.

Commitment: We are committed to providing excellence in all

aspects of our work. Innovation: We believe that new ideas and

quick access to information will lead to better health care.

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Community: we recognize and respect the importance of health care

needs of our community. 

2.4 OBJECTIVES OF PROGRAMS AND AREAS OF SERVICE DELIVERY AND

SUPPORT OF THE HOSPITAL

2.4.1 To carry out the mission assigned to it, the hospital has

Kabutare sets broad objectives:

Improve the availability and capacity of human resources

Ensure the availability of drugs, vaccines and consumables.

Extend geographical accessibility of health care

Making services and affordable health care financially

Improve the quality and service demand and health care in

the control of diseases strengthening institutional

capacity.

Develop a system for proactive health and performance able

to identify health needs and make appropriate responses.

As part of strengthening the health system, the Kabutare hospital

plans to: Strengthen supervision of FOSA

2.4.2 Strengthen the capacity of the hospital in the coordination

and supervision centers Health of its coverage area.

Training Supervisory Development

Make available means of travel

Make available the tools of supervision

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2.4.3 Perform supervisory training and integrated at the health

centers.

Upgrade service standards Hospital

Create an emergency service repressing standards.

Improve the transport system emergency (number of

ambulances, communication delocalization, and coordination

of ambulances)

Evaluate the variations to the standards and needs support

systems based on population projections and changes the

positioning of the hospital.

Making a plan of fundraising in enhancing resources.

Make the argument of building a new modern hospital that

meets the norms and standards of a district hospital.

2.4.4 Strengthen Health of mother and child

• In collaboration with the district, monitor and evaluate the

effectiveness and efficiency of health programs to the needs and

priorities of the district.

• Ensure availability of all required quality services in

different programs at the hospital.

• Strengthen information services, education and communication at

the hospital.

• Improve supervision of health centers in the technical

activities against malaria and HIV.

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• Improve the system for monitoring pregnant women and lactating

women Strengthen activities

• Strengthen activities program for reproductive health (family

Planning, etc.)

1.3. Purpose of the Kabutare hospital

Kabutare hospital has the purpose of:

Providing quality care to patients in the fields of curative and preventive and in the medical consultation, medical surgical and obstetrical, Hospitalization, and psycho-social support,

Provide training to trainees the workers,

Framing technically health centers located in its coverage area.

2.5.2 Financial resources

Various national organizations and international contribute to

the operation of the hospital and these first intervene to

reinforce the subsidies granted by the government. In an explicit

way intervene:

The MINISTRY of Health which provides the drugs of first

requirement; NGO global fund, MAP, PNILT, GTZ, CARE

International also intervene with the financing of Kabutare

hospital. TRAC for the people alive with the VIH/SIDA;

Even though Kabutare Hospital received the grants/funds from the

budget of the government, they add the money collect from

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patients such as: Medical benefits/allowances; Private

room/hospitalization; Consultations; Transfers and counter

transfers of patients.

2.5.3 Material resourcesKabutare Hospital has the following material resources; the

drugs, the equipment of the offices, the buildings, 141 beds, 2

ambulance, etc. Each service is equipped according to the

capacity of the hospital. There are sufficient materials in

offices of consultation, operating room and laboratory. The

hospital has the capacity of 141 beds. Patients are hospitalized

according to diseases and those which can contaminate others.

2.6 relationships with environmentAs we have saw that above, the NGOs and the MINISTRY of health

which intervene for the financing of the hospital, The Kabutare

hospital collaborates with the Univetrsity of Rwanda especially

College of Medicine and Health Sciences, and other Institutes

that have Faculty of nursing and laboratory.

There is a very close cooperation between the Kabutare hospital

and the Centre Hospitalier Universitaire de Butare (CHUB), for

some transfers of which examination, with the Neuropsychiatric

center CARAES Butare for the transfers of mental patients whose

treatment exceeds the possibilities of the District Hospital.

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CHAPTER THREE: STRUCTURE OF KABUTARE HOSPITAL AND PRACTICAL

ACTIVITIES

3. 1 Introduction

Kabutare Hospital has the following services administration and

finance, emergency, outpatient internal medicine, surgery,

obstetrics and gynecology, pediatrics and nutritional

rehabilitation, mental health, ARV service office, pharmacy;

laboratory, dentistry, physiotherapy, radiology, neonatology,

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health and environment, management of health centers, health

information, TBMR.

Table 1 : Source Kabutare Human resource management archive

Finance unit department is a fundamental unit which is enable

Kabutare Hospital to function effectively, ensure reliable 21

Agents Qualification Numbers

Administration A0,A1,A2, 48

Doctors Generalists 12

Medical assistants A2 1

Nurses A1, A2, A3 =36+48+7

Pharmacist A0 1

Social worker A1 1

Clinical

psychologist

A0 2

Social worker A2 5

Social workers A0 1

Paramedical A1 15

Cleaners 20

Total 187

availability of financial resources and maximum internal

efficiency for Kabutare Hospital with concerned by all inflow

and outflow movement of the Hospital Furthermore Finance

department has the following services:

3.2 Human resource

Kabutare hospital disposes human resource with different competences. The following is the table describing the number of 187Employers.

3.2. Accounting service

The accounting service maintains all books of accounts and

responsible for the preparation of financial statements and

financial reporting to the appropriate authorities. This service

is broken down into the following section:

Chief accountant, accountants;

Both six cashiers supervised by chief accountant.

3.2.1The responsibilities of the chief accountant

Under the directorate of Finance, chief accounting officer is

responsible for:

Regularly hold all records and account creditors and debtors;

Make reconciliation of accounts; Reconcile bank account; Approve

the expenditure of cash in conjunction with the director of

Finance; Establish check /payment order for the files ready to be

paid; Develop to the intention of the director general a monthly

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payment plan according to the availability of funds; Clear the

check being honored and dishonored checks; Prepare financial

reports monthly, yearly and whenever necessary in compliance with

financial procedure of the center.

3.2.2 The responsibilities of the accountants

Under the authority of the chief accountant, the accountant is

responsible for: Review and verify all first-level parts of

disbursement; Controlling, centralizing and maintaining all

accounting records; Ensure all entry of accounting; Perform any

other tasks given by his or her superiors.

3.2.2.1 Duties of cashier in charge of income

Under the authority of the chief accountant, the cashier in

charge of income is responsible for: Establishing schedule for

payment by the sellers; Collecting and consolidating all

revenues; Reporting daily or revenues receipt; Depositing all the

revenues collected to the bank.

3.2.2.2 Duties of the cashier in charge of expenditure

Under the authority of the chief accountant, the cashier in

charge of expenditure is responsible for: Managing petty cash for

the expenditure and the refund cautions for hospitalization;

performing any other tasks given by his or her superiors.

3.3. Billing and debt recovery service

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Billing and debt recovery is fundamental service in Kabutare

Hospital which is concerned by all inflow and outflow movement of

the Hospital. It is the department which recovers funds and

delivers good services to the patients. This department is

divided into two subservices: Internal billing and debt recovery

subservice; External billing and debt recovery subservice.

All these categories of agent have different attributions

3.3.1 Reception agent

Reception and orientation of patients; Reception of funds from

patients; Transmission of periodical reports as required by

hierarchical authority; Tariff of medical services and medical

equipment consumed by patients;

3.3.2 External agent/recovery agent

Checking the accuracy of tariff before recording; To record day

to day credit invoice; To establish and submit invoices to

partners on time; Timely establishment and submission of invoices

to partners; To follow up the invoices until they are paid;

Periodical transfer of report as required by hierarchical

authority; Identify any problem relating to payment capacity for

the consumption of medical services.

3.3.3 Functioning of billing and debt recovery Manager

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Coordination of two levels cited above and makes their periodical

report; Distribution and follow up of the books utilized by

reception agent; Follow up of the payment of funds; Follow up of

return of utilized books; to ensure the way agents are applying

their attributions and establish their report.

3. 3 .5 some of the strategies put forth in order to overcome

those problems

The leaders of Kabutare Hospital have to put more effort and to

look for software program in order to reach a high level of

maintaining the data; The leaders of ICT option for the way of

improving technology and communication and install anti-virus in

computers and also internet in order to know the different

information; Constant training about the tariff for employees; As

the technology growth, the employees of accounting department

need the various training about the new software concern the

record and store the data in convenient way; The leaders of

Kabutare Hospital must recruit other employees in the service of

Cashier in order to deliver quick service;

3.4 Budget and finance service

Budget is an aid to coordinate what needs to be done and helps in

the implementation of that plan. Furthermore budget of Kabutare

Hospital generally includes both financial and non financial

aspects of the plan and it serves as a blueprint for the

institution to follow in an upcoming period.

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It consists of checking if the purchase requisition for money of

any item is falling under the project budget line of a specified

service and/or department and observing if their budget balance

is not over, you make a record of that purchase requisition

under the corresponding budget line and sign for a reception and

recording.

3.5Asset management service

This service of asset management department is very important for

Kabutare Hospital, because it help Kabutare Hospital to know the

whole assets and also it is responsible for checking the

available resources either movable or immovable assets acquired

by Kabutare Hospital.

CHAPTER III: REALIZED ACTIVITIES WITHIN SERVICES IN WHICH

INTERNEE PARTICIPATED

3.1 Introduction

This chapter is going to cover all activities carried out in

different services in which the trainee participated in during

her internship period in Kabutare District hospital. When I

started doing my internship, within this Hospital, internee

should have to work hard, to make in practice to reconcile the

class theory with practice in order to introduce myself to a

professional skill. I should have to be in contact with its

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services to know precisely in finance department that they hold

in their service and explore how it works to serve the Hospital.

3.2 Realized activities while carrying out the internship

3.2.1 Reception service

The internee participated in hospitals’ reception service

operations since the reception service is one of hospital

sections making hospital financial unity. Agents in this service

daily receive cash from patients in consultation need or cash

received against medical services provided during nights,

register them and draw bills against these cash so as to submit

them at the end of exercise.

3.2.2 Accountability service

Main activities done in the accountancy service are of two types

which are hospital revenues procedures and expenses procedures.

Thus, during the training period the internee has participated in

recording, classifying, preparing and keeping the hospital

accounting books.

A. Revenues procedures

The hospital refunds come from internal revenues such as medical

services sells and other activities which generate hospital

incomes which can not cover the normal hospital exploitation; and

external revenues such as subsidies either conditional or

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unconditional from government and hospital partners, from donors

and other contractual approach.

B. Procedures of expenditures

Different Procedures of expenses used at Kabutare Hospital were

differentiated as follows by the internee when he has been

participating in the hospital accountancy operations during the

training period:

Budgetary line

Budget is the process of the revenue and expenditures planning;

it provides to the organization the future estimation figure.

Expenses and Revenues must be daily registered in hospital

revenues journal book basing on the double entry registration

principal.

Expenses authorization

- All expenses must be authorized by the competent person,

here the hospital Director

- The payment of goods and services with value not more than

20 0000Rwf is done by cashier using petty cash with the

authorization from hospital Administrator or Titular,

- Buying goods and services with the value between 20 000Rwf

and 100 000Rwf must be submitted to the internal market

commission with at least 3 copies of bill/ invoice profroma,

- The supply of goods and services with the value more than

100 000Rwf is done following the public supply procedures,

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- When the verbal approbation is possible, the responsible who

normally authorizes expenses, must provide the letter by e-

mail, fax, or other support as confirmation of approbation,

and ensure that the document is immediately available to

support the account payment.

Justification documents

- All expenses must be supported by the document justifying

the payment such as contract, bills/ invoices, mission

orders…

Responsibility to save the titles of values is in the accountant

hands, while the cash books’ holding is in the hospital cashier

hand.

3.2.3 Stock management serviceIn the stock management service, the trainee participated

following how non- medical materials are organized at Kabutare

hospital. Those materials are: hospital beds, offices materials,

etc …. The trainee must know haw it acquired and it managed

The acquisition

On the basis of buffer stock, the stock manager passes the

purchasing demand to the hospital Director or titular and when

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the purchasing is approbated, the purchasing procedures are

lawfully applied.

The management

The management covers all hospital administrative and

maintenance and repairing aspects. It management is assured by

the stock manager using stock format made of following steps:

Stock entry: Following documents of supply must be

fulfilled: Supply bond, Demand bond, Invoice.

The stock manager verifies the quality and quantity of procured

goods and services with reference to the demand and supply bond

concerning the quantity and physical status concerning the

quality of goods. Goods or services are procured when are in the

conformity with the order. The stock manager sign on 1st and 2nd

copies of demand bond for the goods or services reception. Those

copies are registered by hospital Administrator. The 1st copy is

attached to the demand bond and both classified in stock in the

file of “executed demand file” while the 2nd one is attached to

the supply invoice.

Stock exit

The used method to make goods exit from stock is first in first

out (FIFO) There must be the requisition bond signed by demander

of goods for each service for efficacy and efficient distribution

of hospital materials.

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At the end of each month the stock manager must proceed to the

stock inventory. The annual inventory is done during the month of

July every year. This inventory helps in reconciliation of the

physical stock status which is established by the stock manager

and the stock form. This reconciliation is materialized on the

inventory form and on the stock forms by the biases of signatures

of Administrator or titular, and Procurement officer and stock

manager.

The stock inventory implies the computation of physical goods in

the stock and the approximation of theoretical balances. This

inventory is done by hospital procurement officer in

collaboration with the stock manager under the supervision of

administration and finance unity or any agent representing

him/her.

Following are types of stocks in the annual report:

- Expired stock: with no movement during 9 months

- Rarely consumed: Basing on the consumption rate the stock

would no longer finished during next 6 months

- Frequently consumed stock: This stock can be consumed during

only next one month.

A part from the stock, there is also other hospital materials

which are made of hospital property that are managed by hospital

materials manager

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3.3 Acquired Experience, Skills and Knowledge

As internee there are following activities relating some

classroom courses in which conducted to bridge the gap between

theories activities to the practical skills from the internship,

the internee acquired additional knowledge and skills from the

training.

a) Courses relating to accounting sciences: I participated

using the accounting techniques such as recording financial

transactions, writing in journal, applying double entry

principle. The trainee also participated in preparation of

all types of payment through either bank or cash. She also

involved in the stock management procedures.

b) Courses relating to the cash management: I participated in

managing liquidity at hand, checks, order of payments, and

so on. I checked also on principles of organizational

behavior and human relations at the same time the bill of

payment preparation.

CHAPTER 4: SWOT ANALYSIS, CONCLUSION AND RECOMMENDATIONS

4.1 SWOT Analysis

4.1.0 Introduction

SWOT analysis is a very effective way of identifying your

Strengths and Weaknesses, and of examining the Opportunities and

Threats you face. Carrying out an analysis using the SWOT 32

framework helps you to focus activities into areas where you are

strong and where the greatest opportunities lie. However the

factory smooth running and goals achievement is due to strengths

and opportunities.

4.1.1 Institution’s strengths

The following are strengths identified in Kabutare hospital

functioning:

Sufficient and modern basic equipments, tools and personnel.

Well designed jobs since in the manner that assigned tasks

can not cause duplications among their responsible.

Well comprehensible procedures to perform the assigned

tasks.

4.1.2 Weaknesses of Kabutare Hospital

Cash flow from operations excluding salaries

Aside from spending staff salaries, the hospital would even

be unable to finance itself local expenses: maintenance of

buildings and equipment, equipment purchases, staff

uniforms, paintings etc...

Or payroll accounts for almost 45% of revenue (about Rwf 17

million / month).

External financing and institutional

The share of foreign funding for the hospital Kabutare is

relatively low.

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Revenue over expenses

Spending Hospital Kabutare often exceed revenues. The

hospital records more and more debt to its customers.

Productivity tracking

The hospital does not perform budget forecasting or

evaluation of spending each year compared to planned

spending or the revenue collected from expected revenues.

4.1.3 Institution’s opportunities

- Being located in Butare city, Kabutare hospital has the chance

of benefiting from advanced infrastructures, such as energy power

in terms of electricity, internet means, good roads, and so on,

- Neighbouring the UR, Kabutare hospital has chance of acquiring

competent personnel working in all its services including

accounting, finance, and management in general,

- Also Kabutare hospital being located in the city, where many

people can have the capacity of paying health insurance premium,

others join association known as Mituelle de sante, MMI, RAMA,

and mituelle de sante universitaire, the number of people with no

capacity to pay health insurance premium is reduced. In this

regard, the problem of non payment of provided service is also

reduced.

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- Kabutare hospital is also neighbour of advanced hospital

(CHUB). This is the facility when the patient is in need of

extra-treatment, the transfer is made easily.

4.1.4 Institution’s threats- Even if the Kabutare hospital is located in the city where

customers are supposed have capacity to pay service provided to

them, there is another part of population rounding the hospital

which doesn’t have that capacity. This part produces the problem

of loss to the hospital.

- Difficulty of managing large institution with many services

leads by many people with different operations.

4.2 Conclusion

During the course of this training, the internee acquired

immeasurable benefits that support a lot to the theoretical

knowledge he attained in classes for a period of the last three

years.

Thus, the trainee ended his training with the general knowledge

of the functioning of the Kabutare Hospital especially how

directors of units coordinate efforts and how they efficiently

and effectively achieve the Hospital’s vision, mission, policies

and objectives. However a good deal of work is still required to

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formulate an adequate program for the success in implementation

of Hospital’s policies.

In one month of internship, the intern observed well how

Accountability department execute their day to day activities and

looked for some problems which can hinder those activities and

sought some of the strategies put forth in order to overcome

those problems. Furthermore, the intern himself examined the SWOT

analysis of the organization on which she based in drawing some

recommendations.

Even Kabutare Hospital encountered some problems; there are some

improvements in its operations such as working conditions,

introduction of computerized system without putting aside team

spirit among employees as well as good relation with patients.

4.3 Recommendation

The practical training that internee carried out in Kabutare

Hospital in the finance unit was successful, however, the trainee

would like to recommend about the functioning of the finance unit

and Kabutare Hospital in general as well as UR as follows:

To install powerful internet in the whole institution is very

crucial role because it help Kabutare Hospital to access more

either National or International information; Facilitate quick

payment from debtors: Example Community health insurance;

Constant training about different services required in Kabutare

Hospital;

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Increase the availability of drugs and vaccines;

To put a database for the whole institution in order to assure a

quick access to all data.

The institution like Kabutare Hospital should have a library in

order to facilitate to access to the necessary information to

Rwandan and foreign, patterns, interns and graduates who want to

carry out their research on Kabutare Hospital from the time when

most people wish to understand what Kabutare Hospital is

functioning;

The UR should give the interns enough time to carry out their

internship. This could enable them to cover all the necessary

trainings, practical sense and also to meet the employer’s needs;

Strengthen the institutional capacity, specialized services;

Finally, as we are integrated in eastern African community, the

Kabutare Hospital should give English training to its personnel

so as to allow them to collaborate and to compete with other

hospitals of eastern Africa and to meet its vision

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REFERENCES

Annual report of Kabutare Hospital ,2009and 2010

Plan strategique de l’hopital kabutare 2012-2018

Departments of finance’s documents,

Minisante report of 2012

Archivals of kabutare district hospital

The Kabutare hospital Business plan of 2011-2012

Règlement d’ordre intérieure de l l’hôpital de Kabutare et

attribution du Juin 2008

Deviations from standards developed of Kabutare.

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APPANDEX

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