Kakamega County Teaching and Referral Hospital (Kakamega County Government)

Annual Report and Financial Statements for The Year Ended 30th June 2025

Kakamega County General Teaching and Referral

HOSPITAL
(Kakamega County Government)

ANNUAL REPORT AND FINANCIAL STATEMENTS

FOR THE YEAR ENDED 30TH JUNE 2025

Prepared in accordance with the Accrual Basis of Accounting Method under the International Public Sector
Accounting Standards (IPSAS)
 Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

I. Contents
1. Acronyms & Glossary of Terms ..................................................................................................... iii
2. Key Entity Information and Management..................................................................................... iv
Vision.......................................................................................................................................................... iv
Mission ....................................................................................................................................................... iv
3. The Board of Management .............................................................................................................. vii
4. Key Management Team...................................................................................................................... x
5. Chairman’s Statement ..................................................................................................................... xiv
6. Report of The Medical Superintendent ........................................................................................ xv
7. Statement of Performance Against Predetermined Objectives .......................................... xvii
8. Corporate Governance Statement ............................................................................................ xxvii
9. Management Discussion and Analysis ..................................................................................... xxx
10. Environmental And Sustainability Reporting ....................................................................... xxxii
11. Report of The Board of Management ..................................................................................... xxxv
Vision..................................................................................................................................................... xxxv
Mission .................................................................................................................................................. xxxv
12. Statement of Board of Management’s Responsibilities ................................................... xxxvi
13. Report of the Office of Auditor General ............................................................................... xxxvii
14. Statement of Financial Performance for The Year Ended 30 June 2025 ............................ 1
15. Statement of Financial Position As At 30th June 2025 ............................................................. 3
16. Statement of Changes in Net Assets for The Year Ended 30 June 2025 ............................ 5
17. Statement of Cash Flows for The Year Ended 30 June 2025 ................................................. 6
18. Statement of Comparison of Budget and Actual Amounts for Year Ended 30 Jun 2025
8
19. Notes to the Financial Statements .............................................................................................. 10
20. Appendices ........................................................................................................................................ 57

ii
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

1. Acronyms & Glossary of Terms

Provide a list of all acronyms and glossary of terms used in the preparation of this report e.g.

CSR Corporate Social Responsibility

OSHA Occupational Health & Safety Act

PFMA Public Financial Management Act

MED SUP Medical Superintendent

KCGTRH Kakamega County General Teaching and Referral Hospital

Fiduciary Management Key management personnel who have financial responsibility in the

entity.

iii
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

2. Key Entity Information and Management

(a) Background information

Kakamega Hospital is a level 5 hospital established under gazette notice number 78, The County
Governments Acts (No.17 0f 2012) and is domiciled in Kakamega County under the Health
Department. The hospital is governed by a Board of Management.

(b) Principal Activities

Vision
To be a regional Centre of Excellence in holistic health care development, medical research and education
Mission
The mission of KCGTRH is to excel in providing healthcare services through the development of
infrastructure, human resources, medical supplies, training, research and the creation of a patient-friendly
environment.
Mandate
Professionalism and integrity- Ethical, honest, and have strong moral principles.
Competent and skilled. It also includes confidentiality and privacy
Accountability- The obligation of all staff in the Hospital to be responsible for activities and actions, and
to disclose the results in a transparent manner.
Customer Focus - Empathetic and caring, treating all people with worth and dignity and timely delivery
of services
Teamwork and Team Spirit - Co-operative or coordinated efforts among staff working together for the
interest of a common cause in the Hospital.
Security and Safety - Offering services in a secure environment free from errors, accidents, injuries and
infections.

(c) Key Management

County department of health
- Board of Management
- Accounting Officer/ Medical Superintendent
- Management
- Others (specify)

(d) Fiduciary Management

iv
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

The key management personnel who held office during the financial year ended 30 th June
2025 and who had direct fiduciary responsibility were:
No. Designation Name
1. Medical Superintendent Dr. Christian Lamba
2. Senior Health Administrator Mr. Hillary Keverenge
3. Head of finance CPA Wycliffe Wanzala
4. Head of supply chain Mr. Peter Wanjala Mandila
5. Nursing Officer Incharge Mr. Hillary Nandasaba
6. Clinical Officer Incharge Ms. Grace Okoth
7. Human Resource Manager Ms. Mary Ayoti
8 Medical Records In charge Mr. Samuel Soita
9 Nutritionist Ms. Maureen Nandwa
10 Public Health Officer Ms. Bethsheba Sifuna
11 Biomedical Engineer Mr. Marvin Nandwa

(e) Fiduciary Oversight Arrangements

[Here, provide a high-level description of the key fiduciary oversight arrangements covering
(say])
No Entity Role
1 Audit Committee and Finance committee Provide oversight of the financial reporting
activities process, the audit process, the system of internal
controls and compliance with laws and
regulations

2 Legislation, Oversight and

Senate Committee Activities Representation

3 Legislation, Oversight and

County Assembly Representation

4 Development partner oversight activities Predominant roles played by development

partners have been shown to include capacity
building, project planning, lobbying and
advocacy, others (including resource
mobilization) and financing respectively
5 Controller of Budget This role involves overseeing the
implementation of the budgets of both national
and county governments. The Controller of
Budget in this role therefore monitors the use of

v
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

public funds in-year and reports to Parliament

on how the funds have been utilised.
6 Office of the Auditor General The Auditor-General (AG) is mandated to audit
and report on the use and management of public
resources by public entities. Article 229(6) of
the Constitution requires the Auditor-General to
confirm whether public money has been applied
lawfully and in an effective way
7 Clinical Research and Standards Approve and regulate clinical trials on health
Committee products. Disseminate information on medical
products to health professionals and to the
public to promote their rational use. Collaborate
with other national, regional, and international
institutions on medicinal substances regulation.

- Clinical Research and Standards Committee.

- Audit committee
- Risk Committee
- County Assembly
- Parliamentary committees
- Other oversight committees

(f) Entity Headquarters

vi
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

P.O. Box 15
Fitina Road
KAKAMEGA, KENYA

(g) Entity Contacts

Telephone: (+254) 702930346

E-mail: [email protected]
Website: www.go.ke

(h) Entity Bankers

KCB Bank LTD Kakamega Branch

1. Revenue Collection A/C No:1152009575
2. Nhif A/C No:1152009362
3. Imprest A/C No:1252762488
4. Kcb Kakamega County Funeral Parlor SPA A/c 1335230114

Independent Auditors

Auditor General
Office of Auditor General
Anniversary Towers, Institute Way
P.O. Box 30084
GPO 00100
Nairobi, Kenya

(i) Principal Legal Adviser

The Attorney General

State Law Office
Harambee Avenue
P.O. Box 40112
City Square 00200
Nairobi, Kenya

(j) County Attorney

P.O. Box. 36
Kakamega, Kenya

3. The Board of Management

vii
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

Ref
Directors Details

He is a medical Doctor by profession

with wide experience in Paediatric
neurology as well as public health
training and fellowship paediatric
neurology. Over 30 years experience
1. in medical field.
Dr. Eren Oyungu
Medical Doctor
Paediatrician
Public health training
Fellowship paediatric neurology

Ms Joy Mudach is a teacher by

2. profession and current board member.

Ms. Joy Mudach-Member

Fr. Erambo represent religious

community at the hospital and he is
3.
the current member of the board.

FR. Maurice Erambo

viii
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

SHA Manager Kakamega branch . he

4. Job Mokaya serves in the board of management of the
county General hospital

Qualified orthopaedic surgeon with four

years’ experience in the industry. Has B.Sc.
5. Medicine{Orthopaedic}.Compassionate
doctor who always considers doctors needs

Dr. Christian Lamba and comfort.

Medical Superintendent

ix
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

4. Key Management Team

Ref Management Details

1.

Qualified orthopaedic surgeon with four years’

experience in the industry. Has B.Sc.
Medicine{Orthopaedic}. Compassionate doctor
who always considers doctors needs and comfort.
Dr. Christian Lamba
Medical Superintendent

Hillary Keverenge Vigatsi, Has BA Arts Egerton

University, Diploma in Human Resource
Management at Kenya Institute of Management
and Msc. Human Resource Management JKUAT.
He has over ten years of experience in matters
hospital management.

2. Mr. Hillary Keverenge

CPA Wycliffe Juma Wanzala is the

current Accountant of the county
general hospital m. CPA Wanzala has
Bachelor’s Degree in finance and
CPA qualifications. He is a member of
ICPAK in good standing.

3. CPA Wycliffee Wanzala

x
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

Mr. Peter Wanjala Mandila has Bachelor’s degree

in procurement and Contract management from
Mount Kenya University, Diploma in Business
Management from Kenya Institute of Management
and Certificate in Education from Vineyard
College. He has over 5 years experience in supply
chain management.

4. Mr. Peter Wanjala Mandila

Mr. Hillary is the current Nurse In charge at

County general hospital. He has Bachelor’s
of science in Nursing with over 10 years of
experience in the medical field.

5. Mr. Hillary Nandasaba

Mrs Okoth is a trained Clinician specialising

ENT. She Higher National Diploma in Audiology
and Diploma in Clinical Medicine and Surgery.
She has over 20 years’ experience in medical
field.

Mrs Grace Okoth

6. Principal Registered Clinical Officer (ENT)

xi
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

NAME: MARVIN NANDWA

Job Designation: Medical Engineering
Technologist 11
PROFFESSIONAL AND ACADEMIC
QUALIFICATIONS
Higher National Diploma in Medical Engineering
Diploma in Medical Engineering
Mr. Marvin Nandwa ACADEMIC QUALIFICATIONS
Medical Engineering Technologist 11 KCSE B-
7.
Name: Moreen Nandwa
1995: KCPE At Mukumu Girls
1999: KCSE At Lugulu Girls High School
2005: Bsc In Food Nutrition & Dietetic Second-
Class Upper Division
Kind Certified
2014: 6 Months Training By Msh On Leadership
Development Program
2015 Training Of Health Care Workers On
Nutrition Assessment On Tb In Patients
2017: One Week Training By KSG On Leadership
Management & Governance For Health Managers
2022: Seven Days Training On Babay Friendly
Moreen Nandwa Community Initiative Supported By Ubj
2024: Six Days Training On Baby Friendly
Hospital Initiative Supported By Who
8.

She is the current Human Resources manager for

the Hospital. She possesses Diploma in Human
resource management. Has over 28 years of
experience in matters personnel management.

9.
Mrs. Mary Ayoti

xii
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

Human Resource Manager

He is the Current In charge of Hospital Records

section. He possesses Bsc Health Records and
Information management.
He has over 20 years experience

Mr. Samuel Soita

10.
Health Records and Information Officer

xiii
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

5. Chairman’s Statement

On behalf of the Board of Management, I am pleased to present this report highlighting the key activities,
successes, challenges, and future outlook for the hospital during the year under review.

Over the past year, the hospital has continued to provide quality healthcare services to our community,
strengthening our commitment to excellence in patient care. Key achievements included the expansion of
our outpatient services, the acquisition of modern medical equipment, and the successful implementation
of community health outreach programs that have enhanced preventive care and health awareness.

Despite these successes, we have faced notable challenges, including rising operational costs, increased
demand for specialized services, and the need to continually upgrade our infrastructure to meet evolving
healthcare standards. These challenges, however, have strengthened our resolve to pursue innovative
solutions and strategic partnerships.

Looking ahead, the hospital remains committed to improving healthcare delivery through investment in
modern facilities, continuous staff development, and the adoption of digital health solutions. Our focus will
also be on strengthening partnerships with stakeholders to ensure sustainability and to meet the growing
health needs of our community.

I take this opportunity to sincerely thank the Board, management, staff, partners, and the wider community
for their unwavering support and dedication. Together, we will continue to build a stronger, more
responsive hospital for the future.

……………………………….
Name Dr. Eren Oyugi
Chairman to the Board

xiv
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

6. Report of The Medical Superintendent

It is my privilege to present the Medical Superintendent’s report for the year under review, highlighting
the hospital’s operations, achievements, challenges, and outlook.

1. Key Activities and Achievements

During the year, the hospital continued to strengthen its role as a trusted provider of healthcare services
in the community. Some of the notable achievements include:

• Service delivery: Expansion of outpatient and inpatient services, resulting in improved access
and reduced waiting times.
• Infrastructure and equipment: Acquisition of modern diagnostic equipment and renovation of
critical departments such as maternity, surgical, and emergency units.
• Community outreach: Successful implementation of preventive health campaigns focusing on
maternal health, child immunization, chronic disease management, and health education.
• Human resources: Recruitment of specialized medical staff and continuous professional training
for doctors, nurses, and support staff to enhance the quality of care.

2. Challenges Faced
Despite the successes, the hospital encountered several challenges:

• Rising costs of medical supplies and consumables due to inflationary pressures.

• High patient demand relative to available bed capacity and specialized services.
• Maintenance of aging infrastructure, which continues to strain financial and operational resources.
• Limited funding, which sometimes affects the timely acquisition of essential drugs and
equipment.

3. Financial Performance
At a high level, the hospital’s financial performance remained stable during the year. Revenue growth
was supported by increased patient attendance and the introduction of new services. However,
operational expenses—particularly on staff remuneration, utilities, and medical supplies—grew
significantly. The hospital has continued to exercise prudent financial management, ensuring
sustainability while seeking avenues to diversify income through partnerships, insurance collaborations,
and government support programs.

4. The Way Forward

Looking ahead, the hospital is committed to:

• Expanding infrastructure to accommodate the growing patient population.

• Investing in digital health technologies to improve efficiency, record management, and
telemedicine.
• Strengthening staff capacity through training, mentorship, and retention programs.
• Enhancing financial sustainability through improved billing systems, cost controls, and strategic
collaborations.

xv
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

In conclusion, I wish to express my sincere appreciation to the Board of Management, the dedicated staff,
our partners, and the community we serve. With continued collaboration, resilience, and innovation, I am
confident that the hospital will continue to achieve its mission of providing accessible, affordable, and
quality healthcare services.

………………………………………….
Dr. Christian Lamba
Secretary to the Board

xvi
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

7. Statement of Performance Against Predetermined Objectives

Kakamega County CIDP 2023-2027 has its goal stated as;

To achieve Social-economic transformation of the people through sustainable in all sectors by 2027.
To achieve this the county government of Kakamega has identified Five (5) strategic pillars within
the current strategic Plan for FY 2024/2025. These strategic pillars are as follows:
1. To improve food security from 80 per cent to 85 per cent by 2025.
2. To improve transport infrastructure.
3. To improve access to quality and affordable health services
4. To improve quality of education.
5. To improve access to clean and safe water.
Kakamega County General Teaching and Referral Hospital develops its annual work plans based
on the above pillars. Assessment of the Board’s performance against its annual work plan is done
on a quarterly basis. The Facility partially achieved its performance targets set for the FY 2024/2025
period for its strategic pillars, as indicated in the diagram below:

Strategic Objective Key Activities Achievements

Pillar/Theme/Issues Performance
Indicators
Pillar/ theme/ issue To Reduce Reduction of Number of 2,500
1: To Improve preventable preventable Emergency
access to quality and mortalities mortalities Surgeries done
affordable health Number of 1,000
services rehabilitative
Services started
Number of 5
departments
started
Percentage of 100%
clients
counselled and
tested for HIV

xvii
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

Number of 1,000
rehabilitative
Services started
Percentage of 98%
HIV positive
Clients linked to
care
Percentage of 99%
Clients with a
viral load of
<200cp
Number of 1,800
Women of
reproductive age
screened for Ca
Cervix
Number of stake 6
holders meeting
by MOH/partner
Improved Number of 2,200
Maternity Emergency
Services through Caesarean
operationalization sections done
of the Theatre
Number of open 24/7
Maternity Days
done

To provide Increased number Number of new 500

accessible of diagnostic diagnostic tests
and tests carried out done
appropriate by the facility

xviii
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

curative and Introduction of Number of 10,000

diagnostic specialized clinic Clinics done
services

The hospital is also guided by the following pillars in discharging its mandates;
Pillar 1: Service Delivery
Pillar 2: Health system financing
Pillar 3: Health Information system
Pillar 4: Human resource
Pillar 5: Infrastructure, equipment and Technologies
Pillar 6: Leadership and Governance

Kakamega County General Teaching and Referral Hospital develops its annual work plans based on the
above 6 pillars/Themes/Issues. Assessment of the Board’s performance against its annual work plan is done
on a quarterly basis. The Kakamega County General Teaching and Referral Hospital achieved its
performance targets set for the FY 2024/2025 period for its 6 strategic pillars, as indicated in the diagram
below:

Strategic Objectives Key Performance Activities

Pillar/Them Indicators
e/Issues
I Service 1.1Maintain supplies % availability of Stock forecasting and timely
Delivery in all service centers supplies ordering
% increase for Lobby for increased allocation
allocation of HPTs for HPTs
1.2. Maintain timely Average patient waiting Optimize patient flow processes
access to healthcare time and staffing
services

xix
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

% of patients seen Set clear service benchmarks

within the target and monitor compliance
timeframe
Review admission and discharge
processes

Audit service delivery charter

and implement
recommendations
1.3. Increase access to No. of integrated Implement outreaches plan
care outreaches conducted
% increase in patients Launch awareness campaigns to
visits from targeted promote available services
communities
1.4 Improve patient No. of Resolved safety Develop and implement a robust
safety incidents incident reporting system
Compliance rate with Conduct regular safety audits
patient safety protocols and compliance checks
No. of HCWs sensitized Sensitization on safety protocols

1.5 Optimize Customer satisfaction Conduct Biannual customer

customer experience index satisfaction survey
Implement recommendations of
customer satisfaction survey
reports
%customer complaints Implement customer feedback
resolved mechanisms
No. of surveys/audits Conduct exit audits and surveys

1.6 Enhance clinical % reduction in LOS Develop and implement

governance treatment protocols

xx
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

% reduction in mortality Conduct monthly mortality

rates audits
No. of audits Carry out annual SOPs audit

% of audit Implement SOP Audit

recommendations recommendations
implemented
No of Clinical Audits Conduct clinical audits

% of audit Implement clinical audit

recommendations recommendations
implemented
%reduction in HAIs Implement IPC policies and
guidelines
No. of surveillance Conduct annual surveillance of
reports HAIs
% reduction in medical Monitor, report and implement
errors the recommended mitigation
measures for medical errors
No of surveys/audits Conduct exit audits and surveys

2 Financial 2.1. Increase revenue % increase in total Implement an electronic billing

. stability collection revenue system at strategic points to
streamline invoicing and
payment processes.

Negotiate with NHIF for

enhanced medical packages.

Negotiate and onboard other

private insurance companies.

xxi
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

Annual review of user fee

Cost management Develop cost management

strategy strategy
%implementation of Implement cost management
cost management strategy.
strategy
No of proposals Develop funding proposals
developed and funded

Functional Amenity Operationalization of Amenity

wing
Functional Credit Establish and operationalize
Control Unit credit control unit.
2.2. Budget and % of budget variance Procure and maintain automated
manage resources from planned financial management system
appropriately expenditures
No. of resource Establish a quarterly review
allocation reviews committee to assess resource
conducted annually allocation effectiveness
% increase in revenue Implement recommendation by
collected the revenue collection
committee.
2.3Automate revenue No. of system audits Conduct annual system audits.
collection
3 Health 3.1. Enhance Data % of departments with Procure and deploy a
. Information quality and integrity functional EMRs comprehensive EMR system
System

xxii
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

% of patient records Implement a patient portal that

digitized and accessible allows patients to access their
through the HMIS appointments (Bulk messaging).
3.2 Strengthen Data % of staff trained on Customize and Implement
Security and Privacy data privacy policies policies on procedures for data
management, data quality,
access and sharing.
3.3 Promote Data- Average time taken to Invest in Data analytics and
Driven Decision generate reports and build capacity of Staff to
making analyze data for generate reports.
decision making
3.4 Increase staff % of staff trained on Sensitize staff on HMIS
Competency in HMIS
Health Information Implement health information
Management strategy
. Meeting 4.1 Hire and retain the Training needs Develop training needs
4 WHO skilled people assessment tool assessment tool
staffing TNA report Conduct training needs
needs and 4.2 Develop assessment
develop competent % implementation of Implement the training needs
highly workforce TNA reports assessment report
skilled and
competent Staff sensitization Develop a framework for
workforce Framework staff sensitization on
strategies, policies and plans
Workload report Undertake a workload analysis

No. of staff recruited Recruit temporary staffs to

supplement Permanent and
Pensionable employees

xxiii
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

Proportion of HCWs Implement performance

appraised management system
% compliance with Implement reward and sanctions
program programs
Succession plan Develop a succession plan

% implementation of Implement succession plan

plan
Talent management Develop talent management
strategy strategy
%implementation of Implement talent
Strategy management strategy
5 Upgrade 5.1 Improve Master Plan Customize Facility Master Plan
and healthcare
% implementation Implement Facility Master Plan
modernize infrastructure
hospital 5.2 Invest in Medical of the plan
infrastructu equipment and Units constructed and Construct (Cancer Centre,
re and technology commissioned Radiotherapy unit, Palliative,
medical Hospice, central store, perimeter
equipment 5.3 Enhance research wall, wellness Centre, Drug and
through and innovation substance abuse Centre,
innovation Theatres)
and Renovation plan Develop a renovation plan
research. % implementation of the Implement renovation plan
plan
Green energy Develop and implement green
framework energy management framework
% implementation of the Implement Green energy
framework framework.
Procurement Plan Develop a procurement plan

xxiv
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

% implementation of the Implement procurement plan

plan
No of PPMs Develop PPMs
% implementation of the Implement PPMs
PPMs
No of Equipment on Institute Equipment Placement
placement contracts contract
No of equipment on Initiate equipment leasing
lease contracts contracts
No of equipment on Contract and Implement Service
service contracts contracts for equipment
Replacement Plan Develop an Equipment
replacement plan
% implementation of the Implement Equipment
replacement plan replacement plan
Research funding Develop a research funding
Tracking Tool tracking tool

% implementation of the Implement a research funding

tool tracking tool
Proposal writing and Establish a framework to
dissemination support proposal writing,
framework dissemination and
No of research implementation
proposals
No of staff trained in
research
No of symposiums
No of conferences

xxv
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

Knowledge Develop a knowledge

management and management and innovation
Innovation Strategy Strategy
% Compliance with Implement knowledge
strategy management and innovation
Strategy
6 Develop 6.1 Foster a culture of No. of ethical practices Organize regular workshops on
. strong transparency and sessions conducted ethics and accountability for all
leadership accountability staff.
and 6.2 Strengthen % coverage of Customize and Distribute IEC
governance governance departments materials
structures structures No. of new MOUs Streamline process flow for
6.3 Facilitate signed MOUs and contracts.
community
No. of new partners Develop partnership proposals.
engagement
Framework Develop a framework for project
6.4 Improve
planning and implementation
partnering and
Resource mobilization Develop a resource mobilization
resource
strategy strategy.
mobilization
% of mobilized Implement resource
6.5 Enhance risk
resources against target mobilization strategy.
management
6.6 Improve
Risk management Develop a risk management
administration
framework framework
process
% Implementation of Implement a risk management
6.7 Improve
Risk management framework
management of
framework
resources

xxvi
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

8. Corporate Governance Statement

The Kakamega County General Teaching and Referral Hospital Management Committee was appointed
and gazetted on 18th February, 2022 The Kenya Gazette Vol.CXXIV – No. 31. The members are as listed
below:
1.Dr.Eren Oyungu – Chairperson
2.Medical Superintendent – Secretary
3. Mr.Hillary Keverenge – Member (representing the office of the Hospital Administrator)
4. Joy Mudachi– Member
5. Fr.Maurice Erambo– Member
6. Joab Mokaya – Member
7. Mr. Alfred Ekesa – Member
8. EngPaul Asikoye Akwatale – Member
9.Dr.Naftali Busakhala Wisindi-Member
Due to the late gazetting of the members the board was unable to have a sitting in the first quarter, the
previous board members continued with the scheduled meetings for the first quarter while awaiting
gazetting.
A handing over from the previous board to the current was done on ….and the sitting HMC had one full
board meeting each quarter and three sub committees had one subcommittee meeting per quarter totalling
to Three full board meetings and Nine subcommittee meetings.
Ad Hoc Members were adopted by the Medical Superintendent for easier coordination in bringing the
board up to speed, they included; The Nursing Officer In-Charge and Health Administrative Officer.
The Sub Committees were divided into the following:
1. Audit Sub Committee
1. Eng Paul Asikoye -Chairperson
2. Mr. Job Mokaya -Member
3. Mr. James Mailu -Member
4. Dr. Christian Lamba-Member

2. Finance & Human Resource Sub Committee

1. Fr. Maurice Erambo – Chairperson
2. Dr. Christian Lamba- Secretary
3. Eng. Paul Asikoye –Member
4. Ms. Joy Mudachi – Member

3. Technical Sub Committee

1. Dr. Naftali Busakala– Chairperson
2. Mrs June Mwajuma Jeophita- Secretary
3. Prof Hussein Golicha-Member
4. Mr. James Mailu-Member
5. Ms Joy Mudachi- Member
6. Dr. Christian Lamba-Member

xxvii
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

The board is on a three-year appointment and members are eligible to vie for two terms, at the end of
their term a new board is elected and a handing over is done for continuity of office.
In the current sitting HMC all members attended the scheduled meetings and when missing a
representative or an apology was sent beforehand.
The facility has an organogram depicting the role of the board in managing the facility but no official
charter other than the one inherited from the national government under the Mwongozo Code of
governance is used, the code’s core values are; Transparency, Accountability, Integrity, Professionalism,
innovativeness and customer focus.

Other than the Audit Sub Committee the two sub committees cover the following functions:
1. Governance
2. Risk
3. Compliance
4. Finance
5. Technical Matters
6. Strategy
7. Human Resource
In furtherance of its responsibilities, the Board has the following roles:
(a) Determine the facility’s mission, vision, purpose and core values.
(b) Review, evaluate and approve, on a regular basis, long-term plans for the facility.
(c) Review, evaluate and approve the facility’s budget and financial forecasts.
(d) Review, evaluate and approve major resource allocations and capital investments.
(e) Ensure that the procurement process is cost-effective and delivers value for money.
(f) Review and approve the operating and financial results of the organization.
(g) Ensure effective, accurate, timely and transparent disclosure of pertinent information on
the facility’s operations and performance.
(h) Ensure that effective processes and systems of risk management and internal controls are
in place.
(i) Review and evaluate the overall facility structure, the assignment of
senior management responsibilities and plans for senior management development and
succession.
(j) Review, evaluate and approve the remuneration structure of the facility.
(k) Adopt, implement and monitor compliance with the Code of Conduct and
Ethics.
(l) Review on a quarterly basis the attainment of targets and objectives set out in the agreed
performance measurement framework with the County Government of Kakamega.
(m) Review periodically the facility’s strategic objectives and policies relating to
sustainability and social responsibility.
(n) Protect the rights of patients and optimize value of care;
(o) Enhance the facility’s public image and ensure engagement with the community
through effective communication.
(p) Monitor compliance with the Constitution, all applicable laws, regulations and standards
(q) Review, monitor and ensure that the facility is effectively and consistently delivering
on its mandate.

xxviii
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

Each individual Board member shall be expected to:

(a) Exercise the highest degree of care, skill and diligence in discharging their duties
(b) Act in the best interest of the facility and not for any other purpose
(c) Act honestly at all times and must not place themselves in a situation where their personal
interests’ conflict with those of the facility.
(d) Exercise independent judgment
(e) Devote sufficient time to carry out their responsibilities, regularly update their knowledge
and enhance their skills
(f) Promote and protect the image of the facility.
(g) Owe their duty to the facility and not to the nominating or appointing authority
(h) Owe the facility the duty to hold in confidence all information available to them
by virtue of their position as a Board member.
Following the handing over, the current board has never been formally inducted but on job trainings have
been conducted within the facility.
The remuneration for board members is as follows:
Full Board;
i. Chairman – 20,000 Ksh
ii. All other Members – 15,000 Ksh

Sub Committees;
All Members –4,000 Kshs

More needs to be done to have an efficient and performing board, a formal induction is yet to be done
neither is an official appointment letters from the County.

xxix
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

9. Management Discussion and Analysis

Section A
The Hospital’s operational and financial performance

Kakamega Hospital is a level 5 hospital established under gazette notice number 78, The County
Governments Acts (No.17 0f 2012) and is domiciled in Kakamega County under the Health Department.
The hospital is governed by a Board of Management.
During the just concluded year ending June 30th, 2025, the hospital performed well, having raised more than Ksh. 1
billion in terms of SHA receipts and claims as well as Funeral parlour revenues, and normal revenue from patients
as well as transfers from FIF.

Kakamega County General Teaching and Referral Hospital relies on the following departments as the main
revenue sources;
The hospital generates revenue from different sources/departments including Outpatient department, Inpatient
Department, Surgical, Laboratory, Radiology, Wards, Maternity, Eye Unit, ENT, Funeral Parlour, Oncology,
pharmacy among others
Section B

Hospital’s compliance with statutory requirements

The hospital has no potential contingent liability though it has incurred costs amounting to Ksh. 217.1 m which is
yet to be paid as outstanding bills as at the end of year under consideration.
The Social Health Authority (SHA) has a balance of Ksh 92,564,164 with unremmited amounts from NHIF, Mtiba
and MINET of Ksh. 121m, 2.7m and 3.3 m respectively that has not been remitted for the year ended ended 30th
June 2025. The total exposure in terms of monetary value for the health cover is Ksh. 197.9 Million.

Section C

Key projects and investment decisions the entity is planning/implementing.

The hospital is investing in the following key projects for the FY 2024/2025.
1. Renovation of amenity ward
2. Purchase of three additional dialysis machine
3. Purchase of new x-ray machine
4. Installation of laparoscopic machine
5. Installation of fire fighting equipments.
The above investments will be financed partly by the parent ministry of health.

Section D

Major risks facing the entity.

The hospital is facing several risks especially on financial related risk. For The hospital to meet its optimal
operational efficiency and to achieve the goal congruence it requires a budget balance of Ksh.1.2 billion. Currently
the hospital is operating on a budget balance of Ksh.700,000,000, this exposes the hospital to a financial deficit of
Ksh.500,000,000.

xxx
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

The hospital faces a lot of competition from neighbouring privately owned facilities though as a referral facility the
hospital receives a lot of patients. Currently the outpatient load is at 500, most of them on referrals from other
lower facilities.

As per the current situation on liquidity and credit risks, the hospital is at risk as the budget is not balanced. Once
the budget is upscaled to 1.2 billion the hospital’s liquidity portfolios will be on float.

The hospital is yet to develop its risk management framework and policy.

Section E
Material arrears in statutory/financial obligations
The Hospital’s current pending bills stands at Ksh. 136 million, this includes major bills not yet paid. Currently the
hospital pays the staff salaries on time despite low budget appropriation.

Section F
The hospital’s financial probity and serious governance issues

The hospital has fully operational board of management that runs the hospital and also constituted the following
committees to ensure transparency, integrity, fairness and follows legal framework in execution of its mandates.

1. Financial and human resource committee

2. Audit committee
3. Quality assurance committee
4. Advisory committee

xxxi
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

10. Environmental And Sustainability Reporting

i) Sustainability strategy and profile
Kakamega County Teaching and referral hospital maintains a Mission to promote and participate in
provision of an integrated quality curative and rehabilitative services to all Kenyans. This is a continuous
objective that needs to be sustained over time, to achieve this the Hospital has identified the following
sustainability priorities; consultative planning and budgeting process, improving revenue collection and
lobbying for staff deployment.
In consultative planning and budgeting the facility has brought together the county health management and
various stakeholders in order to achieve the facility’s mandate. This has directly affected the budgeting
process where aside from the in-house priorities, program-based targets are given a say in the budgets. This
has greatly influenced indicators of the facility on the positive side.
On matters improving revenue the Hospital management team in line with the gazetted County charges for
level five have sealed loopholes that led to revenue loss. This together with encouraging the local populous
on NHIF uptake has led to tremendous revenue increase.
Staff numbers and appropriate deployment is key to quality service provision which is line with the
facility’s core mandate, this has put to task the Medical Superintendent and the Board to lobby for
deployment of staff to the Hospital.
However, in the course of implementation of the above mentioned, there are challenges experienced in the
facility. They include; Inadequate staffing, Inadequate funding and delays in disbursement also had a derail
in implementation of the facility annual work plan.
ii) Environmental performance
Kakamega County General Teaching and Referral Hospital has yet to establish an environmental policy
guideline, however the facility uses established National and County Executive Guidelines on
environmental issues as its guiding principles in the matter.
Some of the environmental issues experienced in the facility include; waste generation, waste segregation,
waste disposal and management, disposal of unclaimed bodies. These still remain a challenge for the
facility and more engagements are needed.

xxxii
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

iii) Employee welfare

The Majority of employees within the facility are County Government of Kakamega employees, followed
by UHC engaged staff. Despite the effort the facility has a massive shortage of staff that, that gap is plugged
by Casual staff engaged by the board.
To improve staff performance, the Hospital has initiated capacity building programmes to staffs through
on-job trainings, continuous medical education, workshops and conference attendance that is supported.
Furthermore, the facility management conducts staff appraisal performance which is coordinated from the
County department of health and the Human Resource Department.
The facility has complied to Occupational Safety and Health Act of 2007, (OSHA) by providing adequate
office space that is regularly cleaned, providing sanitation facilities, regular trainings on drug and substance
abuse and providing PPEs to all staff.

iv) Market place practices-

The facility outlines its efforts to:
a Responsible competition practice.
All staff are inducted into the Code of Conduct, Human Resource Manual and Disciplinary process as well
as made aware of their scope of service, this sorts a lot of the issues with regards to corruption. The facility
has also embraced a total cashless system for easier accountability and reduce the risk of corruption.
b Responsible Supply chain and supplier relations
All procurement processes in the facility adhere to the laid down regulations, with the facility procurement
officer taking lead to ensure guidelines and regulations are followed. The facility maintains good practices
and treats its own suppliers responsibly by honouring contracts, all of which are subject to funds
availability.
c Responsible marketing and advertisement
The facility through Continuous Medical Examination ensures that all its staff are well aligned with the
International, National and County guidelines in regards to Ethical practices within the facility.
d Product stewardship
The Patients’ rights Charter which all staff are well aligned with and frequently reminded of is one of the
documents we use to ensure that Client’s rights are respected and upheld.

E Corporate Social Responsibility / Community Engagements

xxxiii
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

The Hospital is fostering interaction with the surrounding community from which majority of clients come
from. Regular community dialogues are conducted on dialogue days which are usually planned and
executed. The dialogue brings on board the administrative arm of the government, the community health
volunteers and other NGOs.
Community Health volunteers linked to the facility are also engaged in marketing the facility services and
escort clients especially for delivery and Ante natal clinic services. This has led to a drop in maternal
mortalities and morbidities.

xxxiv
 Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

11. Report of The Board of Management

The board members submit their report together with the audited financial statements for the year that
ended June 30, 2025, which show the state of the hospital’s affairs.

Principal activities
Vision
To be a regional Centre of Excellence in holistic health care development, medical research and education
Mission
The mission of KCGTRH is to excel in providing healthcare services through the development of
infrastructure, human resources, medical supplies, training, research and the creation of a patient-friendly
environment.
Mandate
Professionalism and integrity- Ethical, honest, and have strong moral principles.
Competent and skilled. It also includes confidentiality and privacy
Accountability- The obligation of all staff in the Hospital to be responsible for activities and actions, and
to disclose the results in a transparent manner.
Customer Focus - Empathetic and caring, treating all people with worth and dignity and timely delivery
of services
Teamwork and Team Spirit - Co-operative or coordinated efforts among staff working together for the
interest of a common cause in the Hospital.
Security and Safety - Offering services in a secure environment free from errors, accidents, injuries and
infections.
Results
The results of the entity for the year ended June 30 2025 are set out on pages XVII to XXVI

Board of Management
The members of the Board who served during the year are shown on page viii. During the year,
2024/2025 no director(s) retired/ resigned, and no director (s)was appointed with effect from 18/ date.

Auditors
The Auditor General is responsible for the statutory audit of the entity in accordance with Article 229
of the Constitution of Kenya and the Public Audit Act 2015.
By Order of the Board

………………………………………….
Dr. Christian Lamba
Secretary to the Board

xxxv
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

12. Statement of Board of Management’s Responsibilities

Section 164 of the Public Finance Management Act, 2012 (entities should quote the applicable
legislation under which they are regulated) requires the Board of Management to prepare financial
statements in respect of that entity, which give a true and fair view of the state of affairs of the entity at
the end of the financial year/period and the operating results of the entity for that year/period. The
Board of Management is also required to ensure that the entity keeps proper accounting records which
disclose with reasonable accuracy the financial position of the entity. The council members are also
responsible for safeguarding the assets of the entity.

The Board of Management is responsible for the preparation and presentation of the entity’s financial
statements, which give a true and fair view of the state of affairs of the entity for and as at the end of the
financial year (period) ended on June 30, 2025. This responsibility includes: (i) maintaining adequate
financial management arrangements and ensuring that these continue to be effective throughout the
reporting period, (ii) maintaining proper accounting records, which disclose with reasonable accuracy
at any time the financial position of the entity, (iii) designing, implementing and maintaining internal
controls relevant to the preparation and fair presentation of the financial statements, and ensuring that
they are free from material misstatements, whether due to error or fraud, (iv) safeguarding the assets
of the entity; (v) selecting and applying appropriate accounting policies, and (vi) making accounting
estimates that are reasonable in the circumstances.

The Board of Management accepts responsibility for the entity’s financial statements, which have been
prepared using appropriate accounting policies supported by reasonable and prudent judgements and
estimates, in conformity with International Public Sector Accounting Standards (IPSAS), and in the
manner required by the PFM Act, 2012 and (– entities should quote applicable legislation as indicated
under). The Board members are of the opinion that the entity’s financial statements give a true and fair
view of the state of entity’s transactions during the financial year ended June 30, 20xx, and of the entity’s
financial position as at that date. The Board members further confirm the completeness of the accounting
records maintained for the entity, which have been relied upon in the preparation of the entity’s financial
statements as well as the adequacy of the systems of internal financial control.
In preparing the financial statements, the Directors have assessed the Fund’s ability to continue as a
going concern (disclosed, as applicable, matters relating to the use of going concern basis of preparation
of the financial statements) OR
Nothing has come to the attention of the Board of management to indicate that the entity will not remain
a going concern for at least the next twelve months from the date of this statement.
Approval of the financial statements
The Hospital’s financial statements were approved by the Board on _________________ and signed on
its behalf by:

…………………………………………… ………………………………………….
Name: Dr. Eren Oyugi Name: Dr. Christian Lamba
Chairperson Accounting Officer
Board of Management

xxxvi
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

13. Report of the Office of Auditor General

xxxvii
 Kakamega County General Teaching and Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

14. Statement of Financial Performance for The Year Ended 30 June 2025

2024/2025 2023/2024
Description Note
Kshs Kshs

Revenue from non-exchange transactions

Transfers from the County Government 6 0
7,000,000
In- kind contributions from the County 0
7
Government 0
Grants from donors and development partners 8 0
0
Transfers from other Government entities (FIF) 9 0
435,995,429
Public contributions and donations 10 0
0
0
442,995,429
Revenue from exchange transactions
Rendering of services- Medical Service Income 11 0
676,520,492
Revenue from rent of facilities 12 0
461,400
Finance /Interest Income 13 0
0
Miscellaneous Income 14 0
0
Revenue from exchange transactions 0
676,981,892
Total revenue 0
1,119,977,321

Expenses
Medical/Clinical costs 15 0
312,883,657
Employee costs 16 0
104,500,259
Board of Management Expenses 17 0
212,736
Depreciation and amortization expense 18 0
13,345,496
Repairs and maintenance 19 0
27,213,467
Transfer to FIF 20 0
477,009,184
General expenses 21 0
146,623,876
Refunds 22 0
748,200
Total expenses 0
1,080,229,758
Other gains/(losses)
Gain/Loss on disposal of non-Current assets 23 0 0

1
Kakamega County General Teaching and Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

2024/2025 2023/2024
Description Note
Kshs Kshs

Unrealized gain on fair value of investments 24 0 0

Medical services contracts Gains/Losses 25 0 0
Impairment loss 26 0 0
Gain on foreign exchange transactions 0 0
Total other gains/(losses) 0 0
Net Surplus / (Deficit) for the year 37,440,446 0

(The notes set out on pages x to xx form an integral part of the Annual Financial Statements.)

The Hospital’s financial statements were approved by the Board on _________________ and signed
on its behalf by:

…………………………….. …………………………….. ……………………………..

Dr.Eren Oyugi CPA Wycliffe Wanzala Dr. Christian Lamba
Chairman Head of Finance Medical Superintendent
ICPAK No:
Board of Management

2
Kakamega County General Teaching and Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

15. Statement of Financial Position As At 30th June 2025

2024/2025 2023/2024
Description Note
Kshs Kshs
Assets
Current assets
Cash and cash equivalents 27 1,862,188 0
Prepayments 28 0 0
Receivables from exchange transactions 29 197,930,894 0
Receivables from non-exchange transactions 30 46,478,901 0
Inventories 31 60,216,712 0
Total Current Assets 306,488,695 0

Non-current assets
Property, plant, and equipment 32 21,849,059 0
Intangible assets 33 0 0
Investment property 34 0 0
Biological Assets 35 0
Total Non-current Assets 21,849,059 0

Total assets (A) 328,337,754 0

Liabilities
Current liabilities
Trade and other payables 36 217,116,755 0
Refundable deposits from Patients/Prepayments 37 0 0
Provisions 38 0 0
Finance lease obligation 39 0 0
Current portion of deferred income 40 0 0
Current portion of borrowings 41 0 0
Total Current Liabilities 217,116,755 0

Non-current liabilities
Provisions 38 0 0
Non-Current Finance lease obligation 39 0 0
Non-Current portion of deferred income 40 0 0
Non - Current portion of borrowings 41 0 0

3
Kakamega County General Teaching and Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

2024/2025 2023/2024
Description Note
Kshs Kshs
Service concession Arrangements 42 0 0
Total non-current liabilities 0 0

Total Liabilities (B) 217,116,755 0

Net assets (A-B) 111,220,999 0

Represented by:
Revaluation reserve 73,134,601 0
Accumulated surplus/Deficit 37,440,446 0
Capital Fund 0 0

Net Assets 111,220,999 0

(The notes on pages x to xx form an integral part of the Annual Financial Statements.)

The Hospital’s financial statements were approved by the Board on _________________ and signed
on its behalf by:

…………………………….. …………………………….. ……………………………..

Dr.Eren Oyugi CPA Wycliffe Wanzala Dr. Christian Lamba
Chairman Head of Finance Medical Superintendent
ICPAK No:
Board of Management

4
Kakamega County General Teaching and Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

16. Statement of Changes in Net Assets for The Year Ended 30 June 2025

Revaluation Accumulated Capital

Description Total
reserve surplus/Deficit Fund
As at July 1, 2023 (previous year) 0 0 0 0
Revaluation gain 0 0 0 0

Surplus/(deficit) for the year 0 0 0 0

Capital/Development grants 0 0 0 0
As at June 30, 2024 (previous year) 0 0 0 0

At July 1, 2024 (current year) 0 0 0 0

Revaluation gain 73,780,553 0 0 73,780,553
Surplus/(deficit) for the year 0 37,440,446 0 37,440,446
Capital/Development grants 0 0 0 0
At June 30, 20xx (current year) 73,780,553 37,440,446 0 111,220,999

(Note:
1. For items that are not common in the financial statements, the entity should include a note on
what they relate to – either on the face of the statement of changes in equity/net assets or among
the notes to the financial statements.

2. Prior year adjustments should have an elaborate note describing what the amounts relate to.
In such instances, a restatement of the opening balances needs to be done.)

5
Kakamega County General Teaching and Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

17. Statement of Cash Flows for The Year Ended 30 June 2025

2024/2025 2023/2024
Description Note
Kshs Kshs
Cash flows from operating activities
Receipts
Transfers from the County Government 7,000,000 0
Grants from donors and development partners 0 0
Transfers from other Government entities FIF 389,516,528 0
Public contributions and donations 0 0
Rendering of services- Medical Service Income 478,589,598 0
Revenue from rent of facilities 461,400 0
Finance / interest income 0 0
Miscellaneous receipts(specify) 0 0
Total Receipts 875,567,526 0

Payments
Medical/Clinical costs 187,334,550 0
Employee costs 94,536,610 0
Board of Management Expenses 212,736 0
Repairs and maintenance 16,446,193 0
Transfer to FIF 477,009,184 0
General expenses 97,432,136 0
Finance costs 0 0
Refunds paid out 748,200 0
Total Payments 873,719,609 0
Net cash flows from operating activities 43 1,847,917 0
Decrease in inventories 13,754,520 0
Cash flows from investing activities
Purchase of property, plant, equipment (15,249,569) 0
Purchase of intangible assets 0 0
Proceeds from the sale of PPE 0 0
Acquisition of investments 0 0
Net cash flows used in investing activities (15,249,569) 0
Cash flows from financing activities
Proceeds from borrowings 0 0
Repayment of borrowings 0 0

6
Kakamega County General Teaching and Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

2024/2025 2023/2024
Description Note
Kshs Kshs
Capital grants received 0 0
Net cash flows used in financing activities 0 0
Net increase/(decrease) in cash and cash equivalents (1,495,049) 0
Cash and cash equivalents as at 1 July 27 3,357,237 0
Cash and cash equivalents as at 30 June 27 1,862,188 0

(PSASB has now prescribed the direct method of cashflow presentation for all entities under the IPSAS
Accrual basis of accounting).

Comparative FY refers to the financial year preceding the current year.

7
Kakamega County Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

18. Statement of Comparison of Budget and Actual Amounts for Year Ended 30 Jun 2025
Description Original Adjustments Final budget Actual on Performance % of
budget comparable difference utilisati
basis on
a b c=(a+b) d e=(c-d) f=d/c%
Kshs Kshs Kshs Kshs Kshs
Budget carryovers from the previous year 0 0 0 0 0 %
Receipts
Transfers from the County Government 7,000,000 0 7,000,000 7,000,000 0 100
Grants from donors and development 0 0 0 0 0 0
partners
Transfers from other Government entities 665,469,607 0 665,469,607 389,516,528 275,953,079 59
(FIF)
Public contributions and donations 0 0 0 0 0 0
Rendering of services- Medical Service 672,469,607 0 672,469,607 478,589,598 193,880,009 71
Income
Revenue from rent of facilities 500,000 0 500,000 461,400 38,600 92
Finance / interest income 0 0 0 0 0 0
Miscellaneous receipts (specify) 0 0 0 0 0 0
Total receipts 1,345,439,214 0 1,345,439,214 884,950,586 193,918,609 66
Payments
Medical/Clinical costs 493,631,764 0 493,631,764 196,717,610 296,914,154 40
Employee costs 150,000,000 0 150,000,000 94,536,610 55,463,390 63
Remuneration of directors 400,000 0 400,000 212,736 187,264 53
Repairs and maintenance 30,000,000 0 30,000,000 16,446,193 13,553,807 55
Transfer to FIF 500,607,450 0 500,607,450 477,009,184 23,598,266 95
General expenses 150,000,000 0 150,000,000 97,432,136 52,567,894 65
Finance costs 0 0 0 0 0 0
Refunds 800,000 0 800,000 748,200 51,800 94
Total Operational Expenditure paid 1,345,439,214 0 1,345,439,214 883,102,669 442,336,575 50
Capital Expenditure paid 20,000,000 0 20,000,000 15,249,569 4,750,431 76
Surplus 0 0 0 (1,495,049) 0 0
Kakamega County General Teaching and Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

(Budget carryovers* This is for entities whose budget lapses at year-end, but the surpluses are not legally required to be remitted to the
Exchequer. Budget carryovers should not include third-party funds such as contractors’ retention.)
(Entities can present the Statement of Comparison of Budget & Actual amounts in a different format/categorization as approved
by the governing body.)

Budget notes
1. Provide an explanation of differences between actual and budgeted amounts (any over/ 90% under) IPSAS 24.14
2. Provide an explanation of changes between the original and final budget, indicating whether the difference is due to reallocations or other
causes. (IPSAS 24.29)

:
Budget Reconciliation

Description of Particulars Amount in Kshs

Actual Surplus Amounts as per the statement of Budget (1,495,049)
1 Reason for differences (Opening Reserves) 3,357,237
2 Reason for differences 0
3 Reason for differences 0
4 Reason for differences 0
Closing Cash and Cash Equivalent as per the statement of Cash flows 1,862,188

9
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
19. Notes to the Financial Statements

1. General Information
Kakamega Hospital is a level 5 hospital established under gazette notice number 78, The
County Governments Acts (No.17 0f 2012) and is domiciled in Kakamega County under the
Health Department. The hospital is governed by a Board of Management.

Vision
To be a regional Centre of Excellence in holistic health care development, medical research
and education
Mission
The mission of KCGTRH is to excel in providing healthcare services through the development
of infrastructure, human resources, medical supplies, training, research and the creation of a
patient-friendly environment.
Mandate
Professionalism and integrity- Ethical, honest, and have strong moral principles.
Competent and skilled. It also includes confidentiality and privacy
Accountability- The obligation of all staff in the Hospital to be responsible for activities and
actions, and to disclose the results in a transparent manner.
Customer Focus - Empathetic and caring, treating all people with worth and dignity and timely
delivery of services
Teamwork and Team Spirit - Co-operative or coordinated efforts among staff working
together for the interest of a common cause in the Hospital.
Security and Safety - Offering services in a secure environment free from errors, accidents,
injuries and infections.

2. Statement of Compliance and Basis of Preparation

The financial statements have been prepared on a historical cost basis except for the
measurement at re-valued amounts of certain items of property, plant, and equipment,
marketable securities and financial instruments at fair value, impaired assets at their estimated
recoverable amounts and actuarially determined liabilities at their present value. The
preparation of financial statements in conformity with International Public Sector Accounting
Standards (IPSAS) allows the use of estimates and assumptions. It also requires management
to exercise judgement in the process of applying the entity’s accounting policies. The areas
involving a higher degree of judgment or complexity, or where assumptions and estimates are
significant to the financial statements, are disclosed in Note xx The financial statements have

10
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
been prepared and presented in Kenya Shillings, which is the functional and reporting currency
of the entity. The financial statements have been prepared in accordance with the PFM Act, and
(include any other applicable legislation), and International Public Sector Accounting
Standards (IPSAS). The accounting policies adopted have been consistently applied to all the
years presented.

11
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
3. Adoption of New and Revised Standards

(When an IPSAS becomes effective on 1st January 2024, it is applicable in Kenya from 1st July
2025)

i. New and amended standards and interpretations in issue effective in the year ended 30
June 2025

There were no new and amended standards issued in the financial year.

ii) New and amended standards and interpretations in issue but not yet effective in the year
ended 30 June 2025.
Standard Effective date and impact:
IPSAS 43 Applicable 1st January 2025
The standard sets out the principles for the recognition, measurement,
presentation, and disclosure of leases. The objective is to ensure that lessees
and lessors provide relevant information in a manner that faithfully
represents those transactions. This information gives a basis for users of
financial statements to assess the effect that leases have on the financial
position, financial performance and cashflows of an Entity.
The new standard requires entities to recognise, measure and present
information on right of use assets and lease liabilities.
State the expected impact of the standard to the Entity if relevant
IPSAS 44: Applicable 1st January 2025
Non- Current The Standard requires,
Assets Held Assets that meet the criteria to be classified as held for sale to be measured
for Sale and at the lower of carrying amount and fair value less costs to sell and the
Discontinued depreciation of such assets to cease and:
Operations Assets that meet the criteria to be classified as held for sale to be presented
separately in the statement of financial position and the results of
discontinued operations to be presented separately in the statement of
financial performance.
State the expected impact of the standard to the Entity if relevant

12
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
Standard Effective date and impact:
IPSAS 45- Applicable 1st January 2025
Property The standard supersedes IPSAS 17 on Property, Plant and Equipment.
Plant and IPSAS 45 has additional guidance/ new guidance for heritage assets,
Equipment infrastructure assets and measurement. Heritage assets were previously
excluded from the scope of IPSAS 17 in IPSAS 45, heritage assets that
satisfy the definition of PPE shall be recognised as assets if they meet the
criteria in the standard. IPSAS 45 has an additional application guidance for
infrastructure assets, implementation guidance and illustrative examples.
The standard has clarified existing principles e.g. valuation of land over or
under the infrastructure assets, under- maintenance of assets and
distinguishing significant parts of infrastructure assets.
State the expected impact of the standard to the Entity if relevant
IPSAS 46 Applicable 1st January 2025
Measurement The objective of this standard was to improve measurement guidance across
IPSAS by:
i. Providing further detailed guidance on the implementation of
commonly used measurement bases and the circumstances under
which they should be used.
ii. Clarifying transaction costs guidance to enhance consistency
across IPSAS;
iii. Amending where appropriate guidance across IPSAS related to
measurement at recognition, subsequent measurement and
measurement related disclosures.
The standard also introduces a public sector specific measurement bases
called the current operational value.
State the expected impact of the standard to the Entity if relevant
IPSAS 47- Applicable 1st January 2026
Revenue This standard supersedes IPSAS 9- Revenue from exchange transactions,
IPSAS 11 Construction contracts and IPSAS 23 Revenue from non-
exchange transactions. This standard brings all the guidance of accounting
for revenue under one standard. The objective of the standard is to establish
the principles that an entity shall apply to report useful information to users

13
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
Standard Effective date and impact:
of financial statements about the nature, amount, timing and uncertainty of
revenue and cash flow arising from revenue transactions.
State the expected impact of the standard to the Entity if relevant
IPSAS 48- Applicable 1st January 2026
Transfer The objective of the standard is to establish the principles that a transfer
Expenses provider shall apply to report useful information to users of financial
statements about the nature, amount, timing and uncertainty of expenses and
cash flow arising from transfer expense transactions. This is a new standard
for public sector entities geared to provide guidance to entities that provide
transfers on accounting for such transfers.
State the expected impact of the standard to the Entity if relevant
IPSAS 49- Applicable 1st January 2026
Retirement The objective is to prescribe the accounting and reporting requirements for
Benefit Plans the public sector retirement benefit plans which provide retirement to public
sector employees and other eligible participants. The standard sets the
financial statements that should be presented by a retirement benefit plan.
State the expected impact of the standard to the Entity if relevant
IPSAS 50: Applicable 1st January 2027
Exploration The objective of this Standard is to specify the financial reporting for the
For & exploration for and evaluation of mineral resources. The Standard requires:
Evaluation of i. Limited improvements to existing accounting practices for
Mineral exploration and evaluation expenditures.
Resources ii. Entities that recognize exploration and evaluation assets to assess
such assets for impairment in accordance with this Standard and
measure any impairment in accordance with IPSAS 26.
iii. Disclosures that identify and explain the amounts in the entity’s
financial statements arising from the exploration for and evaluation
of mineral resources and help users of those financial statements
understand the amount, timing and certainty of future cash flows
from any exploration and evaluation assets recognized.
State the expected impact of the standard to the Entity if relevant

14
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
iii) Early adoption of standards

The Entity did not early – adopt any new or amended standards in the financial year or the
entity adopted the following standards early (state the standards, reason for early adoption
and impact on entity’s financial statements.)

15
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
4. Summary of Significant Accounting Policies

a. Revenue recognition

i) Revenue from non-exchange transactions

Transfers from other Government entities
Revenues from non-exchange transactions with other government entities are measured at fair
value and recognized on obtaining control of the asset (cash, goods, services and property) if
the transfer is free from conditions and it is probable that the economic benefits or service
potential related to the asset will flow to the Entity and can be measured reliably. To the extent
that there is a related condition attached that would give rise to a liability to repay the amount,
the amount is recorded in the statement of financial position and realised in the statement of
financial performance over the useful life of the asset that has been acquired using such funds.
ii) Revenue from exchange transactions

Rendering of services
The entity recognizes revenue from rendering of services by reference to the stage of
completion when the outcome of the transaction can be estimated reliably. The stage of
completion is measured by reference to labour hours incurred to date as a percentage of total
estimated labour hours. Where the contract outcome cannot be measured reliably, revenue is
recognized only to the extent that the expenses incurred are recoverable.
Sale of goods
Revenue from the sale of goods is recognized when the significant risks and rewards of
ownership have been transferred to the buyer, usually on delivery of the goods and when the
amount of revenue can be measured reliably, and it is probable that the economic benefits or
service potential associated with the transaction will flow to the entity.

Interest income
Interest income is accrued using the effective yield method. The effective yield discounts
estimated future cash receipts through the expected life of the financial asset to that asset’s net
carrying amount. The method applies this yield to the principal outstanding to determine
interest income for each period.

Rental income
Rental income arising from operating leases on investment properties is accounted for on a
straight-line basis over the lease terms and included in revenue.

16
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
Notes to the Financial Statements (Continued)
b. Budget information

The original budget for FY 24/25 was approved by Board on 9/6/2024. Subsequent revisions
or additional appropriations were made to the approved budget in accordance with specific
approvals from the appropriate authorities. The additional appropriations are added to the
original budget by the entity upon receiving the respective approvals in order to conclude the
final budget. Accordingly, the entity recorded additional appropriations of 0 on the FY
2024/2025 budget following the Board’s approval. The entity’s budget is prepared on a
different basis to the actual income and expenditure disclosed in the financial statements. The
financial statements are prepared on accrual basis using a classification based on the nature of
expenses in the statement of financial performance, whereas the budget is prepared on a cash
basis. The amounts in the financial statements were recast from the accrual basis to the cash
basis and reclassified by presentation to be on the same basis as the approved budget.
A comparison of budget and actual amounts, prepared on a comparable basis to the approved
budget, is then presented in the statement of comparison of budget and actual amounts. In
addition to the Basis difference, adjustments to amounts in the financial statements are also
made for differences in the formats and classification schemes adopted for the presentation of
the financial statements and the approved budget.
A statement to reconcile the actual amounts on a comparable basis included in the statement of
comparison of budget and actual amounts, and the actuals as per the statement of cash flows.

c. Taxes

Sales tax/ Value Added Tax

Expenses and assets are recognized net of the amount of sales tax, except:

➢ When the sales tax incurred on a purchase of assets or services is not recoverable
from the taxation authority, in which case, the sales tax is recognized as part of the
cost of acquisition of the asset or as part of the expense item, as applicable.

➢ When receivables and payables are stated with the amount of sales tax included.
The net amount of sales tax recoverable from, or payable to, the taxation authority
is included as part of receivables or payables in the statement of financial position.

17
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
Notes to the Financial Statements (Continued)

d. Investment property
Investment properties are measured initially at cost, including transaction costs. The carrying
amount includes the replacement cost of components of an existing investment property at the
time that cost is incurred if the recognition criteria are met and excludes the costs of day-to-
day maintenance of an investment property.
Investment property acquired through a non-exchange transaction is measured at its fair value
at the date of acquisition. Subsequent to initial recognition, investment properties are measured
using the cost model and are depreciated over a period of xxx years. Investment properties are
derecognized either when they have been disposed of or when the investment property is
permanently withdrawn from use and no future economic benefit or service potential is
expected from its disposal. The difference between the net disposal proceeds and the carrying
amount of the asset is recognized in the surplus or deficit in the period of de-recognition.
Transfers are made to or from investment property only when there is a change in use.

e. Property, plant and equipment

All property, plant and equipment are stated at cost less accumulated depreciation and
impairment losses. Cost includes expenditure that is directly attributable to the acquisition of
the items. When significant parts of property, plant and equipment are required to be replaced
at intervals, the entity recognizes such parts as individual assets with specific useful lives and
depreciates them accordingly. Likewise, when a major inspection is performed, its cost is
recognized in the carrying amount of the plant and equipment as a replacement if the
recognition criteria are satisfied. All other repair and maintenance costs are recognized in
surplus or deficit as incurred. Where an asset is acquired in a non-exchange transaction for nil
or nominal consideration the asset is initially measured at its fair value.

18
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
Notes to the Financial Statements (Continued)

f. Leases
Finance leases are leases that transfer substantially the entire risks and benefits incidental to
ownership of the leased item to the Entity. Assets held under a finance lease are capitalized at
the commencement of the lease at the fair value of the leased property or, if lower, at the present
value of the future minimum lease payments. The Entity also recognizes the associated lease
liability at the inception of the lease. The liability recognized is measured as the present value
of the future minimum lease payments at initial recognition.
Subsequent to initial recognition, lease payments are apportioned between finance charges and
reduction of the lease liability so as to achieve a constant rate of interest on the remaining
balance of the liability. Finance charges are recognized as finance costs in surplus or deficit.
An asset held under a finance lease is depreciated over the useful life of the asset. However, if
there is no reasonable certainty that the Entity will obtain ownership of the asset by the end of
the lease term, the asset is depreciated over the shorter of the estimated useful life of the asset
and the lease term.
Operating leases are leases that do not transfer substantially all the risks and benefits incidental
to ownership of the leased item to the Entity. Operating lease payments are recognized as an
operating expense in surplus or deficit on a straight-line basis over the lease term.

g. Intangible assets

Intangible assets acquired separately are initially recognized at cost. The cost of intangible
assets acquired in a non-exchange transaction is their fair value at the date of the exchange.
Following initial recognition, intangible assets are carried at cost less any accumulated
amortization and accumulated impairment losses. Internally generated intangible assets,
excluding capitalized development costs, are not capitalized and expenditure is reflected in
surplus or deficit in the period in which the expenditure is incurred. The useful life of the
intangible assets is assessed as either finite or indefinite.

19
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
Notes to the Financial Statements (Continued)
h. Biological Assets

The entity recognizes biological assets when it controls the assets due to past events, it is
probable that future economic benefits associated with the asset will flow to the entity, and
when the fair value or cost of the asset can be measured reliably. Biological assets are initially
and subsequently measured at fair value less costs to sell, except where fair value cannot be
reliably determined. In such cases, the asset is measured at its cost less accumulated
depreciation and any accumulated impairment losses. Changes in fair value less costs to sell
are recognized in surplus/deficit in the period in which they occur.

i. Research and development costs

The Entity expenses research costs as incurred. Development costs on an individual project are
recognized as intangible assets when the Entity can demonstrate:
➢ The technical feasibility of completing the asset so that the asset will be
available for use or sale

➢ Its intention to complete and its ability to use or sell the asset

➢ The asset will generate future economic benefits or service potential

➢ The availability of resources to complete the asset

➢ The ability to measure reliably the expenditure during development.

Following initial recognition of an asset, the asset is carried at cost less any accumulated
amortization and accumulated impairment losses. Amortization of the asset begins when
development is complete and the asset is available for use. It is amortized over the period of
expected future benefit. During the period of development, the asset is tested for impairment
annually with any impairment losses recognized immediately in surplus or deficit.

j. Financial instruments
IPSAS 41 addresses the classification, measurement and de-recognition of financial assets and
financial liabilities, introduces new rules for hedge accounting and a new impairment model
for financial assets. The entity does not have any hedge relationships and therefore the new
hedge accounting rules have no impact on the hospital’s financial statements. (amend as
appropriate).

20
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

A financial instrument is any contract that gives rise to a financial asset of one entity and a
financial liability or equity instrument of another entity. At initial recognition, the entity
measures a financial asset or financial liability at its fair value plus or minus, in the case of a
financial asset or financial liability not at fair value through surplus or deficit, transaction costs
that are directly attributable to the acquisition or issue of the financial asset or financial liability.

Financial assets

Classification of financial assets

The entity classifies its financial assets as subsequently measured at amortised cost, fair value
through net assets/ equity or fair value through surplus and deficit on the basis of both the
entity’s management model for financial assets and the contractual cash flow characteristics of
the financial asset. A financial asset is measured at amortized cost when the financial asset is
held within a management model whose objective is to hold financial assets in order to collect
contractual cash flows and the contractual terms of the financial asset give rise on specified
dates to cash flows that are solely payments of principal and interest on the principal
outstanding. A financial asset is measured at fair value through net assets/ equity if it is held
within the management model whose objective is achieved by both collecting contractual
cashflows and selling financial assets and the contractual terms of the financial asset give rise
on specified dates to cash flows that are solely payments of principal and interest on the
principal amount outstanding. A financial asset shall be measured at fair value through surplus
or deficit unless it is measured at amortized cost or fair value through net assets/ equity unless
an entity has made irrevocable election at initial recognition for particular investments in equity
instruments.
Subsequent measurement

Based on the business model and the cash flow characteristics, the entity classifies its financial
assets into amortized cost or fair value categories for financial instruments. Movements in fair
value are presented in either surplus or deficit or through net assets/ equity subject to certain
criteria being met.

Amortized cost

21
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

Financial assets that are held for collection of contractual cash flows where those cash flows
represent solely payments of principal and interest, and that are not designated at fair value
through surplus or deficit, are measured at amortized cost. A gain or loss on an instrument that
is subsequently measured at amortized cost and is not part of a hedging relationship is
recognized in profit or loss when the asset is de-recognized or impaired. Interest income from
these financial assets is included in finance income using the effective interest rate method.

Fair value through net assets/ equity

Financial assets that are held for collection of contractual cash flows and for selling the
financial assets, where the assets’ cash flows represent solely payments of principal and
interest, are measured at fair value through net assets/ equity. Movements in the carrying
amount are taken through net assets, except for the recognition of impairment gains or losses,
interest revenue and foreign exchange gains and losses which are recognized in surplus/deficit.
Interest income from these financial assets is included in finance income using the effective
interest rate method.

Fair value through surplus or deficit

Financial assets that do not meet the criteria for amortized cost or fair value through net assets/
equity are measured at fair value through surplus or deficit. A business model where the entity
manages financial assets with the objective of realizing cash flows through solely the sale of
the assets would result in a fair value through surplus or deficit model.

Trade and other receivables

Trade and other receivables are recognized at fair values less allowances for any uncollectible
amounts. Trade and other receivables are assessed for impairment on a continuing basis. An
estimate is made of doubtful receivables based on a review of all outstanding amounts at the
year end.
Impairment

The entity assesses, on a forward-looking basis, the expected credit loss (‘ECL’) associated
with its financial assets carried at amortized cost and fair value through net assets/equity. The
entity recognizes a loss allowance for such losses at each reporting date. Critical estimates and
significant judgments made by management in determining the expected credit loss (ECL) are
set out in Note xx.

22
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
Financial liabilities
Classification
The entity classifies its liabilities as subsequently measured at amortized cost except for
financial liabilities measured through profit or loss.
k. Inventories

Inventory is measured at cost upon initial recognition. To the extent that inventory was received
through non-exchange transactions (for no cost or for a nominal cost), the cost of the inventory
is its fair value at the date of acquisition.

Costs incurred in bringing each product to its present location and conditions are accounted for
as follows:

➢ Raw materials: purchase cost using the weighted average cost method.

➢ Finished goods and work in progress: cost of direct materials and labour, and a
proportion of manufacturing overheads based on the normal operating capacity but
excluding borrowing costs.

After initial recognition, inventory is measured at the lower cost and net realizable value.
However, to the extent that a class of inventory is distributed or deployed at no charge or for a
nominal charge, that class of inventory is measured at the lower cost and the current
replacement cost.Net realizable value is the estimated selling price in the ordinary course of
operations, less the estimated costs of completion and the estimated costs necessary to make
the sale, exchange, or distribution. Inventories are recognized as an expense when deployed for
utilization or consumption in the ordinary course of operations of the Entity.

l. Provisions
Provisions are recognized when the Entity has a present obligation (legal or constructive) as a
result of a past event, it is probable that an outflow of resources embodying economic benefits
or service potential will be required to settle the obligation and a reliable estimate can be made
of the amount of the obligation.
Where the Entity expects some or all of a provision to be reimbursed, for example, under an
insurance contract, the reimbursement is recognized as a separate asset only when the
reimbursement is virtually certain.
The expense relating to any provision is presented in the statement of financial performance
net of any reimbursement.

23
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
m. Social Benefits
Social benefits are cash transfers provided to i) specific individuals and / or households that
meet the eligibility criteria, ii) mitigate the effects of social risks and iii) Address the need of
society as a whole. The entity recognises a social benefit as an expense for the social benefit
scheme at the same time that it recognises a liability. The liability for the social benefit scheme
is measured at the best estimate of the cost (the social benefit payments) that the entity will
incur in fulfilling the present obligations represented by the liability.

n. Contingent liabilities
The Entity does not recognize a contingent liability but discloses details of any contingencies
in the notes to the financial statements unless the possibility of an outflow of resources
embodying economic benefits or service potential is remote.

o. Contingent assets

The Entity does not recognize a contingent asset but discloses details of a possible asset whose
existence is contingent on the occurrence or non-occurrence of one or more uncertain future
events not wholly within the control of the Entity in the notes to the financial statements.
Contingent assets are assessed continually to ensure that developments are appropriately
reflected in the financial statements. If it has become virtually certain that an inflow of
economic benefits or service potential will arise and the asset’s value can be measured reliably,
the asset and the related revenue are recognized in the financial statements of the period in
which the change occurs.

p. Nature and purpose of reserves

The entity creates and maintains reserves in terms of specific requirements. (Entity to state the
reserves maintained and appropriate policies adopted.)

q. Changes in accounting policies and estimates

The Entity recognizes the effects of changes in accounting policy retrospectively. The effects
of changes in accounting policy are applied prospectively if retrospective application is
impractical.

24
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
Notes to the Financial Statements (Continued)
r. Employee benefits

Retirement benefit plans

The Entity provides retirement benefits for its employees and directors. Defined contribution
plans are post-employment benefit plans under which an entity pays fixed contributions into a
separate entity (a fund) and will have no legal or constructive obligation to pay further
contributions if the fund does not hold sufficient assets to pay all employee benefits relating to
employee service in the current and prior periods. The contributions to fund obligations for the
payment of retirement benefits are charged against income in the year in which they become
payable. Defined benefit plans are post-employment benefit plans other than defined-
contribution plans. The defined benefit funds are actuarially valued tri-annually on the
projected unit credit method basis. Deficits identified are recovered through lump-sum
payments or increased future contributions on a proportional basis to all participating
employers. The contributions and lump sum payments reduce the post-employment benefit
obligation. (the entity to retain information relating to defined benefits or contributions, where
both schemes are managed full policy applies)

s. Foreign currency transactions

Transactions in foreign currencies are initially accounted for at the ruling rate of exchange on
the date of the transaction. At each reporting date, foreign currency monetary items are
translated using the closing rate. Non-monetary items measured in historical cost are translated
using the exchange rate at the date of the transaction, and those measured at fair value are
translated using the exchange rates at the date when the fair value was determined. Exchange
differences arising from the settlement of monetary items or translation of monetary/non-
monetary items at rates different from those at which they were initially reported are recognized
in surplus or deficit in the period.

t. Borrowing costs
Borrowing costs are capitalized against qualifying assets as part of property, plant and
equipment. Such borrowing costs are capitalized over the period during which the asset is being
acquired or constructed and borrowings have been incurred. Capitalization ceases when

25
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
construction of the asset is complete. Further borrowing costs are charged to the statement of
financial performance.

u. Related parties

The Entity regards a related party as a person or an entity with the ability to exert control
individually or jointly, or to exercise significant influence over the Entity, or vice versa.
Members of key management are regarded as related parties and comprise the directors, the
CEO/principal and senior managers.

v. Service concession arrangements

The Entity analyses all aspects of service concession arrangements that it enters into in
determining the appropriate accounting treatment and disclosure requirements. In particular,
where a private party contributes an asset to the arrangement, the Entity recognizes that asset
when, and only when, it controls or regulates the services. The operator must provide together
with the asset, to whom it must provide them, and at what price. In the case of assets other than
’whole-of-life’ assets, it controls, through ownership, beneficial entitlement or otherwise – any
significant residual interest in the asset at the end of the arrangement. Any assets so recognized
are measured at their fair value. To the extent that an asset has been recognized, the Entity also
recognizes a corresponding liability, adjusted by a cash consideration paid or received.

w. Cash and cash equivalents

Cash and cash equivalents comprise cash on hand and cash at bank, short-term deposits on call
and highly liquid investments with an original maturity of three months or less, which are
readily convertible to known amounts of cash and are subject to insignificant risk of changes
in value. Bank account balances include amounts held at the Central Bank of Kenya and at
various commercial banks at the end of the financial year. For the purposes of these financial
statements, cash and cash equivalents also include short term cash imprests and advances to
authorised public officers and/or institutions which were not surrendered or accounted for at
the end of the financial year.

x. Comparative figures

Where necessary comparative figures for the previous financial year have been amended or
reconfigured to conform to the required changes in presentation.

26
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
y. Subsequent events

There have been no events subsequent to the financial year end with a significant impact on the
financial statements for the year ended June 30, 2025.

5. Significant Judgments and Sources of Estimation Uncertainty

The preparation of the Entity's financial statements in conformity with IPSAS requires
management to make judgments, estimates and assumptions that affect the reported amounts
of revenues, expenses, assets and liabilities, and the disclosure of contingent liabilities, at the
end of the reporting period. However, uncertainty about these assumptions and estimates could
result in outcomes that require a material adjustment to the carrying amount of the asset or
liability affected in future periods.
Estimates and assumptions.
The key assumptions concerning the future and other key sources of estimation uncertainty at
the reporting date, that have a significant risk of causing a material adjustment to the carrying
amounts of assets and liabilities within the next financial year, are described below. The Entity
based its assumptions and estimates on parameters available when the consolidated financial
statements were prepared. However, existing circumstances and assumptions about future
developments may change due to market changes or circumstances arising beyond the control
of the Entity. Such changes are reflected in the assumptions when they occur. ( IPSAS 1.140)
Useful lives and residual values
The useful lives and residual values of assets are assessed using the following indicators to
inform potential future use and value from disposal:
➢ The condition of the asset based on the assessment of experts employed by the Entity.
➢ The nature of the asset, its susceptibility and adaptability to changes in technology
and processes.
➢ The nature of the processes in which the asset is deployed.
➢ Availability of funding to replace the asset.
➢ Changes in the market in relation to the asset.
Provisions
Provisions were raised and management determined an estimate based on the information
available. Additional disclosure of these estimates of provisions is included in Note xxx.
Provisions are measured at the management's best estimate of the expenditure required to settle
the obligation at the reporting date and are discounted to present value where the effect is
material.
(Include provisions applicable for your organisation e.g. provision for bad debts, provisions of obsolete stocks and
how management estimates these provisions).

27
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
Notes to Financial Statements Continued
6. Transfers from the County Government
FY2024/202 FY2023/202
Description 5 4
KShs KShs
Unconditional grants
Operational grant 7,000,000 0
Level 4/5 grants 0 0
Unconditional development grants 0 0
Other grants (specify) 0 0
7,000,000 0
Conditional grants
User fee forgone 0 0
Transforming health services for Universal care project 0 0
(THUCP)
DANIDA 0 0
Wards Development grant 0 0
Paediatric block grant 0 0
Administration block grant 0 0
Laboratory grant 0 0
Total government grants and subsidies 7,000,000 0

6 b Transfers from The County Government

Name of the Amount Amount Amount Total grant
Entity recognized to deferred recognised income Comparative
sending the Statement of under in capital during the Period
grant financial deferred fund. year
performance* income
KShs KShs
KShs KShs KShs
Kakamega
County
Government 7,000,000 0 0 7,000,000 0

Total 7,000,000 0 0 7,000,000 0

(Ensure that the amount recorded above as having been received from the County fully reconciles to
the amount recorded by the amount recorded as transferred by the County. An acknowledgement
note/receipt should be raised in favour of the sending County Government. The details of the
reconciliation have been included under appendix III).

*Amount recognised in the statement of financial performance should be the recurrent grant and the
development grant to the extent that there are no conditions attached. Total of column 1 should tie to
note 6(the part on unconditional grants).

28
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
Notes to Financial Statements Continued

7. In Kind Contributions from The County Government

2024/2025 2023/2025
Description
KShs KShs
Salaries and wages 0 0
Medical supplies-Drawings Rights (KEMSA) 0 0
Pharmaceuticals and Non-Pharmaceutical Supplies 0 0
(other suppliers)
Utility bills 0 0
Total grants in kind 0 0
(These include payments made directly by the County Governments for staff salaries and
medical drugs. These should be recorded both as income and expense for completeness of
financial statements)

8. Grants From Donors and Development Partners

2024/2025 2023/2024
Description
KShs KShs
Cancer Centre grant- DANIDA 0 0
World Bank grants 0 0
Paediatric ward grant- JICA 0 0
Research grants 0 0
Other grants (specify) 0 0
Total grants from development 0 0
partners
(Provide brief explanation for this revenue)

8 (a) Grants from donors and development partners (Classification)

Amount Amount Total
Amount
recognized to deferred grant
recognised Comparative
Name of the Entity Statement of under
in capital
income
financial deferred during Period
sending the grant fund.
performance income the year
KShs KShs KShs KShs KShs
Donor e.g., DANIDA 0 0 0 0 0
JICA 0 0 0 0 0
World Bank 0 0 0 0 0
Total 0 0 0 0 0

29
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
Notes to Financial Statements Continued

9. Transfers From Other Government Entities

2024/2025 2023/2024
Description
KShs KShs
Transfer from National Government (FIF) 435,995,429 0
Transfer from National Hospital 0 0
Total Transfers 435,995,429 0

10. Public Contributions and Donations

2024/2025 2023/2024
Description
KShs KShs
Public donations 0 0
Donations from local leadership 0 0
Donations from religious institutions 0 0
Donations from other international organisations and individuals 0 0
Other donations(specify) 0 0
Donations in kind-amortised 0 0
Total donations and sponsorships 0 0

(Provide brief explanation for this revenue)

10 (a)Reconciliations of amortised grants

2024/2025 2023/2024
Description
Kshs Kshs
Balance unspent at beginning of year 0 0
Current year receipts 0 0
Amortised and transferred to revenue 0 0
Conditions to be met – remain liabilities 0 0

30
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
Notes to Financial Statements Continued

11. Rendering of Services-Medical Service Income

2024/2025 2023/2024
Description
Kshs Kshs
Pharmaceuticals 267,986,000 0
Non-Pharmaceuticals 220,090,600 0
Laboratory 43,386,276 0
Radiology 67,300,0003 0
Orthopedic and Trauma Technology 8,900,000 0
Theatre 9,000,456 0
Accident and Emergency Service 5,790,000 0
Anesthesia Service 2,500,000 0
Ear Nose and Throat service 1,000,000 0
Nutrition service 1,200,000 0
Cancer centre service 6,890,400 0
Dental services 3,879,000 0
Reproductive health 15,908,000 0
Paediatrics services 7,689,000 0
Farewell home services 15,000,760 0
Ambulance services 0 0
Other medical services income (specify) 0 0
Total revenue from the rendering of
676,520,492 0
services
(Other medical services fee relates to other charges not listed above and should be specified)

31
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
Notes to the Financial Statements (Continued)

12. Revenue From Rent of Facilities

2024/2025 2023/2024
Description
Kshs Kshs
Residential property 0 0
Commercial property 461,400 0
Total Revenue from rent of facilities 461,400 0
(Provide brief explanation for this revenue)

13. Finance /Interest Income

2024/2025 2023/2024
Description
Kshs Kshs
Interest income from Cash investments
0 0
and fixed deposits
Interest income from short- term/ current
0 0
deposits
Interest income from Treasury Bills 0 0
Interest income from Treasury Bonds 0 0
Interest from outstanding debtors 0 0
Total finance income 0 0
(Provide brief explanation for this revenue)

14. Miscellaneous Income

2024/2025 2023/2024
Description
KShs KShs
Insurance recoveries 0 0
Income from sale of tender 0 0
Services concession income 0 0
Sale of goods (water, publications, containers etc) 0 0
Write backs (Deposits, payments in advance etc) 0 0
Bad debts recovered 0 0
Others (Specify) 0 0
Total Miscellaneous income 0 0

(NB: All income should be classified as far as possible in the relevant classes and miscellaneous
income should be used to recognise income not elsewhere classified).

32
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
Notes to the Financial Statements (Continued)
15. Medical/ Clinical Costs

2024/2025 2023/2024
Description
Kshs Kshs
Dental costs/ materials 2,400,000 0
Laboratory chemicals and reagents 26,061,513 0
Public health activities 1,550,450 0
Food and Ration 34,885,003 0
Uniform, clothing, and linen 2,809,250 0
Dressing and Non-Pharmaceuticals 133,039,313 0
Pharmaceutical supplies 52,144,312 0
Health information stationery (Medical records) 7,978,505 0
Reproductive health materials 2,011,963 0
Sanitary and cleansing Materials 18,350,334 0
Purchase of Medical gases 3,387,000 0
X-Ray/Radiology supplies 21,196,109 0
Other medical related clinical costs (therapy 0
7,069,905
applianaces)
Total medical/ clinical costs 312,883,657 0
(Other medical/clinical related costs refers to all other costs involved in management of the patients
directly not analysed above.)

16. Employee Costs

2024/2025 2023/2024
Description
Kshs Kshs
Salaries, wages, and allowances 85,956,449 0
Contributions to pension schemes 8,757,150 0
Service gratuity 0 0
Performance and other bonuses 0 0
Staff medical expenses and Insurance cover 2,614,192 0
Group personal accident insurance and WIBA 0 0
Social contribution*Welfare 349,500 0
Other employee costs (AHL,PAYE) 6,822,968 0
Employee costs 104,500,259 0
(Social contribution relates to expenses incurred by the employer towards social welfare of Employees)

33
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
Notes to the Financial Statements (Continued)
17. Board of Management Expenses

2024/2025 2023/2024
Description
Kshs Kshs
Chairman's Honoraria 0 0
Sitting allowance 212,736 0
Mileage 0 0
Insurance expenses 0 0
Induction and training 0 0
Travel and accommodation allowance 0 0
Airtime allowances 0 0
Total 212,736 0

18. Depreciation and Amortization Expense

2024/2025 2023/2024
Description
Kshs Kshs
Property, plant and equipment 13,345,496 0
Intangible assets 0 0
Investment property carried at cost 0 0
Total depreciation and amortization 13,345,496 0

19. Repairs And Maintenance

2024/2025 2023/2024
Description
Kshs Kshs
Property- Buildings 10,318,381 0
Medical equipment 2,097,219 0
Plant & machinery 11,631,132 0
Furniture and fittings 0 0
Computers and accessories 798,875 0
Motor vehicle expenses 2,367,860 0
Maintenance of civil works 0 0
Total repairs and maintenance 27,213,467 0

34
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
Notes to the Financial Statements (Continued)
20. Transfer to FIF

2024/2025 2023/2024
Description
Kshs Kshs
To FIF 479,316,301 0
Education initiatives and programs 0 0
Free/ subsidised medical camp 0 0
Disability programs 0 0
Free cancer screening 0 0
Social benefit expenses 0 0
Other grants and subsidies(specify) 0 0
Total grants and subsidies 479,316,301 0
Social benefit schemes include benefits such as cash transfers for unemployment or elderly in line with IPSAS 42.

21. General Expenses

2024/2025 2023/2024
Description
Kshs Kshs
Advertising and publicity expenses 0 0
Catering expenses 4,681,343 0
Waste management expenses 0 0
Insecticides and rodenticides 0 0
Audit fees 0 0
Bank charges 216,739 0
Conferences and delegations 7,459,125 0
Consultancy fees 0 0
Contracted services 59,597,546 0
Electricity expenses 7,627,212 0
Fuel and Lubricants 6,516,338 0
Insurance 0 0
Research and development expenses 0 0
Travel and accommodation allowance 26,400 0
Legal expenses 0 0
Licenses and permits 0 0
Courier and postal services 42,665 0
Printing and stationery 8,939,746 0
Consumables stores 5,860,979 0
Computer accessories 6,432,427 0
Water and sewerage costs 26,406,000 0
Household appliances 146,932 0

35
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
2024/2025 2023/2024
Description
Kshs Kshs
Telephone and mobile phone services 1,685,000 0
Internet expenses 1,545,668 0
Staff training and development*Accomodation 2,746,650 0
Subscriptions to professional bodies 907,089 0
Subscriptions to newspapers periodical, 0
0
magazines, and gazette notices
Daily subsistence allowance 3,379,900 0
Industrial gas 99,000 0
Total General Expenses 144,316,759 0

22. Refunds

2024/2025 2023/2024
Description
KShs KShs
Refunds to patients 748,200 0
Finance leases (amortized cost) 0 0
Interest on Bank overdrafts/Guarantees 0 0
Interest on loans from commercial banks 0 0
Total Refunds 748,200 0
(Borrowing costs that relate to interest expense on acquisition of non- current assets and do not
qualify for Capitalisation as per IPSAS 5: on borrowing costs should be included under this note.)
23. Gain/Loss on Disposal of Non-Current Assets

2024/2025 2023/2024
Description
KShs KShs
Property, plant, and equipment 0 0
Intangible assets 0 0
Other assets not capitalised (specify) 0 0
Total gain on sale of assets 0 0

24. Unrealized Gain On Fair Value Investments

2024/2025 2023/2024
Description
KShs KShs
Investments at fair value 0 0
Total gain 0 0

36
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
Notes to the Financial Statements (Continued)
25. Medical Services Contracts Gains /Losses

2024/2025 2023/2024
Description
KShs KShs
Comprehensive care contracts with NHIF/SHA 0 0
Non- Comprehensive contracts care with NHIF/SHA 0 0
Linda Mama Program 0 0
Waivers and Exemptions 0 0
Total Gain/Loss 0 0

26. Impairment Loss

2024/2025 2023/2024
Description
KShs KShs
Property, plant, and equipment 0 0
Intangible assets 0 0
Investments 0 0
Total impairment loss 0 0

27. Cash And Cash Equivalents

2024/2025 2023/2024
Description
KShs KShs
Current accounts 1,790,748 0
On - call deposits 0 0
Fixed deposits accounts 0 0
Cash in hand 71,440 0
Others(specify)- Mobile money 0 0
Total cash and cash equivalents 1,862,188 0

(The amount should agree with the closing and opening balances as included in the statement
of cash flows)

37
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
Notes to the Financial Statements (Continued)
27 (a). Detailed Analysis of Cash and Cash Equivalents

Description 2024/2025 2023/2024

Account
Financial institution KShs KShs
number
a) Current account
Kenya Commercial bank 1252762488 331,224 0
Kenya Commercial bank 1335230114 256,925 0
Kenya Commercial bank 1338581368 70,789
Kenya Commercial bank 1152009362 0.50
Kenya Commercial bank 1152009575 1,139,809
Sub- total 1,798,748 0
b) On - call deposits
Kenya Commercial bank 0 0
Equity Bank – etc 0 0
Sub- total 0 0
c) Fixed deposits account 0
Bank Name 0 0
Sub- total 0 0
d) Others(specify) 0 0
Imprest 71,440 0
Mobile money- Mpesa, Airtel 0 0
money
Sub- total 0 0
0
Grand total 1,862,188 0
Provide disclosure on any restricted cash that the entity is holding.

28. Prepayments

Description 2024/2025 2023/2024

Kshs Kshs
Insurance 0 0
Rent 0 0
Water 0 0
Internet 0 0
Others specify 0 0
Total 0 0

38
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
29. Receivables From Exchange Transactions

2024/2025 2023/2024
Description
KShs KShs
Medical services receivables 0 0
Rent receivables 0 0
Other exchange debtors 0 0
Less: impairment allowance 0 0
Total receivables 0 0
(Entity to state the expected credit loss rates for various categories of its receivables. The entity should
also disclose how ECL was arrived at in line with provisions of IPSAS 41.)

Analysis of Receivables From Exchange Transactions

2024/2025 2023/2024
Description
Kshs Kshs
% of
Current Comparative % of
the
FY FY the total
total
Less than 1 year 0 % 0 %
Between 1- 2 years 0 % 0 %
Between 2-3 years 0 % 0 %
Over 3 years 0 % 0 %
Total (a+b) 0 % 0 %

39
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

30. Receivables From Non-Exchange Transactions

2024/2025 2023/2024
Description
KShs KShs
Transfers from the County Government 0 0
Undisbursed donor funds 0 0
Other debtors (non-exchange transactions) 46,478,901 0
Less: impairment allowance (0) (0)
Total 46,478,901 0
(Undisbursed donor funds refer to funds expected where conditions for disbursements have been met
by the recipient as at the reporting date)

Analysis of Receivables From Non-Exchange Transactions

2024/2025 2023/2024
Description
Kshs Kshs
% of
Current Comparative % of the
the
FY FY total
total
Less than 1 year 46,478,901 % 0 %
Between 1- 2 years 0 % 0 %
Between 2-3 years 0 % 0 %
Over 3 years 0 % 0 %
Total (a+b) 46,478,901 % 0 %

31. Inventories

2024/2025 2023/2024
Description
KShs KShs
Pharmaceutical supplies 10,766,009 0
Nonpharm 35,108,612 0
Records 1,456,210 0
Public health (Cleaning materials supplies) 1,603,145 0
Othopaedic technology 1,618,000 0
Radiology 3,252,000 0
Labaratory 4,330,963 0
Nutrition 200,124 0
General office supplies 1,881,649 0
Less: provision for impairment of stocks 0 0
Total 60,216,712 0

40
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

Detailed disclosure on inventories

2024/2025 2023/2024

Opening balance 70,423,316 0

Additional Inventory in the year 379,928,942 0

Inventory expensed in the year 390,135,546 0

Write-downs in the year 0 0

Others specify 0 0

Closing balance 60,216,712 0

41
Kakamega County General Teaching And Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
Notes to the Financial Statements (Continued)
32. Property, Plant and Equipment

Description Land Buildings Motor Furniture, ICT Plant and Other Capital Total
and Civil vehicles fittings, and Equipment medical Assets
works office (specify)
equipment
equipment Work in progress
Ksh Ksh Ksh Ksh Ksh Ksh Ksh Ksh
Cost
At 1 July 2023 (previous 0 0 0 0 0 0 0 0 0
year)
Additions 0 0 0 0 0 0 0 0 0
Disposals 0 0 0 0 0 0 0 0 0
Transfers/adjustments 0 0 0 0 0 0 0 0 0
Revaluation Adjustments 0 0 0 0 0 0 0 0 0
At 30th Jun 2024 0 0 0 0 0 0 0 0 0

At 1 July 2024 (current 0 0 0 0 0 0 0 0 0

year)
Additions 0 0 0 0 0
2,396,202 1,100,000 31,698,353 35,194,555
Disposals 0 0 0 0 0 0 0 0 0
Transfer/adjustments 0 0 0 0 0 0 0 0 0
Revaluation Adjustments 0 0 0 0 0 0 0 0 0
At 30th Jun 2025 - - - - -
2,396,202 1,100,000 31,698,353 35,194,555

42
Kakamega County General Teaching And Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
Depreciation and
impairment
At 1 July 2023 (previous 0 0 0 0 0 0 0 0
year)
Depreciation for the year 0 0 0 0 0 0 0 0
Disposals 0 0 0 0 0 0 0 0
Impairment 0 0 0 0 0 0 0 0
At 30 June 2024 0 0 0 0 0 0 0 0
At July 2024 (current year) 0 0 0 0 0 0 0 0
Depreciation 0 0 0 0
299,525 366,630 12,679,341 13,345,496
Disposals 0 0 0 0 0 0 0 0
Impairment 0 0 0 0 0 0 0 0
Transfer/adjustment 0 0 0 0 0 0 0 0
th
At 30 June 2025 - - - -
299,525 366,630 12,679,341 13,345,496

Net book values

At 30th Jun 2024 0 0 0 0 0 0 0 0 0
(previous)
At 30th Jun 20XX 0 0 0 - -
(current) 2,096,677 733,370 19,019,012 21,849,059

43
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
Notes to the Financial Statements (Continued)
33. Intangible Assets-Software
0 0
Description
KShs KShs
Cost
At beginning of the year 0 0
Additions 0 0
Additions–Internal development 0 0
Disposal 0 0
At end of the year 0 0

Amortization and impairment

At beginning of the year 0 0
Amortization for the period 0 0
Impairment loss 0 0
At end of the year 0 0
NBV 0 0

34. Investment Property

2024/2025 2023/2024
Description
KShs KShs
At beginning of the year 0 0
Additions 0 0
Disposals during the year 0 0
Fair value gain 0 0
Depreciation (where investment property is at cost) 0 0
Impairment 0 0
At end of the year 0 0
(For investment property held at fair value, changes in fair value should go through the statement of
financial performance. Where cost model is elected, deprecation and impairment should not be charged.
Investment measured at fair value should be evaluated at the end of the reporting period for changes in
fair value.). Entity should disclose the independent valuers, rental income from the investment property
if any and the direct costs attributed to the investment property. Any charges on the investment property
as well as any difficulty in classifying this asset as an investment property.

44
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
Notes to the Financial Statements (Continued)
35. Biological Assets

Description 2024/2025 2023/2024

Kshs Kshs
Trees in a plantation forest 0 0
Animals: Dairy Cattle, Pigs, Sheep 0 0
Others specify 0 0
Total 0 0

36. Trade and other Payables

2024/2025 2023/2024
Description
KShs KShs
Trade payables 217,116,755 0
Employee dues 0 0
Third-party payments (e.g. unremitted 0 0
payroll deductions)
Audit fee 0 0
Doctors’ fee 0 0
Total trade and other payables 217,116,755 0
% of % of
the the
Ageing analysis: 2024/2025 Total 2023/2024 total
Under one year 0 % 0 %
1-2 years 217,116,755 % 0 %
2-3 years 0 % 0 %
Over 3 years 0 % 0 %
Total 217,116,755 % 0 %

37. Refundable Deposits from Customers/Patients

2024/2025 2023/2024
Description
KShs KShs
Medical fees paid in advance 0 0
Credit facility deposit 0 0
Rent deposits 0 0
Others (specify) 0 0
Total deposits 0 0

45
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
% of
% of the the
Ageing analysis: 2024/2025 Total 2023/2024 Total
Under one year 0 % 0 %
1-2 years 0 % 0 %
2-3 years 0 % 0 %
Over 3 years 0 % 0 %
Total 0 % 0 %

38. Provisions

Leave Bonus Other

Description provision provision provision Total
KShs KShs KShs KShs
Balance at the beginning of the year 0 0 0 0
Additional Provisions 0 0 0 0
Provision utilised 0 0 0 0
Change due to discount & time value for money 0 0 0 0
Total provisions 0 0 0 0

Current Provisions 0 0 0 0
Non-Current Provisions 0 0 0 0
Total Provisions 0 0 0 0

39. Finance Lease Obligation

Description 2024/2025 2023/2024

0 0
Current Lease obligation 0 0
Long term lease obligation 0 0
Total 0 0

40. Deferred Income

2024/2025 2023/2024
Description
KShs KShs
Current Portion 0 0
Non-Current Portion 0 0
Total 0 0

46
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
Notes to the Financial Statements (Continued)
40 (a) The deferred income movement is as follows:
Public
National Internation
contributio
Description governmen al funders/ Total
ns and
t donors
donations
Balance b/f 0 0 0 0
Additions during the year 0 0 0 0
Transfers to Capital fund 0 0 0 0
Transfers to statement of 0 0 0 0
financial performance
Other transfers (Specify) 0 0 0 0
Balance C/F 0 0 0 0

41. Borrowings

2024/2025 2023/2024
Description
KShs KShs
Balance at beginning of the period 0 0
External borrowings during the year 0 0
Domestic borrowings during the year 0 0
Repayments of external borrowings during the year 0 0
Repayments of domestic borrowings during the 0 0
year
Balance at end of the period 0 0

41. (a) Breakdown of Long- and Short-Term Borrowings

2024/2025 2023/2024
Description
KShs KShs
Current Obligation 0 0
Non-Current Obligation 0 0
Total 0 0
(Current portion of borrowings are those borrowings that are payable within one year or the next
financial year. Additional disclosures on terms of borrowings, nature of borrowings, security and
interest rates should be disclosed).

47
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

Notes to the Financial Statements (Continued)

42. Service Concession Arrangements

2024/2025 2023/2024
Description
KShs KShs
Fair value of service concession assets recognized 0 0
under PPE
Accumulated depreciation to date 0 0
Net carrying amount 0 0
Service concession liability at beginning of the year 0 0
Service concession revenue recognized 0 0
Service concession liability at end of the year 0 0

43. Cash Generated from Operations

2024/2025 2023/2024
Description
KShs KShs
Surplus for the year before tax 37,440,446 0
Adjusted for:
Depreciation 13,345,496 0
Non-cash grants received 0 0
Impairment 0 0
Gains and losses on disposal of assets 0 0
Contribution to provisions 0 0
Contribution to impairment allowance 0 0
Working Capital adjustments
Increase in inventory 10,206,604 0
Increase in receivables (59,144,629) 0
Increase in deferred income 0 0
Increase in payables 0 0
Increase in payments received in advance 0 0
Net cash flow from operating activities 1,847,917 0
(The total of this statement should tie to the cash flow section on net cash flows from/ used in
operations

48
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
Notes to the Financial Statements (Continued)

44. Financial Risk Management

The entity’s activities expose it to a variety of financial risks including credit and liquidity risks
and effects of changes in foreign currency. The hospital’s overall risk management programme
focuses on the unpredictability of changes in the business environment and seeks to minimise
the potential adverse effect of such risks on its performance by setting acceptable levels of risk.
The hospital does not hedge any risks and has in place policies to ensure that credit is only
extended to customers with an established credit history.
The entity’s financial risk management objectives and policies are detailed below:
(i) Credit risk
The entity has exposure to credit risk, which is the risk that a counterparty will be unable to
pay amounts in full when due. Credit risk arises from cash and cash equivalents, and deposits
with banks, as well as trade and other receivables and available-for-sale financial investments.
Management assesses the credit quality of each customer, taking into account its financial
position, past experience and other factors. Individual risk limits are set based on internal or
external assessment in accordance with limits set by the directors. The amounts presented in
the statement of financial position are net of allowances for doubtful receivables, estimated by
the hospital’s management based on prior experience and their assessment of the current
economic environment. The carrying amount of financial assets recorded in the financial
statements representing the entity’s maximum exposure to credit risk without taking account
of the value of any collateral obtained is made up as follows:

Fully
Total
performin Past due Impaired
Description amount
g
Kshs Kshs Kshs Kshs
At 30 June 2024 (previous year)
Receivables from exchange transactions 0 0 0 0
Receivables from –non-exchange 0 0 0 0
transactions
Bank balances 0 0 0 0
Total 0 0 0 0
At 30 June 2025 (current year)
Receivables from exchange transactions 0 0 0 0
Receivables from –non-exchange 0 0 0 0
transactions
Bank balances 0 0 0 0
Total 0 0 0 0
(NB: The totals column should tie to the individual elements of credit risk disclosed in the entity’s
statement of financial position)

49
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

Notes to the Financial Statements (Continued)

The customers under the fully performing category are paying their debts as they continue
trading. The credit risk associated with these receivables is minimal and the allowance for
uncollectible amounts that the hospital has recognised in the financial statements is considered
adequate to cover any potentially irrecoverable amounts. The entity has significant
concentration of credit risk on amounts due from xxxx The board of management sets the
hospital’s credit policies and objectives and lays down parameters within which the various
aspects of credit risk management are operated.

(ii) Liquidity risk management

Ultimate responsibility for liquidity risk management rests with the hospital’s board of
management who have built an appropriate liquidity risk management framework for the
management of the entity’s short, medium and long-term funding and liquidity management
requirements. The entity manages liquidity risk through continuous monitoring of forecasts and
actual cash flows.
The table below represents cash flows payable by the hospital under non-derivative financial
liabilities by their remaining contractual maturities at the reporting date. The amounts disclosed
in the table are the contractual undiscounted cash flows. Balances due within 12 months equal
their carrying balances, as the impact of discounting is not significant.

Less than 1 Between 1-3 Over 5

Total
Description month months months
Kshs Kshs Kshs Kshs
At 30 June 2025
Trade payables 0 0 0 0
Current portion of borrowings 0 0 0 0
Provisions 0 0 0 0
Deferred income 0 0 0 0
Employee benefit obligation 0 0 0 0
Total 0 0 0 0
At 30 June 2025
Trade payables 0 0 0 0
Current portion of borrowings 0 0 0 0
Provisions 0 0 0 0
Deferred income 0 0 0 0
Employee benefit obligation 0 0 0 0
Total 0 0 0 0

50
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
Notes to the Financial Statements (Continued)

(iii) Market risk

The hospital has put in place an internal audit function to assist it in assessing the risk faced by
the entity on an ongoing basis, evaluate and test the design and effectiveness of its internal
accounting and operational controls. Market risk is the risk arising from changes in market
prices, such as interest rate, equity prices and foreign exchange rates which will affect the
entity’s income or the value of its holding of financial instruments. The objective of market
risk management is to manage and control market risk exposures within acceptable parameters,
while optimising the return. Overall responsibility for managing market risk rests with the
Audit and Risk Management Committee.

The hospital’s Finance Department is responsible for the development of detailed risk
management policies (subject to review and approval by Audit and Risk Management
Committee) and for the day-to-day implementation of those policies. There has been no change
to the entity’s exposure to market risks or the way it manages and measures the risk.

a) Foreign currency risk

The entity has transactional currency exposures. Such exposure arises through purchases of
goods and services that are done in currencies other than the local currency. Invoices
denominated in foreign currencies are paid after 30 days from the date of the invoice and
conversion at the time of payment is done using the prevailing exchange rate. The carrying
amount of the entity’s foreign currency denominated monetary assets and monetary liabilities
at the end of the reporting period are as follows:
Other
KShs Total
Description currencies
Kshs Kshs
At 30 June 2025
Financial assets (investments, cash, debtors) 0 0 0
Liabilities
Trade and other payables 0 0 0
Borrowings 0 0 0
Net foreign currency asset/(liability) 0 0 0

The entity manages foreign exchange risk from future commercial transactions and recognised
assets and liabilities by projecting expected sales proceeds and matching the same with
expected payments.

51
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
Notes to the Financial Statements (Continued)

KShs Other currencies Total

Description
Kshs Kshs
At 30 June 2025
Financial assets (investments, cash, debtors) 0 0 0
Liabilities
Trade and other payables 0 0 0
Borrowings 0 0 0
Net foreign currency asset/(liability) 0 0 0

Foreign currency sensitivity analysis

The following table demonstrates the effect on the hospital’s statement of financial
performance on applying the sensitivity for a reasonable possible change in the exchange rate
of the three main transaction currencies, with all other variables held constant. The reverse
would also occur if the Kenya Shilling appreciated with all other variables held constant.
Change in Effect on Profit Effect on
Description currency rate before tax equity
Kshs Kshs Kshs
2024 (previous year)
Euro 10% 0 0
USD 10% 0 0
2025 (current year)
Euro 10% 0 0
USD 10% 0 0
b) Interest rate risk
Interest rate risk is the risk that the entity’s financial condition may be adversely affected as a
result of changes in interest rate levels. The hospital’s interest rate risk arises from bank
deposits. This exposes the hospital to cash flow interest rate risk. The interest rate risk exposure
arises mainly from interest rate movements on the hospital’s deposits.

Management of interest rate risk

To manage the interest rate risk, management has endeavoured to bank with institutions that
offer favourable interest rates.

52
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
Notes to the Financial Statements (Continued)

Sensitivity analysis
The entity analyses its interest rate exposure on a dynamic basis by conducting a sensitivity
analysis. This involves determining the impact on profit or loss of defined rate shifts. The
sensitivity analysis for interest rate risk assumes that all other variables, in particular foreign
exchange rates, remain constant. The analysis has been performed on the same basis as the
prior year.

Using the end of the year figures, the sensitivity analysis indicates the impact on the statement
of financial performance if current floating interest rates increase/decrease by one percentage
point as a decrease/increase of KShs 0 (2025: KShs 0). A rate increase/decrease of 5% would
result in a decrease/increase in surplus of KShs 0 (2025 – KShs 0).
iv) Capital Risk Management
The objective of the entity’s capital risk management is to safeguard the Hospital’s ability
to continue as a going concern. The entity capital structure comprises of the following
funds:

2024/2025 2023/2024
Description
Kshs Kshs
Revaluation reserve 0 0
Retained earnings 0 0
Capital reserve 0 0
Total funds 0 0

Total borrowings 0 0
Less: cash and bank balances 0 0
Net debt/ (excess cash and cash equivalents) 0 0
Gearing 0 0

53
Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
Notes to the Financial Statements (Continued)

45. Related Party Balances

Nature of related party relationships

Entities and other parties related to the entity include those parties who have the ability to
exercise control or exercise significant influence over its operating and financial decisions.
Related parties include management personnel, their associates, and close family members.

xxx County Government is the principal shareholder of the entity, holding 100% of the entity’s equity
interest. The National Government of Kenya has provided full guarantees to all long-term lenders of the
entity, both domestic and external. The related parties include:
i) The National Government;
ii) The County Government;
iii) Board of Directors;
iv) Key Management

2024/2025 2023/2024
Description
Kshs Kshs
Transactions with related parties

a) Services offered to related parties

Services to xxx 0 0
Sales of services to xxx 0 0
Total 0 0

b) Grants from the Government

Grants from County Government 0 0
Grants from the National Government Entities 0 0
Donations in kind 0 0
Total 0 0

c) Expenses incurred on behalf of related party

Payments of salaries and wages for xxx employees 0 0
Payments for goods and services for xxx 0 0
Total 0 0

54
 Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
2024/2025 2023/2024
Description
Kshs Kshs
d) Key management compensation
Directors’ emoluments 0 0
Compensation to the medical Sup 0 0
Compensation to key management 0 0

Total 0 0

46. Segment Information

(Where an organisation operates in different geographical regions or in departments, IPSAS 18 on

segmental reporting requires an entity to present segmental information of each geographic region or
department to enable users understand the entity’s performance and allocation of resources to different
segments)

47. Contingent Liabilities

2024/2025 2023/2024
Contingent liabilities
Kshs Kshs
Court case xxx against the hospital 0 0
Bank guarantees in favour of subsidiary 0 0
Total 0 0

(Give details)

48. Capital Commitments

2024/2025 2023/2024
Capital Commitments

Kshs Kshs
Authorised For 0 0
Authorised And Contracted For 0 0
Total 0 0
(NB: Capital commitments are commitments to be carried out in the next financial year and are
disclosed in accordance with IPSAS 17. Capital commitments may be those that have been authorised
by the board but at the end of the year had not been contracted or those already contracted for and
ongoing)

55
 Kakamega County General Teaching And Referral Hospital (Kakamega County
Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
49. Events after the Reporting Period

There were no material adjusting and non-adjusting events after the reporting period.

50. Ultimate and Holding Entity

The entity is a County Corporation/ or a Semi- Autonomous Government Agency under the
Department of Health Service . Its ultimate parent is the County Government of Kakamega.

51. Currency
The financial statements are presented in Kenya Shillings (Kshs) and all values are rounded off
to the nearest shilling.

56
Kakamega County General Teaching And Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
20. Appendices

Appendix 1: Progress on Follow Up of Auditor Recommendations

The following is the summary of issues raised by the external auditor, and management comments that were provided to the auditor. We have
nominated focal persons to resolve the various issues as shown below with the associated time frame within which we expect the issues to be
resolved.
This is the first set of financial report and statements.

Timeframe:
Status:
Reference No. on the Issue / Observations from (Put a date when you
Management comments (Resolved / Not
external audit Report Auditor expect the issue to be
Resolved)
resolved)

Guidance Notes:

(i) Use the same reference numbers as contained in the external audit report.

(ii) Obtain the “Issue/Observation” and “management comments”, required above, from the final external audit report that is signed by
Management.

(iii) Before approving the report, discuss the timeframe with the appointed Focal Point persons within your entity responsible the for
implementation of each issue.

(iv) Indicate the status of “Resolved” or “Not Resolved” by the date of submitting this report to National Treasury.

……………………………….
Accounting Officer

57
Kakamega County General Teaching And Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025

Appendix II: Projects Implemented by The Entity

Projects

Projects implemented by the Hospital Funded by development partners

Project title Project Number Donor Period/ Donor commitment Separate donor Consolidated in
duration reporting required as these financial
per the donor statements
agreement (Yes/No) (Yes/No)
1
2

Status of Projects completion

(Summarise the status of project completion at the end of each quarter, i.e. total costs incurred, stage which the project is etc)

SN Project Total project Total expended to Completion % to Budget Actual Sources of funds
Cost date date
1
2
3

58
Kakamega County General Teaching And Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
Appendix III: Inter-Entity Confirmation Letter

Name of Transferring entity FIF and County executive

Name of Beneficiary entity County General Hospital

Confirmation of amounts received by [Insert name of beneficiary Entity] as at 30th June (Current FY)

Total
Remarks
Reference Number Date Disbursed Recurrent (A) Development (B) (C)=(A+B)
FIF 30/6/2025 435,995,429 435,995,429
COUNTY TREASURY 30/6/2025 7,000,000 7,000,000
0
Total 442,995,429 442,995,429

I confirm that the amounts shown above are correct as of the date indicated.

Head of Accounts Department - Disbursing Entity:

Name Cpa Wycliffe Kotonya . Sign ……………………………. Date ………………

Head of Accounts Department - Beneficiary Entity:

Name Cpa Wycliffe Wanzala Sign ……………………………. Date………………

________

59
Kakamega County General Teaching And Referral Hospital (Kakamega County Government)
Annual Report and Financial Statements for The Year Ended 30th June 2025
Appendix IV Reporting of Climate Relevant Expenditures

Project Project Project Project Quarter Source Of Implementing

Name Description Objectives Activities Funds Partners
Q1 Q2 Q3 Q4

60
XX Hospital (XX County Government)
Annual Report and Financial Statements for The Year Ended 30th June 20xx
Appendix V: Disaster Expenditure Reporting Template

Programme Sub- Disaster Category of disaster related Activity that Expenditure Amount Comments
programme Type require expenditure reporting item (Kshs.)
(response/recovery/mitigation/preparedness)

61