Chapter One:

Introduction
1.1 Background of the Study
The industrial attachment at Kitui County Referral Hospital's Accounts Department provided an
opportunity to gain practical experience in financial management within a public healthcare
setting. KCRH, located in Kitui County, Kenya, serves as a key healthcare provider in the region,
offering a range of medical services to the local population. As a critical institution in the public
sector, effective financial management is essential for ensuring the efficient use of resources and
maintaining operational sustainability.
The Accounts Department at the hospital plays a vital role in managing financial transactions,
maintaining accurate records, and ensuring compliance with financial regulations. This
attachment was aimed at bridging the gap between theoretical knowledge acquired during
academic studies in finance and its practical application in a real-world environment. The
experience gained during this attachment is intended to enhance understanding of financial
operations and contribute to personal and professional development in the field of finance.

1.1.1 Scope of the Attachment Report

The scope of this report covers the entire duration of the industrial attachment at KCRH,
focusing on the practical application of financial principles within the Accounts Department.
This includes:
 Financial Transactions Management: Detailed analysis of the processes involved in
recording and managing financial transactions, such as posting Authority to Incur
Expenditure (AIEs) in the cash book and preparing payment vouchers.
 Cheque and Payment Processing: Examination of the procedures for issuing and
processing cheques, handling payments, and managing imprests.
 Record Keeping and Reconciliation: Insights into maintaining accurate financial
records, filing payment vouchers, and performing bank reconciliations.

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  Challenges and Solutions: Discussion of the specific challenges faced during the
attachment, along with practical solutions and improvements implemented to address
these challenges.
The report aims to provide a comprehensive account of the attachment experience, highlighting
key activities, skills acquired, and lessons learned.

1.1.2 Objectives of the Attachment

The objectives of the attachment were designed to bridge theoretical knowledge with practical
experience in financial management. These objectives included:
 Practical Experience: To gain hands-on experience in the day-to-day financial
operations of a public healthcare institution, such as managing accounts payable and
receivable, and preparing and processing payment vouchers.
 Understanding Financial Processes: To understand and actively participate in critical
financial processes, including the posting of AIEs, commitment of LPOs and LSOs, and
cheque management.
 Skill Development: To develop and refine professional skills in financial management,
including accuracy in financial record-keeping, adherence to financial procedures, and
effective problem-solving.
 Challenge Identification and Solution: To observe and identify challenges in financial
management within a public healthcare setting and to propose and implement practical
solutions to these challenges.

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1.1.3 Benefits of Industrial Attachment
The industrial attachment provided several key benefits, including:
 Enhanced Practical Knowledge: The opportunity to apply and deepen theoretical
knowledge of financial management in a real-world context, enhancing understanding of
financial operations and practices.
 Development of Professional Skills: Improvement in practical skills related to financial
management, such as accurate record-keeping, cheque processing, and bank
reconciliation.
 Exposure to Real-World Challenges: Insight into the challenges faced in financial
management within a healthcare institution, providing valuable experience in problem-
solving and decision-making.
 Networking Opportunities: Establishing professional connections with experienced
finance practitioners and gaining insights into career opportunities and industry practices.
1.2 Organization History
Kitui County Referral Hospital has a rich history that reflects its development and growth as a
key healthcare provider in Kitui County. Established to address the healthcare needs of the
region, the hospital has evolved over time to expand its services and improve healthcare delivery.
Key historical milestones include:
 Foundation and Early Years: The hospital was established to provide basic healthcare
services to the local population. Initially, it focused on primary care and essential medical
services.
 Expansion and Development: Over the years, the hospital expanded its facilities and
services, incorporating specialized departments and advanced medical technologies to
better serve the community.

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  Recent Developments: In recent years, the hospital has continued to grow, with
improvements in infrastructure, the introduction of new medical services, and efforts to
enhance overall healthcare delivery.

1.2.1 Objectives
The primary objectives of Kitui County Referral Hospital are:
 To Provide Comprehensive Healthcare: To deliver a wide range of medical services,
including preventive, curative, and rehabilitative care, to meet the healthcare needs of the
Kitui County population.
 To Promote Public Health: To contribute to the improvement of public health through
various health programs, community outreach, and health education initiatives.
 To Ensure Efficient Resource Management: To manage financial, human, and material
resources effectively to ensure sustainability and optimal service delivery.

1.3 Organization Profile

1.3.1 Vision
The vision of Kitui County Referral Hospital is to be a leading healthcare institution renowned
for excellence in patient care, medical research, and healthcare innovation. The hospital aspires
to set the standard for high-quality healthcare services and to be recognized as a center of
excellence in the region.
1.3.2 Mission
The mission of Kitui County Referral Hospital is to provide accessible, affordable, and high-
quality healthcare services to the residents of Kitui County. The hospital is dedicated to
improving health outcomes through compassionate care, professional excellence, and active
engagement with the community.
1.3.3 Core Values
The core values that guide the operations of Kitui County Referral Hospital include:
 Patient-Centered Care: Prioritizing the needs and well-being of patients in all aspects of
service delivery, ensuring that care is respectful, responsive, and personalized.

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  Integrity: Upholding transparency, honesty, and ethical behavior in all interactions and
operations, maintaining the trust of patients, staff, and stakeholders.
 Excellence: Committing to the highest standards of quality and professionalism in
healthcare services, striving for continuous improvement and innovation.
 Teamwork: Fostering a collaborative environment where staff work together to achieve
common goals, enhance patient care, and support one another in their roles.
 Innovation: Embracing new technologies, practices, and approaches to improve
healthcare delivery and patient outcomes.
1.3.4 Strategic Objectives
The strategic objectives of Kitui County Referral Hospital include:
 Expanding Healthcare Services: To enhance and expand the range of medical services
offered, including the introduction of new specialties and advanced treatments to meet
the evolving needs of the community.
 Improving Infrastructure: To upgrade and modernize facilities and equipment,
ensuring a safe, efficient, and comfortable environment for patients and staff.
 Strengthening Human Resources: To invest in the development and training of
healthcare professionals, improving their skills and competencies to provide high-quality
care.
 Enhancing Financial Management: To implement effective financial management
practices that ensure sustainability, optimize resource use, and support the hospital’s
operational goals.

1.3.5 Our Customers and Stakeholders

Kitui County Referral Hospital serves a diverse range of customers and stakeholders, including:
 Patients: The primary beneficiaries of healthcare services, encompassing individuals and
families seeking medical care, treatment, and support.
 Healthcare Providers: Medical and support staff, including doctors, nurses, and allied
health professionals, who deliver care and contribute to the hospital’s operations.

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  Government Agencies: Local and national government bodies responsible for healthcare
policy, funding, and oversight, including the Ministry of Health and Kitui County
Government.
 Community Organizations: Non-governmental organizations and community groups
that collaborate with the hospital on health initiatives, outreach programs, and service
delivery.
 Donors and Partners: Organizations and individuals who provide financial support,
resources, or expertise to enhance the hospital’s capabilities and service offerings.

1.4 Attached Departments

During the attachment, experience was gained in several key departments within the hospital,
including:
 Accounts Department: Responsible for managing financial transactions, maintaining
accurate records, preparing payment vouchers, and reconciling bank statements.
 Procurement Department: Handling the acquisition of goods and services, including
the preparation and processing of Local Purchase Orders (LPOs) and Local Service
Orders (LSOs).
 Treasury Department: Managing the processing of cheques, payments, and imprests, as
well as liaising with banks for financial transactions and fund management.
 Human Resources Department: Overseeing staff recruitment, training, payroll
management, and employee benefits administration.

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1.5 Methodology
The methodology for this attachment involved a combination of practical engagement and
observational learning. The key methods employed included:
 Active Participation: Engaging in daily accounting tasks such as posting transactions,
preparing payment vouchers, and managing cheque processing to gain hands-on
experience.
 Observation: Observing financial processes and procedures within the Accounts
Department to understand the workflow and identify best practices.
 Documentation Review: Reviewing financial documents, including AIEs, LPOs, LSOs,
payment vouchers, and bank statements, to understand the documentation requirements
and accuracy standards.
 Interviews and Discussions: Conducting interviews and discussions with departmental
staff and supervisors to gain insights into financial management practices and address any
queries.
Data collected during the attachment was analyzed to assess the effectiveness of financial
processes, identify areas for improvement, and draw conclusions based on practical experience.
1.6 Structure of the Report
The structure of the report is organized to provide a clear and comprehensive overview of the
attachment experience:
 Chapter One: Introduction – Provides background information, objectives, scope,
methodology, and report structure.
 Chapter Two: task performed ,analysis of duties in detail ,documents in finance
accounts
 Chapter Three: Experience and insights

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 2.0 CHAPTER TWO
2.1 Tasks Performed
This chapter provides a detailed description of the tasks and responsibilities undertaken during
the industrial attachment at Kitui County Referral Hospital’s Accounts Department. It highlights
the specific financial duties performed and the processes involved in carrying out these tasks.
2.1.1 Analysis of Duties in Detail
This section delves into each duty performed in the Accounts Department, offering an in-depth
analysis of the tasks and responsibilities involved
• Posting of AIEs in Cash Book
• Commitment of LPO and LSO
• Preparation of Payment Vouchers
• Commitment of Payments in Vote Book and Posting in Cash Book
• Examination of Payment Vouchers
• Writing and Processing Cheques
• Processing of Cheques and Payments / Imprests at County Treasury
• Dispatching Cheques Using Cheque Register
• Depositing Cheques, Schedules, and Payrolls to Banks
• Filling of Payment Vouchers
• Bank Reconciliation

I was placed in the Accounting and Finance Department under Vote book section where matters
to do with payment vouchers and petty cash warrants were handled. My assigned tasks were to
record all the details of the payment vouchers and the petty cash warrants in their respective
books of records. Then I was to proceed on and commit the funds in the vote book and later on, I
forward the data to hospital Accountant to invoice them in the integrated financial management
system (IFMIS) for accountability.

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In their preparations, I was expected to ensure that the payee names and the amounts to be paid
were in correspondence with the details shown in the payment vouchers and the petty cash.
Bearing in mind June was the closing month of financial year, more work was on examination of
payment vouchers whereby attached details must be same to amount recorded in the voucher. In
our section, I was responsible for awarding cheques to respective PAYEs after calculating their
VAT. The VAT deducted is also written inform of cheque and dedicated to the commissioners of
domestic taxes. We would also take all these transactions of cheques, receipts and vouchers and
post them in the cashbook according to their assigned numbers. After posting them, all vouchers
and cheques are posted in their respective movement register.

Besides, I was preparing imprest warrants for monthly claims and then submit them to the HA to
run them in the Integrated Financial Management system (IFMIS). Despite preparing the
vouchers, examining and invoicing them was among my duties as well. Far from finance related
activities, I was attending meeting and other official functions as requested by HA or the
administration. After preparing the imprest warrants and attaching the relevant receipts in the
imprest section, i take them to our office for verification and payment. All the transaction and
expenditures of the week are also recorded in the weekly expenditure register. These are
activities I have been socializing with in my ten week period.

Moreover, all these transaction could be recorded in the cashbook according to their cheque and
voucher numbers. After balancing the cashbook I would match the result with the bank
statements as a form of reconciliation. In the office, I was responsible for typing, printing,
photocopying, and filing as well. However, my attachment was not only limited to these
activities, there are more activities that arose especially in June when we were closing the
national financial year. During auditing, the auditor would require certain information which was
not in the normal schedule of the activities that I ran, and so I would be assigned other duties, for
instance, retrieving the required documents from the various files.

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2.1.2 Documents in Finance Accounts
 AIE (Authority to incur expenditure) Forms: Documents used to authorize and record
internal expenditures.
 LPO (Local Purchase Order) Forms: Used for procuring goods and services,
documenting order details.
 LSO (Local Service Order) Forms: Similar to LPOs but specifically for services.
 Payment Vouchers: Forms used to authorize and document payments made by the
hospital.
 Cheques: Written orders for bank payments, including details of the payee, amount, and
date.
 Bank Statements: Documents from the bank showing all transactions for the account,
used for reconciliation.
 Vote Books: Record of budgetary commitments and expenditures.

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 CHAPTER THREE

Experience and Insights

3.0 Introduction
This chapter presents a reflective overview of the attachment experience, including personal
insights and reflections on the work undertaken.
3.1 Experiences at Work Station
This section provides a detailed account of the day-to-day experiences and activities at the
Accounts Department, including:
 Daily Responsibilities: Description of daily tasks performed, interactions with staff, and
overall workflow.
 Learning Experiences: Insights gained from working on specific tasks and how they
contributed to understanding financial management in a healthcare setting.
 Professional Development: Skills and competencies developed during the attachment,
including technical and soft skills.

3.2 Achievement of Objectives

 Application of Knowledge: How effectively theoretical knowledge was applied to
practical tasks.
 Skill Development: Assessment of skill enhancement in areas such as financial
documentation, compliance, and reporting.
 Understanding Financial Procedures: Insight into how well the attachment contributed
to understanding specific financial procedures and practices in the hospital.

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3.3 Challenges
 Operational Difficulties: Issues faced in performing financial tasks and how they were
addressed.
 Compliance and Accuracy: Challenges related to ensuring compliance with financial
regulations and maintaining accuracy in financial records.
 Technical and Procedural Issues: Any technical or procedural difficulties encountered
and their impact on the attachment experience.
3.4 Recommendations
3.4.1 to the Institution
 Process Improvements: Suggestions for improving financial processes and procedures.
 Training and Development: Recommendations for enhancing training programs for
new staff or interns.
 Operational Efficiency: Ideas for increasing efficiency in the Accounts Department’s
operations.
3.4.2 To the School
 Curriculum Enhancements: Suggestions for incorporating practical aspects into the
finance curriculum.
 Support for Attachments: Recommendations for improving support and preparation for
industrial attachments.
 Industry Collaboration: Ideas for enhancing collaboration between the school and
industry to provide better attachment opportunities.

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3.5 Conclusions
This section summarizes the key findings and insights from the attachment, including:
 Overall Experience: Reflection on the overall experience and its impact on professional
development.
 Achievement of Goals: Summary of how well the attachment met its objectives and
contributed to learning.
 Future Implications: Consideration of how the experience will influence future career
plans and professional growth.

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References
 Logbook
 Kitui County Referral Hospital
 Regulatory Frameworks: References to financial regulations and policies applicable to
public healthcare institutions.

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