2017 ANNUAL REPORT

PARIRENYATWA GRO

UP OF HOSPITALS

CONTENTSCONTENTSCONTENTSCONTENTSCONTENTSCONTENTS

1

Hospital Management 6

Board Members 2Hospital Executive 4

Auditors, Bankers and Legal Counsel 8Mission, Vision and Values 9Chairperson’s Statement 10

Group Chief Executive’s Statement 12Corporate Governance Report 16

Laboratory Services 18Pharmacy 19School of Nursing 20School of Radiography 21School of Midwifery 22

Catering Department 23Theatre 24Philanthropic Camp Statistics 25

Casualty Statistics 25Auditor General Report 26Group Financial Statements 34

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PGH 2017 BOARD MEMBERSBoard Members

2

DR. G. SIKIPA

CHAIRPERSON

MR T. A. ZIGORA

BOARD MEMBER&

GROUP CEO

MR M. KHALPEY

BOARD MEMBER

PROF C. NDHLOVU

BOARD MEMBER

Mr R Mvududu (Chairperson)

Dr C Dhliwayo

Prof C Ndhlovu

Mr T.A Zigora

Prof C Ndhlovu(Chairperson)

Dr G Sikipa

Mr J.B.M Flemming

Mr T.A Zigora

MR J. B. M FLEMMING

BOARD MEMBER

Clinical Audit CommitteeHuman Resources Committee

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PGH 2017 BOARD MEMBERSBoard Members

3

DR C. DHLIWAYO

BOARD MEMBER

MR M. KHALPEY

BOARD MEMBER

PROF C. NDHLOVU

BOARD MEMBER

MR R. MVUDUDU

BOARD MEMBER

Dr C Dhliwayo (Chairperson)

Mr M Khalpey

Mr R Mvududu

Mr M Khalpey (Chairperson)

Mr J.B.M Flemming

Dr G Sikipa

Mr T.A Zigora

Audit and Risk Management Committee Finance and ICT CommitteeClinical Audit Committee

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017 HOSPITAL EXECUTIVE

GROUP CHIEF EXECUTIVE

mr. t. a zigora

CLINICAL DIRECTOR

mr. n. madziva

HOSPITAL EXECUTIVE

GROUP CHIEF EXECUTIVE

mr. t. a zigora

CLINICAL DIRECTORCLINICAL DIRECTORCLINICAL DIRECTOR

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017HOSPITAL EXECUTIVE

FINANCE DIRECTOR

mrs m. sanzira

OPERATIONS DIRECTOR

mr e. mundenda

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HOSPITAL MANAGEMENT TEAM

6

DR, L. G. DODZO

PRINCIPAL NURSING OFFICER

MR. D. N. VURAGU

CHIEF PHARMACIST

MRS. Y. CHIVASA

CHIEF RADIOGRAPHER

DIAGNOSTIC

MR L. HAPARIMWI

HOSPITAL ENGINEER

Management Team

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HOSPITAL MANAGEMENT TEAM

7

MRS. R. KANYEMBA

PRINCIPAL TUTOR - SCHOOL OF NURSING

MR. L. DHIRE

PUBLIC RELATIONS OFFICER

MR. C. ZVOUSHE

CHIEF BUYER

MRS. M. NKOMO

PRINCIPAL TUTOR - SCHOOL OF MIDWIFERY

Management Team

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AUDITORS, BANKERS AND LEGAL COUNSEL

Auditors, bankers and legal counsel

AUDITORS: AUDITOR GENERAL (ZIMBABWE) Burroughs House Corner 4th Street / George Silundika Avenue Harare

BANKERS: COMMERCIAL BANK OF ZIMBABWE Kwame Nkrumah Avenue Branch 60 Kwame Nkrumah Avenue Harare, Zimbabwe Telephone: +263-4-748050 +263-4-758077

LEGAL COUNSEL: KANTOR & IMMERMAN LEGAL PRACTITIONERS MacDonald House 10 Selous Avenue Harare Telephone: +263-4-700454 +263-4-704351/2

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contact detailsPARIRENYATWA GROUP OF HOSPITALS

P.O Box CY 198 Harare

Website : www.parihosp.org Telephone : 701520-701554/7 Fax : 706627 Facebook : Parirenyatwa Group of Hospitals Twitter : pghzim Email : publicrelations@parihosp.org parirenyatwapr@gmail.com

MISSION

VISION

VALUES

To provide quality and cost-e� ective special-ist healthcare services to the public together with modern training and research facilities for health professionals

To be a centre of excellence in the provision of specialist healthcare services as well as training and research opportunities in Zimbabwe and the Region by 2025

COMMITMENTAll our e� orts are ultimately directed towards the health of our patients

ACCOUNTABILITYWe uphold high standards of professionalism

and will not compromise ethicsRESPECT

Everyone should be treated with courtesy at all times in spite of individual di� erences and

personal circumstancesNON-DISCRIMINATION

We receive and attend to all patients and clients without regards to gender, religion, col-

our, creed, tribe, race or political a� liationINNOVATIVENESS

We strive to continuously improve our services across the board through new technologies

Mission, vision and values

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017 CHAIRPERSON’S STATEMENT

IntroductionsIt is my pleasure once again to present the AnnualReport and � nancial statements of the PGH for theyear ended 31 December, 2017. � is report is oursecond during the life of this Board, and indeed forthe hospital. � e Board was re-appointed in November, 2017 a� er a successful 3-year term.

Operating Environment� e year 2017 was by and large a continuation of the challenges which characterised the previous year. Shortage of foreign currency in the country coupled with lack of local production of drugs andmedicines posed a big challenge in the provision ofconsistent and quality service.� e performance of the health sector has always been on thespotlight hence a lot is expected from those running the hospitals.In the absence of comprehensive � nancial support for the sector, challenges will always be experienced.

It is no secret that PGH, along with the broader health systems across the country, faces a myriad of challenges now and into the future. � e demands for the service are increasing due to the rise of NCDs and other chronic diseases. � e depressed economy on the other hand has made a lot of people to depend on government for support.

CHAIRPERSON’S STATEMENT

� e performance of the health sector has always been on thespotlight hence a lot is expected from those running the hospitals.In the absence of comprehensive � nancial support for the sector,

It is no secret that PGH, along with the broader health systems across the country, faces a myriad of challenges now and into the future. � e demands for the service are increasing due to the rise of NCDs and other chronic diseases. � e depressed economy on the other hand has made a lot of people to depend on government for

� e Board is however grateful of some relief given to hospitals in the form of drugs and surgicals through theHealth Levy Fund.

Further Outlook - 2018� ere is renewed hope a� er the new government was ushered in. � e Board is very positive about the prospects of better and improved health delivery system in view of the renewed interest in supporting the health sector. For the � rst time in as many years, the Parliamentarians raised a concern on the paltry allocation of the 2018 budget to health, which resulted in the upward review. � e move was applauded and it is hoped that in future this thinking will impact positively on government support to the sector.

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Group Chief Executive’s statement

GROUP CHIEF EXECUTIVE’S STATEMENT

Introduction� e PGH remains the hospital of choice in the public health sector and as such it serves as a benchmark forbest practice of public health delivery system. � is has kept us on our toes to ensure that the brand that wecarry continues to shine, hence our payline phrase “striving for excellence”.

Human Capital � e human resource status for the hospital was at 78% in terms of the establishment strength, with 2 537 inpost as at 31st December, 2017. � is increase in total establishment followed an allocation of an additional173 nurses and 24 Senior House O� cer (SHO) posts, respectively during the course of the year. � is has given some relief on the nurses’ coverage as reports of burnouts and requests for time o� were now on the rise.

� e hospital continues to largely rely on locum nurses for specialities such as � eatre and Intensive CareNursing. Pharmacists, Radiographers and Laboratory Scientists are highly mobile cadres as we continue tohave inexperienced sta� manning these departments. During the year under review a cumulative total of 41sta� in this category le� the institution.

Shortage of Anaethetists or inadequate anaesthetic coverage has a bearing on the performance of theatres.Of concern is the continued occupation of posts by Senior Registrars who would have completed their man-datory one year registrarship. � is has now created a bottleneck in the training posts for incoming MMed doctors. A total of 22 doctors are in this category for di� erent specialities. � e nation would bene� t if these doctors could be deployed to other hospitals or take up specialists posts, especially at Provincial hospitals, so as to improve on service delivery at that level. � is will also reduce the number of referrals to Central hospi-tals, hence reducing the current workload burden, as well as the risk of losing patients in transit to CentralHospitals.

WorkloadsAn average of between 900 to 1 000 in patients was recorded daily throughout the year. Accident and Emer-gency Department (Casualty) attended to 55 989 patients in 2017 .

Outpatient department (OPD) saw a total of 29 114 patients across all speciality clinics with Orthopaedics attending to 7 800 patients.

Cancer of the cervix screening also increased marginally from 322 in 2016 to 390 by close of the year 2017.

However long waiting elective theatre lists especially for Urology and Orthopaedics remain a cause of concern. � is has been attributed to shortage of Specialists and inadequate theatre time, against the high number of patients requiring our services.

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Group Chief Executive’s statement

Capital Projects

• Expansion of High Dependency Unit� e bed capacity for the High Dependency Unit (HDU) has been increased from 7 to 15. � is has eased pres-sure on the demand for high dependency beds considering the increase in � eatre operations.

• Dialysis Machines upgrade � e hospital has a total of 18 dialysis machines which were installed in 2013. � e machines were upgradedto the newer version during the course of the year. Four (4) of these machines have been dedicated to privatepatients.

• Refurbishment of Nurses Homes� e hospital undertook massive refurbishment works at the nurse’s homes which salvaged a total of 50 x unitswhich had become inhabitable due to storm water damage. � e roofs, ablution facilities, power supplies andbuilt in cupboards were rehabilitated at an estimated cost of $30 000.

• Installation of Switchgear� e hospital procured and installed 2 x Medium Voltage (MV) distribution boards replacing the aged units putin place in the 1970s. � e MV boards distribute power to the heart of the hospital; theatres, intensive care units, sterilisation department and the main elevators. � e modern distribution boards are equipped with miniature circuit breakers to provide protection on downstream equipment in the event of a fault. � e old boards were equipped with high rapture capacity fuses which are now very expensive as their production has since been discontinued. � is has seen a reduction in maintenance cost and improved electrical distribution e� ciency. � e equipment was procured at a total cost of $78 000.

• Hospital Lighting � e hospital has embarked on a programme to replace the old traditional � uorescent tubes with the modern LED lamps. � e new energy saving lamps will reduce energy consumption (lighting) by about 50% while

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the light intensity has been improved. A total of 500 of the 6000 installed lamps were replaced and thebalance is expected to be completed within the next 2 years. � e estimated cost of the rehabilitation was$76 000.

• Water Supply� e hospital continues to experience water supply challenges due to the constant shutdowns by the City Council. In addition to the 2.5megalitre water reservoir installed in 2016, six boreholes were installed and commissioned during the year. � is has improved the water supply to the hospital as the reserved water can support the hospital for a period of 72 hours. � e cost of the installation of the pumps, electri-cal controls and water reticulation system was $30 000.

• Water ReticulationWork on the replacement of the old water pipes in the hospital basement which had numerous leaks con-tinued in the year 2017. A total of 600m of pipe and 5 main valves have been replaced out of an estimated cost of $50 000. An additional 2,4km is expected to be replaced in the next � nancial year. � e replace-ment of the old corroded water pipes has reduced the water leakages on the reticulation system.

FINANCIAL REPORT: KEY HIGHLIGHTS

Economic Environment� e general economic environment remained challenging for most of the year. Cash shortages were experienced throughout the country. However, the Hospital quickly adjusted and embraced other pay-ment platforms. � e shortage of foreign currency a� ected the availability and pricing of consumables, medicines and capital equipment from our suppliers but our bank, CBZ Bank, was quite supportive and availed the foreign currency without unnecessarily long delays.

Audit of AccountsIn terms of section 23 (1) of the Health Service Act Chapter 15:16, and in compliance with the Public Fi-nance Management Act, 49, (d) (i) (ii) our books of Accounts and other systems are periodically audited. We have a fully-� edged internal audit department which reports directly to the Audit and Risk Manage-ment Committee of the Board. � e Financial Statements were audited by the Auditor General and we are pleased to report that we had an unquali� ed audit opinion.

Operating Results� e Hospital operations are largely � nanced from user fees. � e Hospital projected to collect $18.4 mil-lion from user fees, but managed to collect $15.4 million. Treasury allocated $1.4 million for recurrent expenditure but managed to disburse $1.2 million. However, the allocated capital grant was $2.57 million but nothing was disbursed due to � nancial constraints. � e Hospital managed to buy a few pieces of equipment using user fees.

� e Hospital generated revenue amounting to $23.6 million compared to $24.6 million the previous year resulting in a decrease of $1 million or 4%. � e decrease was attributable to less patients who were at-tended to during the year under review. � e total comprehensive surplus for the year was $7.2 million compared to $242 330 the previous year. � e Hospital made some set o� s involving ZESA, PSMAS and City of Harare totalling $9.1 million.

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CORPORATE GOVERNANCE REPORT Board Members

In terms of the Health Service Act (Chapter 15:16) section 19 (1)(2), the board shall consist of not more than seven (7) members. � e Board therefore operated with a full complement of 7.

Overall Responsibility of the Board� e Board’s role is to provide strategic guidance and ensure that e� ective internal controls and management systems are in place. To achieve this mandate, the Board has put in place the following Committees:

1. Finance and IT CommitteeFunctions• Ensure optimum utilization of mobilized resources - fi nancial or otherwise to adhere to the objectives of the institution.• Ensure proper maintenance of books of accounts and the preparation of fi nal accountswithin the statutory deadlines.• Monitor and review budget performance.• Monitor and give guidance on debt management.• Monitor and evaluate ICT systems.• Advise on effi cient ICT systems.

2. Human Resources CommitteeFunctions:• To consider proposals on creation of posts.• Discuss and ratify disciplinary determinations and penalties imposed on persons below the level of directors.• Consider all issues with Human Resources implications.

3. Audit & Risk Management CommitteeFunctions:• Examine and evaluate the Internal Audit reports on adequacy and eff ectiveness of theHospital systems and internal controls.• Assess and advise the Hospital Management Board and Management on compliance to laws and regulations.• Ensure compliance with corporate governance principles.• Advises the Board on the Hospital’s fi nancial and operating risk areas and systems of

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017internal controls.

4. Clinical Audit Committee

Functions:• To monitor and review the Clinical audits and quality assurance checklists and performance indicators for each unit / department.• Analysis of clinical audits reports from Hospital departments and recommend corrective ac-tion.• To ensure the management and proper implementation of fi re drills, disaster management plans.• Oversee the designing and implementation of SOPs for all Units /departments of the Hospital.

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LABORATORY SERVICESParirenyatwa Group of Hospitals comprises of eight well-tooled Laboratory Departments namely; his-topathology, blood bank, haematology, microbiology, biochemistry, serology and Immunochemistry & vi-ral load.

� e National Virology Laboratory which is jointly run by the University of Zimbabwe and Parirenyatwa Group of Hospitals is also housed at Parirenyatwa Group of Hospitals.

� e laboratory departments conform to the ISO15189 quality management system and are working towards full SANAS accreditation by 2022. � ese departments are manned by highly trained personnel � t for a refer-ral hospital (Table 1).

Highest quali� cation Medical and Clinical Scientists Council (MLCSCZ) registration

Number of personnel

Masters Degrees in various disciplines Clinical scientists 10Bachelors (Honours) Medical Lab. Scientists 25Certi� cates State Cert. Med. Lab technicians 10

TABLE 1.

Table 2.� e following table shows the number of samples received by departments over a three years period from 2015 to 2017.

Year 2015 Year 2016 Year 2017 Average number of samples per year

HAEMOTOLOGY 91 473 85 166 90 866 89 168MICROBIOLOGY 13 025 13 414 15 950 14 130HISTOPATHOLOGY 6 456 5 822 6 390 6 223IMMUNOLOGY/SEROLOGY 18 223 15 812 25 053 19 696BLOOD BANK 23 33 26 27BIOCHEMISTRY 115 377 111 044 115 920 114 114

TOTAL 244 577 231 291 254 205 243 358

Laboratory services

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PHARMACY� e Parirenyatwa Group of Hospitals pharmacy’s main objective is to ensure adequate availability of medicines and medical consumables to enable quality treatment of patients. In addition, Pharmacy has the role of ensur-ing rational use of medicines in line with national guidelines.

2017 was a di� cult year as serious market shortages were experienced in the pharmaceutical Industry. � e country largely relies on importation as only a small percentage of medicines are manufactured locally. � e foreign currency shortages adversely a� ected the supply chain leading in consistent supplies. � e hospital managed to maintain an average of 60% availability with major focus on the vital (V) lifesaving medicines. � e patients unfortunately had to source the essential (E) and necessary (N) medicines for themselves.

Human resources for pharmacy remains a major challenge due to an outdated establishment and the failure to fi ll a number of vacancies due to freezing of posts. Th is has led to low staff motivation and morale due to the heavy workload. Th e department continues to lobby for expansion and unfreezing of posts while doing its best with the limited resources.

Mr D. N. Vuragu,Hospital Chief Pharmacist

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TRAI

NIN

GTR

AIN

ING

TRAI

NIN

GTR

AIN

ING

TRAI

NIN

GTR

AIN

ING

SCHOOL OF NURSING� e School of Nursing o� ers General Nurse Training and Post Basic Training in the following specialities: • Nurse Anaesthetist • Intensive and Coronary Care Nursing • Operating Th eatre Nursing • Renal Nursing • Ophthalmology Nursing • Oncology and Palliative Care Nursing. • Mental Health Nursing (Introduced in 2017)

Parirenyatwa Group of Hospitals remains the only public health institution in Zimbabwe training specialist oncology and Palliative Care Nurses, Renal Nurses and Nurse Anaes-thetists.

In terms of the number of post basic training disciplines, Parirenyatwa Group of Hospitals remains second to none in Zimbabwe.

� e school continues to respond to new disease trends by o� ering relevant and up to date training for emerging conditions like cancer, kidney disease and mental health.

NURSING AREA PASS RATEGeneral Nursing 72.4%Intensive and Coronary Care Nursing 100%Nurse Anaesthetist 100%Operating � eatre Nursing 100%Ophthalmology 100%Oncology and Palliative Care Nursing 90%Renal Nursing 80%

Pass

Rat

es

R. KANYEMBAPRINCIPAL TUTOR - SCHOOL OF NURSING

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017SCHOOL OF RADIOGRAPHY

2017 saw the School of Radiography making great strides in its quest of becoming a world class training institu-tion. Part of this was achieved through the � nalisation of the process of making the School an a� liate of the Harare Institute of Technology (HIT). � e completion of acquiring this a� liate status also coincided with approval of 3 new programs to be o� ered by the school by the Zimbabwe Higher Education Council (ZIMCHE). � is approval speaks volumes of the level of seriousness and the high quality standards met by the School. � e new programmes approved are: • Bachelor of Science Honours degree in Radiography (� erapeutic and Diagnostic), Post Graduate Diploma in Medical Ultrasound and Post Graduate Diploma in Medical Dosimetry. � e School is going to become the � rst training institution in Africa to o� er training in Medical dosimetry.

� e approval of these programs ushered in a new dispensation which saw the phasing out of the Diploma in Radiography training with the last group of the Diploma trained Radiographers (14 students) completing their studies in December 2018.

� e School of Radiography has already started the training of Ultra Sonographers with the � rst group of 26 students having already been recruited and are commencing their studies in April 2018. 30 undergraduate students for the BSc Honours Degree in Radiography will start their studies in August 2018.

� e selection of these students has already been done by the school in conjunction with Harare Institute of Technology. � e Medical Dosimetry Program is going to attract international students with about 5 coun-tries having expressed interest already. � is program will also start in August 2018.

2017 also saw 3 lecturers from the School of Radiog-raphy namely; Mrs Mutandiro, Mr Sauramba and Mrs Manyanga completing their Masters Studies in Ra-diography, Medical Physics as well as Public Health respectively. � e school is looking forward to further training of lecturers up to PhD level so as to ensure maintenance of high quality training. Plans to set up a Virtual Learning Centre at one of the facilities at Parireny-atwa Group of Hospitals are underway. � is will go a long way in o� ering high quality education. E. MUSHOSHO

PRINCIPAL TUTOR - SCHOOL OF RADIOGRAPHY

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SCHOOL OF MIDWIFERY

It was yet another year where the School of Midwifery made ad-vances towards continuity in the contribution towards the churning out of adequately skilled birth at-tendants in the country.In 2017, the School of Midwifery enrolled a total of 64 students,

83% of which passed their State Final Examinations.� e school’s approved sta� establish-ment is four Midwifery Tutors, � ve Clinical Instructors and one secretary who are charged with training 40 students per annum. � ere is however a shortage of sta� with one Clinical

Instructor having le� during the course of the year. � e attainment of competence-based midwifery education which prepares highly skilled midwives who meet interna-tional standards remains an attain-able goal if all parties continue with their cooperative e� orts.

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017FOOD SERVICES/CATERING DEPARTMENT

� e Hospital Food Services Supervisors (H.F.S.S) managed to provide nutrition education to inpatients and out-patients. On average, 100 inpatients were provided with one- on-one diet counselling sessions per month. On the other hand, an average of 900 out-patients were provided with group counselling in di� erent clinics such as the Diabetic as well as the Infant and Young Child Feeding Clinics.

� e department managed to prepare all therapeutic feeds and special diets for patients despite challenges such as equipment breakdowns, delays in food provisions by suppliers, erratic steam supply and water cuts by the City of Harare.

Introduction of traditional dishes was also a huge success. All patients were served with maltabella porridge once a week throughout the year. Appetising dishes like sadza rezviyo served with road-runner chicken, okra, mufushwa and muboora in peanut sauce were also served to our private and oncology pa-tients.

60 ward service sta� and 53 cooks were provided with in-house training by the H.F.S.S for 2 weeks on the follow-ing topics; Special Diets, Serving and Storage of therapeutic feeds as well as Food and Kitchen Hygiene. 14 cooks and 2 H.F.S.S were attached to private institutions (Catercra� ) for a period of 1 month in order to enhance their skills in food preparation and management.

� e department managed to pro-vide nutritious meals to patients, sta� and special catering func-tions. � e 2017 Nurses Gradua-tion Ceremony is one good ex-ample of such functions in which we catered for more than 1 300 people.Major challenges include; criti-cal shortage of equipment, most work in the department is done

manually and this is a very big challenge considering that we cater for over 1 000 patients and 540 sta� members, 400 moth-ers, 83 catering functions and we prepare an average of 138 li-tres of texturised and specialised feeds per day. Erratic supplies of steam and a critical shortage of sta� pose challenges to the de-partment.

Mrs J. Kandemiri (PHFSS) and Mr T. Muremarira (PHFSS), preparing � erapeutic Feeds for patients

Mrs M. Garapo, (Hospital Food Services Manager/ Catering Manager)

Mrs B. Banda, (Principal Hos-pital Food Services Supervisor), giving a lecture at PGH O.I Clinic

THEATRETHEATRETHEATRE

THEATRE STATISTICS PER SPECIALITYGEN-ERAL

GYN AE ORTHO URO NEURO CARDIO OPTHA ENT MAXI-LO

PLAS-TICS

B3 OBS MNOT

JAN 125 94 12 43 40 54 87 32 3 11 83 305FEB 96 82 101 27 44 51 117 25 2 23 120 285MAR 138 99 108 33 47 66 123 45 5 17 100 320APR 115 107 157 50 44 45 85 21 17 6 109 311MAY 157 103 134 51 57 64 139 51 4 26 115 323JUN 151 100 167 61 56 50 150 34 57 21 138 316JUL 136 100 164 65 62 63 130 54 5 22 111 305AUG 161 154 94 63 62 74 190 39 7 14 143 311SEPT 144 92 168 55 57 63 585 61 7 18 112 288OCT 123 125 170 52 51 80 183 53 7 19 126 310NOV 119 80 138 50 49 52 114 15 4 0 97 290DEC 114 107 131 33 58 49 113 23 5 3 62 296

TOTAL 1579 1243 1544 583 627 711 2016 453 123 180 1316 3660PER-CENTAGE 11 8.8 10.9 4.11 4.42 6 14.2 3.17 0.86 1.31 9.28 25.9

PHILANTHROPIC CAMP STATISTICS� e hospital, in collaboration with other organisations, conducted a total of 6 camps for the treatment of patients. � e partnering organisations supported the hospital through the provision of resources, equipment, manpower as well as the expertise necessary for the treatment of the concerned patients. � e hospital on the other hand provided the venue, equipment, manpower and other supporting sta� to make these camps a suc-cess. � ese camps were carried out successfully with minimum challenges encountered.

CAMP PERIOD No OF PATIENTS SEEN No OF OPERATED PATIENTS

Open Heart 31/01/17 – 07/02/17 10 10Urology Stone Workshop 03/03/17 – 05/03/17 9 9Plastics Workshop 10/05/17 – 11/05/17 13 13Laparascopic Hernia 15/06/17 – 16/06/17 15 15Maxilofacial Cle� Lip 19/06/17 – 24/06/17 51 51Eye Camp 25/09/17- 29/09/17 1 649 467

CASUALTY STATISTICSMONTH A1 Ortho-

paedicGy-neclogy

Medi-cine

Paedri-atics

Resus Room

Patients treated by Casualty Of-� cer

Total patients recorded by Casualty

January 1569 281 248 979 934 294 456 4761February 1205 226 159 919 678 305 604 4096March 1374 276 242 944 1014 305 669 4155April 1456 326 170 983 900 324 259 4418May 1731 308 264 1065 912 343 255 4623June 1725 376 244 1074 843 331 261 4593July 1512 390 245 1092 886 326 314 4451August 1604 384 248 1168 991 404 136 4985September 1605 356 246 936 903 393 214 4439October 1744 407 276 1057 969 454 303 5210November 1672 385 309 1117 848 355 124 4810December 2091 356 315 1136 889 467 194 5448

TOTAL 19288 4071 2966 12470 10767 4301 3789 55989

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The audit evidence I have obtained is suffi cient and appropriate to provide a basis for my opinion.

Key Audit Ma� ersKey ma� ers are those ma� ers that, in my professional judgement, were of most signifi cance in my audit of the fi nan-cial statements of the Parirenyatwa Group of Hospitals for the year ended December 31, 2017. These ma� ers were addressed in the context of my audit of the hospital’s fi nancial statements as a whole, and in forming my opinion thereon, I do not provide a separate opinion on these ma� ers. The key audit ma� ers noted below relate to the fi nan-cial statements:

Key Audit Ma� er How audit addressed the Key Audit Ma� erValua� on of property, plant and equipment. Refer to note 4

This hospital’s property and equipment has a signifi cant net carrying value of USD $668 834 206 as at December 31, 2017.

The carrying amounts of the hospital’s property, plant and equipment are reviewed con� nuously to determine whether there are any indica� ons of impairment with reference to internal and external factors.

In addi� on, the carrying value es� mated deprecia� on rates are reviewed annually by management with refer-ence to current, forecast and relevant technical factors. This involves a signifi cant degree of management judge-ment and assump� ons when making these es� mates. There is a risk the es� mates used in the calcula� ons for both deprecia� on rates and recoverable amounts may diff er from the actual outcome.

I consider the valua� on and impairment of property, plant and equipment to cons� tute a key audit ma� er in the audit of the hospital.

My audit procedures to address the risk of material mis-statement rela� ng to valua� on and impairment of the property, plant and equipment included:

• Assessed the reasonableness of the judgements and es� mates applied.

• Analysed the management’s assessment of im-pairment indicators and test whether they take into account both internal and external impair-ment indicators.

• Evaluated the hospital’s business strategy in regards to asset capacity u� lisa� on.

• Analysed the processes used by the manage-ment in valua� on of specialised equipment.

Based on evidence gathered, I found management’s as-sump� ons reasonable.

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REPORT ON THE AUDIT OF FINANCIAL STATEMENTS

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Valua� on of receivables and allowance for credit losses. Refer to item 6.

The management has es� mated the recoverable amount of trade receivables to be USD 54 849 as at December 31, 2017 with an allowance of credit losses of USD 20 842 194

With signifi cant amounts of trade and other receivables overdue for payment and considering current economic environment characterised by liquidity challenges allow-ance for credit losses is an area requiring management to make signifi cant judgement on whether billed rev-enue amounts present considera� on receivable.

Accordingly, the es� ma� on of the recoverable amount of trade and other payables requires signifi cant manage-ment judgement area and is therefore considered a key audit ma� er.

The audit procedures that I performed to address the risk of material misstatement rela� ng to valua� on of receivables included:

• Evaluated the assessment of the allowances for credit losses made by the management to test adequacy.

• Scru� nised the hospital’s policies in calcula� ng the allowance for credit losses and analysed the allowance for credit losses model.

• Assessed the nature and sustainability of any historic data used to support the judgements and assump� ons made in es� ma� ng the allow-ance for credit losses.

I was sa� sfi ed that the hospital’s receivables were fairly valued and adequately provided for and disclosures related to trade receivable in the fi nancial statements were appropriate.

Recogni� on of revenue. Refer to note 11 and 12

The hospital recognised revenue amoun� ng to USD $ 43 855 202 for the year ended December 31, 2017. The hospital has several streams of revenue.

The hospital receives revenue from billing a wide range of medical services. Some of the services are exempt while others are non-exempt. For a pa� ent to qualify for exemp� on, the criteria had to be met. There is also inherent risk of human error in recording due to volumi-nous transac� ons processed through the computerised system. As a result, revenue recogni� on was signifi cant to my audit.

The audit procedures that I performed to address the risk of material misstatement rela� ng to the recogni� on of revenue included:

• Evaluated the reasonableness of the budgets, assump� ons and projec� ons made by manage-ment.

• Re-computed and analysed revenue streams and the collec� ons.

• Evaluated management’s assessment of the risk that the fi nancial statements may be materially misstated due to fraud, including the nature, extent and frequency of such assessments.

Based on the evidence I gathered, the revenue was fairly stated.

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REPORT ON THE AUDIT OF FINANCIAL STATEMENTS

Responsibili� es of Management and Directors for the Financial StatementsThe hospital’s management is responsible for the prepara� on and fair presenta� on of these fi nancial statements in accordance with Interna� onal Financial Repor� ng Standards (IFRSs) and � n the manner required by the Health Services Act (Chapter 15: 16) and for such internal controls as management determines is necessary to enable the prepara� on of the fi nancial statements that are free from material misstatement, whether due to fraud or error.

In preparing the fi nancial statements, management is responsible for assessing the hospital’s ability to con� nue as a going concern, disclosing, as applicable, ma� ers related to going concern and using the going concern basis of ac-coun� ng unless management either intends to liquidate the en� ty or to cease opera� ons, or has no realis� c alterna-� ve but to do so.

Those charged with governance are responsible for overseeing the hospital fi nancial repor� ng process.

Auditor’s Responsibili� es for the Audit of the Financial StatementsMy objec� ves are to obtain reasonable assurance about whether the fi nancial statements as a whole are free from material misstatements, whether due to fraud or error, and to issue an auditor’s report that includes my opinion. Reasonable assurance is a high level of assurance, but it’s not a guarantee that an audit conducted in accordance with ISAs will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to infl uence the eco-nomic decisions of users taken on the basis of these fi nancial statements.

As part of an audit in accordance with ISAs, I exercise professional judgment and maintain professional scep� cism throughout the planning and performance of the audit. I also:

• Iden� fy and assess the risks of material misstatement of the fi nancial statements, whether due to fraud or error, design and perform audit procedures responsive to those risks, and obtain audit evidence that is suf-fi cient and appropriate to provide a basis for my opinion. The risk of not detec� ng a material misstatement resul� ng from fraud is higher than for one resul� ng from error, as fraud may involve collusion, forgery, inten-� onal omissions, misrepresenta� ons, or the override of internal control.

• Obtain an understanding of internal control relevant to the audit in order to design audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the eff ec� veness of the en� ty’s internal control.

• Evaluate the appropriateness of accoun� ng policies used and the reasonableness of accoun� ng es� mates and related disclosures made by management.

• Conclude on the appropriateness of the management’s use of the going concern basis of accoun� ng and based on the audit evidence obtained, whether a material uncertainty exists, I am required to draw a� en� on in my auditor’s report to the related disclosures in the fi nancial statements or, if the disclosures are inad-equate, to modify my opinion. My conclusions are based on the audit evidence obtained up to date of my auditor’s report. However, future events or condi� ons may cause the hospital to cease to con� nue as a going concern.

• Evaluate the overall presenta� on, structure and content of the fi nancial statements, including the disclo-sures, and whether the fi nancial statements represent the underlying transac� ons in a ma� er that achieves fair presenta� on.

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REPORT ON THE AUDIT OF FINANCIAL STATEMENTS

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31-Dec-17 31-Dec-16 Note USD USD Revenue Hospital services 23 570 005 24 613 175 Supplies and Services 10 ( 19 662 914) (15 937 321) Income from hospital services 3 907 091 8 675 854 Government revenue grant 11 30 985 403 21 737 584 Donations 4 868 033 2 638 141 Amortised capital grant 1 690 775 1 583 359 Interest earned 12 790 10 564 Rental income 419 591 390 477 Other income 12 1 971 520 438 632 Total income 43 855 202 35 474 611 Less operating expenses 36 627 470 35 232 280 Administration costs 13 13 334 592 13 797 249 Other expenses 14 23 292 878 21 435 032 Operating surplus for the year 7 227 732 242 330 Other comprehensive income - - Total comprehensive surplus for the year 7 227 732 242 330

31-Dec-17 31-Dec-16 Note USD USD

Hospital services 23 570 005 24 613 175 ( 19 662 914)( 19 662 914)

Income from hospital services 3 907 091 8 675 854

Government revenue grant 11 30 985 403 21 737 584 Donations 4 868 033 2 638 141 Amortised capital grant 1 690 775 1 583 359 Interest earned 12 790 10 564 Rental income 419 591 390 477

1 971 520 43 855 202 35 474 611

36 627 470 35 232 280 Administration costs 13 13 334 592 13 797 249 Other expenses 14 23 292 878 21 435 032

7 227 732 242 330

- -

7 227 732

STATEMENT OF PROFIT AND LOSS AND OTHER COMPREHENSIVE INCOME

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STATEMENT OF CHANGES IN FUNDS AND RESERVES

Accumulated fund Non Distributable Reserve TOTAL USD USD USD

Balance at January 1, 2016 ( 348 295 687) 1 053 409 963 705 114 276

Operating surplus for the year 242 330 - 242 330

Balance at December 31, 2016 ( 348 053 357) 1 053 409 963 705 356 606

Balance at January 1, 2017 ( 348 053 357) 1 053 409 963 705 356 606

Operating surplus for the year 7 227 732 - 7 227 732

Balance at December 31, 2017 ( 340 825 625) 1 053 409 963 712 584 338

Balance at January 1, 2017 ( 348 053 357) 1 053 409 963 705 356 606

Operating surplus for the year 7 227 732 - 7 227 732

( 340 825 625) 1 053 409 963 712 584 338

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STATEMENT OF CASH FLOWS

31-Dec-17 31-Dec-16 Note USD USD CASH FLOWS FROM OPERATING ACTIVITIES Net cash utilised by operating activities 2 110 443 1 465 929 Operating pro� t before working capital changes 14 647 455 7 568 660 Operating pro� t before working capital changes 7 227 732 242 330 Adjustments for: 7 419 723 7 326 330 Provisions ( 28 618) ( 72 262)Depreciation charge for the year 4 9 145 676 8 958 375 Amortised grant (1 690 774) (1 583 359)Loss on disposal 6 229 34 140 Interest earned ( 12 790) ( 10 564)

Changes in working capital (12 537 522) (6 102 731)(Increase) in accounts receivables (7 002 424) (8 737 901)Decrease/(increase) in inventory 53 332 ( 506 380)(Decrease)/increase in payables (5 588 430) 3 141 550

CASH FLOWS FROM INVESTING ACTIVITIES ( 957 727) (1 745 764)Interest received 12 790 10 564 Proceeds from sale of assets 8 858 29 112 Purchase of property, plant and equipment 4 ( 979 375) (1 785 440)

CASH FLOWS FROM FINANCING ACTIVITIES - 250 000 Government capital grant - 250 000

Net increase in cash and cash equivalents 1 152 716 ( 29 835)Cash and cash equivalents at beginning of the year 568 770 598 605 Cash and cash equivalents at end of the period 7 1 721 486 568 770

31-Dec-17 31-Dec-16 Note USD USD

2 110 443 1 465 929

14 647 455 7 568 660 7 227 732 242 330

7 419 723 7 326 330Provisions ( 28 618) ( 72 262)Depreciation charge for the year 4 9 145 676 8 958 375 Amortised grant (1 690 774) (1 583 359)Loss on disposal 6 229 34 140 Interest earned ( 12 790) ( 10 564)

(12 537 522) (6 102 731)(Increase) in accounts receivables (7 002 424) (8 737 901)Decrease/(increase) in inventory 53 332 ( 506 380)(Decrease)/increase in payables (5 588 430) 3 141 550

( 957 727) (1 745 764)Interest received 12 790 10 564 Proceeds from sale of assets 8 858 29 112 Purchase of property, plant and equipment 4 ( 979 375) (1 785 440)

- 250 000 Government capital grant - 250 000

1 152 716 ( 29 835) 568 770 598 605

1 721 486

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REPORTING ENTITY AND ITS NATURE OF BUSINESS

1. Parirenyatwa Group of Hospitals as a Central Hospital is a body corporate established in terms of sec� on 18(1) of the Health Service Act, [Chapter 15:16) of 2004. The Group consists of Mbuya Nehanda Maternity Hospital, Sekuru Kaguvi Eye Unit, and Annex Hospital for the Mentally Disabled and the Main Hospital.

2. BASIS OF PREPARATION

2.1 Statement of compliance

The statements for the year ended December 3l, 2017 have been prepared in conformity with Interna� onal Financial Repor� ng Standards, promulgated by the Interna� onal Accoun� ng Standard Board (IASB), which includes standard and interpreta� ons approved by the IASB as well as Interna� onal Accoun� ng Standards and Interna� onal Financial Repor� ng Interpreta� ons Commi� ee (IFRIC).

Basis of measurement

The fi nancial statements are based on the statutory records that are maintained under the historical cost basis.

2.3 Func� onal and presenta� on currency

The fi nancial statements are presented in United States (US) which is the group’s currency. All the informa-� on presented has been rounded off to the nearest dollar

2.4 Cri� cal accoun� ng judgment, assump� ons and es� mates

In the applica� on of the Hospital’s accoun� ng policies, management is required to make judgments, es� -mates and assump� ons about the carrying amounts of assets and liabili� es that are not readily apparent from other sources. The es� mates and associated assump� ons are based on historical experience and other factors that are considered to be relevant. Actual outcomes may diff er from these es� mates.

2.4.1 Useful lives and residual values of property, plant and equipment.

The Hospital assesses useful lives and residual values of property, plant and equipment each year taking into account past experience and technology changes. The deprecia� on rates are set out in note 3.3 and no changes to these useful lives have been considered necessary during the year. Management has set residual values for all classes of property, plant and equipment at zero.

2.4.2 Impairment and provisioning policies

At each statement of fi nancial posi� on date, the group reviews the carrying amount of its assets to deter-mine whether there is an indica� on that those assets suff ered any impairment. If any such indica� on exists, the recoverable amount of the assets es� mated in order to determine the extent of the impairment (if any). If the recoverable amount of an asset is es� mated to be less than its carrying amount, the carrying amount of the asset is reduced to its recoverable amount. Impairment is recognized as an expense immediately, unless the relevant asset is carried at a revalued amount, in which case the impairment is treated as a revalua� on decrease.

In the event that, in the subsequent period, an asset that has been subject to an impairment loss is no longer considered to be impaired, the value is restored and the gain is recognized in the statement of comprehen-sive income. The restora� on is limited to the value which would have been recorded had the impairment adjustment not taken place.

NOTES TO THE FINANCIAL STATEMENTS

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2.4.3 Es� mate for uncollectable pa� ents’ accounts receivable

The Hospital es� mates the allowance for uncollectable accounts based on management’s assessment of col-lec� on indicators to determine the rate applied. The rate applied during the period was 35%.

2.4.4 Revalua� on of property, plant and equipment

Revalua� ons are performed with suffi cient regularity such that the carrying amounts do not diff er materially from those that would be determined using fair values at the end of the repor� ng period.

Any revalua� on increase arising on the revalua� on of property, plant and equipment is recognised in other comprehensive income, except to the extent that it reverses a revalua� on decrease for the same asset previously recognized in profi t and loss, in which case the increase is credited to profi t and loss to the extent of the decrease previously expensed. A decrease in the carrying amount arising on the revalua� on of such property, plant and equipment is recognized in profi t and loss to the extent that it exceeds the balance, if any, held in asset revalua� on reserve rela� ng to previous of the asset.

Deprecia� on on revalued assets is recognize in profi t and loss.

The revalua� on surplus on land and buildings is directly transferred to accumulated fund in so far as it is realized through use While the surplus on other items of property, plant and equipment is realized when the related asset is either sold or withdrawn from use.

2.5 New and revised standards and interpreta� ons

2.5.1 Applicable new and revised standards and interpreta� ons eff ec� ve for annual periods beginning on Janu-ary 1, 2017

i. Amendments to IAS 7- Statement of Cash Flows

In January 2016, the IASB issued amendments to IAS 7 Statement of Cash Flows with the inten� on to im-prove disclosures of fi nancial ac� vi� es and help users to be� er understand the repor� ng en� � es’ liquidity posi� ons and changes in debt. The amendments require en� � es to provide disclosures about changes in their liabili� es as a result of fi nancial ac� vi� es such as changes arising from cash fl ows and non-cash items (e.g. foreign exchange gains and losses)

This standard is eff ec� ve for annual periods beginning on or a� er 1 January 2017 and early applica� on is permi� ed.

New standards, amendments and interpreta� ons eff ec� ve January 1, 2017 which have been adopted and applied.

1.5.2 New standards, amendments and interpreta� ons issued but not eff ec� ve for the fi nancial year beginning January 1, 2017 and not early adopted

A number of new standards, amendments to standards and interpreta� ons are eff ec� ve for annual periods beginning on or a� er January 1, 2017, and have not been applied in preparing these fi nancial statements. The Company intends to adopt these standards, if applicable, when they become eff ec� ve.

ii. IFRS 9 Financial Instruments eff ec� ve January 1, 2018

a. Classifi ca� on and measurement of fi nancial assets

All fi nancial assets are measured at fair value on ini� al recogni� on, adjusted for transac� ons costs if the instrument is not accounted for at fair value through profi t or loss (FVTPL),

Debt instruments are subsequently measured at FVTPL, amor� sed cost or fair value through other compre-hensive income (FVOCI), on the basis of their contractual cash fl ows and the business model under which the debt in are held.

There is a fair value op� on (FVO) that allows fi nancial assets on ini� al recogni� on to be designated as FVTPL if that eliminates or signifi cantly reduces an accoun� ng mismatch. Equity instruments are generally mea-sured at FVTPL.

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However, en� � es have at irrevocable op� on on an instrument-by-instrument basis to present changes in the fair value of non-trading instruments in other comprehensive income (OCI) (without subsequent Reclassifi ca-� on to profi t or loss).

b. Classifi ca� on and measurement of fi nancial liabili� es

For fi nancial liabili� es designated as fair value through profi t or loss (FVTPL) using the fair value op� on (FVO), the amount of change in the fair value of such fi nancial liabili� es that is a� ributable to changes in credit risk must be presented in other comprehensive income (OCI).The remainder of the change in fair value is pre-sented in profi t or loss, unless presenta� on of the fair value change in respect of the liability’s credit risk in OCI would create or enlarge an accoun� ng mismatch in profi t or loss.

All other IAS 39 Financial Instruments: Recogni� on and Measurement classifi ca� on and measurement re-quirements for fi nancial liabili� es have been carried forward into IFRS 9, including the embedded deriva� ve separa� on rules and the criteria for using the FVO.

c. Impairment

The impairment requirements are based on an expected credit loss (ECL) model that replaces the IAS 39 incurred loss model. The ECL model applies to: debt instruments accounted for at amor� sed cost or at FVOCI; most loan commitments; fi nancial guarantee contracts; contract assets under IFRS 15; and lease receivables under IAS 17 Leases.

iii. IFRS 15 Revenue from Contracts with Customers, eff ec� ve for annual periods beginning on or a� er January 1, 2018.

IFRS 15 replaces all exis� ng revenue requirements in IFRS (IAS 1I Construc� on 18 Revenue, IFRIC 13 Customer Loyalty Programmes, IFRIC 15 Agreements Construc� on of Real Estate, IFRICSs Transfers of Assets from Customers and SiC 3L Revenue - Barter Transac� ons Involving Adver� sing Services) and applies to all revenue arising from contracts with customers. It also provides a model for the recogni� on and measurement of dis-posal of certain non-fi nancial assets including property, equipment and intangible assets.

The standard outlines the principles an en� ty must apply to measure and recognise revenue. Therefore prin-ciple is that an en� ty will recognise revenue at an amount that refl ects the considera� on to which the en� ty expects to be en� tled in exchange for transferring goods or services to a customer.

The principles in IFRS 15 will be applied using a fi ve-step model:

• Iden� fy the contract(s) with a customer

• Iden� ty the performance obliga� ons in the contract

• Determine the transac� on price

• Allocate the transac� on price to the performance obliga� ons in the contract

• Recognise revenue when (or as) the en� ty sa� sfi es a performance obliga� on

The standard requires en� � es to exercise judgment, taking into considera� on all of the relevant Allocate the transac� on price to the performance obliga� ons in the contract facts and circumstances when applying each step of the model to contracts with their customers.

The standard also specifi es how to account for the incremental costs of obtaining a contract and the costs directly related to fulfi lling a contract. Applica� on guidance is provided in IFRS 15 to assist en� � es in applying its requirements to certain common arrangements, including licenses warran� es, rights of return, principal- versus agent considera� ons, op� ons for addi� onal goods or services.

iv. IFRS 16 Leases

A lease is defi ned as a contract, or part of a contract, that conveys the right to use the underlying asset for a period of � me in exchange for considera� on.

IFRS 16 requires lessees to recognise leases on their statement of fi nancial posi� on as lease liabili� es with

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the corresponding right-of-use assets. Lessees are required to apply a single mode for all recognised leases, but have an op� on not to recognise “short-term” leases (i.e. leases with a lease term of 12 months of less) and leases of “low value” assets (e.g. personal computers).

Lessees will be required to separately recognise the interest expense on the lease liability and the deprecia-� on expense on the right of use asset. Lessee will also be required to re-measure the lease liability upon the occurrence of certain events (e.g. a change in the lease term, a change in future lease payments resul� ng from a change in an index or rate used to determine those payments). The lessee will generally recognise the amount of the re-measurement of the lease liability as an adjustment to the right-of-use asset.

IFRS 16 is eff ec� ve for annual periods beginning on or a� er 1 January 2019. Early applica� on is permi� ed provided the new revenue standard, IFRS 15, is applied on the same date. Lessees are required to adopt IFRS 16 using either a full retrospec� ve approach or a modifi ed retrospec� ve approach.

3.0 SIGNIFICANT ACCOUNTING POLICIES

3.1 Change in Accoun� ng Policy

The accoun� ng policies applied in the prepara� on of these fi nancial statements are consistent with those applied in the previous years.

Recogni� on and measurement

Items of property, plant and equipment are measured at cost less accumulated deprecia� on and accumu-lated impairment losses.

Cost includes expenditures that are directly a� ributable to the acquisi� on of the asset. The cost of self-constructed assets includes the cost of raw materials and direct labor, any other costs directly a� ributable to bringing the assets to a working condi� on for their intended use, the costs of dismantling and removing the items and restoring the site on which they are located and capitalised borrowing costs. Purchased so� ware that is integral to the func� onality of the related equipment is capitalised as part of that equipment.

When parts of an item of property, plant and equipment have diff erent useful lives, they are accounted for as separate items of property, plant and equipment

The gain or loss on disposal of an item of property, plant and equipment is determined by comparing the proceeds from disposal with the carrying amount of the item of property, plant and equipment, and is rec-ognized in the statement of profi t or loss and other comprehensive income capitalized as part of that equip-ment.

3.2 Deprecia� on of property, plant and equipment

Deprecia� on is calculated as full year deprecia� on in the year of purchase and no deprecia� on in the year of disposal, Property, plant and equipment is stated at cost less accumulated deprecia� on and impairment losses. Deprecia� on, which is calculated on the straight line basis, is provided to write off the cost less the es� mated residual value of fi xed assets over their es� mated useful lives The Hospital assesses useful life and residual values of property, plant and equipment each year taking into account past experiences and technological changes. No changes to these useful lives have been considered necessary for all other items of property, plant and equipment. Management has set residual values for all classes of property, plant and equipment as nil.

The rates are applied per annum over the useful life as follows:

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Fumiture fi xtures and fi � ngs 10 years

Offi ce equipment 10 years

Computer equipment 3 years

Motor vehicles 5 years

“Buildings 100 years

Specialized medical equipment 10 years

General medical equipment 10 years

Kitchen equipment 5 years

Plant 20 years

Cell phones 3 years

Where the items of property, plant and equipment are revalued, deprecia� on is based on the gross replace-ment cost.

3.3 lnventory

Inventories’ are valued at the lower of cost and net realizable value using the following methods:

Raw materials and consumables: Weighted Average Cost

Pharmaceu� cals and supplies (medicines and sundries): Weighted Average Cost

3.4 Grants and dona� ons

Capital grant is recorded as deferred income in the statement of fi nancial posi� on when it becomes receiv-able and is then recognized as income on systema� c basis over the period necessary to match the grant with the related costs which they are intended to compensate. Grant amor� zed is credited to the income state-ment over the expected useful lives of the respec� ve assets, on a straight line basis. Revenue grant is recog-nized as income during the year in which it is received.

3.5 Financial instruments

Financial assets and fi nancial liabili� es are recognized on the Hospital’s fi nancial posi� on when the Hospital becomes a party to the contractual provisions of the instrument. These instruments are generally carried at their es� mated carrying values.

Non-deriva� ve fi nancial instruments carried in the statement of fi nancial posi� on comprise: cash and cash equivalents, trade and other receivables, trade and other payables and amounts owing to and from related par� es. These instruments are recognized ini� ally at fair value plus, for instruments not at fair value through profi t or loss, any directly a� ributable transac� on costs. Subsequent to ini� al recogni� on non-deriva� ve fi nancial instruments are measured as described below:

The classifi ca� on depends on the nature and purpose of the fi nancial asset and is determined at the � me of ini� al recogni� on.

3.5.1 Loans and receivables

Loans and receivables are non-deriva� ve fi nancial assets with fi xed or determinable payments that are not quoted in an ac� ve market other than those that the Hospital intends to sell in the short term or it has desig-nated as at fair value through profi t or loss or available-for-sale.

3.5.2 Trade and other receivables

Trade and other receivables are measured at their cost less impairment losses. A provision for impairment of

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trade receivables is established when there is objec� ve evidence that the Hospital will not be able to collect all amounts due according to the original terms of receivables. Signifi cant fi nancial diffi cul� es of the debtor, probability that the debtor will enter bankruptcy or fi nancial reorganiza� on and default or delinquency in payments are considered indicators that the trade receivables are impaired. When a trade receivable is uncollec� ble, it is wri� en off against the allowance for trade receivables. Subsequent recoveries of amounts previously wri� en off are credited against the trade receivables impairment provision in profi t or loss.

353 Cash and cash equivalents

For the purpose of the statement of cash fl ows, cash and cash equivalents comprise cash in hand, short term investments and group balances.

3.6 Financial liabili� es

3.6.1 Provisions

A provision is recognized in the statement of fi nancial posi� on when the Hospital has a legal or construc� ve obliga� on as a result of a past event, and it is probable that an ou� low of economic benefi ts will be required to se� le the obliga� on. If the eff ect is material, provisions are determined by discoun� ng the expected future cash fl ows at a pre-tax rate that refl ects current market assessments of the � me value of money and, where appropriate, the risks specifi c to the liability. The unwinding of the discount is recognized as fi nance costs.

3.6.2 Trade and other payables

These fi nancial liabili� es are measured at amor� zed cost using the eff ec� ve interest rate method.

3.6.3 Off set

If a legally enforceable right exists to set-off recognized amounts of fi nancial assets and liabili� es, which are in determinable monetary amounts and the Hospital intends to se� le on a net basis, the relevant fi nancial assets and liabili� es are off set.

3.7 Impairment of assets

3.7.1 Financial assets

A fi nancial asset is considered to be impaired if objec� ve evidence indicates that one or more events have had a nega� ve eff ect on the es� mated future cash fl ows of that asset.

An impairment loss in respect of a fi nancial asset measured at amor� zed cost is calculated as the diff erence between its carrying amount and the present value of the es� mated future cash fl ows discounted at the original eff ec� ve interest rate. An impairment loss in respect of an available-for-sale fi nancial asset is calcu-lated by reference to its current fair value.

Individually signifi cant fi nancial assets are tested for impairment on an individual basis. The remaining fi nan-cial assets are assessed collec� vely in groups that share similar credit risk characteris� cs.

All impairment losses are recognized in profi t or loss. Any cumula� ve loss in respect of an available-for-sale fi nancial asset, recognized previously in equity, is transferred to profi t or loss.

An impairment loss was recognized in profi t of loss. For fi nancial assets measured at amor� zed cost and available for-sale fi nancial assets that are debt securi� es, the reversal is recognised in profi t or loss. For available-for-sale assets that are equity security, the reverse is recognised directly in equity.

3.7.2 Non-fi nancial assets

The carrying amounts of the Hospital’s non-fi nancial assets, other than invensories and deferred tax assets are reviewed at each repor� ng date to determine whether there is any indica� on of impairment if any such indica� on exists, then the asset’s recoverable amount is es� mated.

The impairment losses recognized in prior periods are assessed at each repor� ng date for any indica� ons that the loss has decreased or no longer exists. An impairment loss is reversed if there has been a change in the es� mate used to determine the recoverable amount. As impairment loss is reversed only to the extent

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that the asset’s carrying amount does not exceed the carrying amount that would have been determined, net of deprecia� on or amor� za� on, if no impairment loss had been recognized.

3.8 Foreign currency transac� ons and balances

While the Hospital’s records are maintained in United States Dollars, some of its transac� ons and conducted in other major foreign currencies. Transac� ons in foreign currencies are translated to the United States Dol-lars at rates of exchange ‘ruling at the � me of the transac� ons. Transac� ons and transla� on gains and losses arising from conversion or se� lement of foreign debts are dealt with in the statement of comprehensive income in determina� on of the opera� ng income.

3.9 Taxa� on

The Hospital is exempt from paying tax.

3.10 Pa� ent service revenue

Hospital fees are recognized as the services are provided

4.0 Reten� on allowances

During 2017 fi nancial year the Hospital received $670 159 from Crown Agents as reten� on allowance for hospital employees. The payments were made directly to the employees.

41

NOTES TO THE FINANCIAL STATEMENTS

PGH

Ann

ual R

epor

t 2

017

NO

TES TO TH

E FINA

NC

IAL STATEM

ENTS

4. Property, plant and equipment

Opening carrying am

ount G

ross carrying amount

Accum

ulated depreciation A

dditions at cost

Donations

Transfer to Plant

Disposal

Cost

Accum

ulated Depreciation

Depreciation charge for the year

Closing carrying am

ount G

ross carrying amount

Accum

ulated depreciation

Buildings

USD

658 033 316 772 395 044

(114 361 728)

-

-

-

- - -

(6 646 801)

651 386 514 772 395 044

(121 008 530)

Land

USD

6 267 750 6 267 750

-

-

-

-

- - -

-

6 267 750 6 267 750

-

Plant

USD

1 531 111 2 348 310 ( 817 199)

66 777

1 951 328

1 954 750

( 6 000)( 10 000)

4 000

( 211 726)

3 331 490 4 356 415

(1 024 925)

O� ce

Equipment

USD

48 886 208 438

( 159 552)

320

-

( 217)( 1 086)

869

( 14 929)

34 060 207 672

( 173 612)

Furniture, Fixtures and

Fittings

USD

246 377 1 011 267 ( 764 890)

5 946

420

-

(135.53) (677.69) 542.16

( 101 783)

150 815 1 016 955 ( 866 131)

Com

puter

USD

35 482 1 017 554 ( 982 072)

78 524

340

-

- ( 7 578) 7 578

( 50 842)

63 503 1 096 418

(1 032 914)

Motor

Vehicles

USD

139 954 702 176

( 562 222)

62360

-

-

- - -

( 63 357)

138 957 764 536

( 625 579)

Specialised Equipm

ent

USD

7 762 395 17 313 833 (9 551 438)

732 739

58 427

-

( 304)( 1 520) 1 216

(1 803 801)

6 749 456 18 103 479

(11 354 023)

General

Equipment

USD

883 951 2 322 026

(1 438 075)

31 099

26 951

-

( 8 425)( 25 041) 16 616

( 237 994)

695 582 2 117 041

(1 421 459)

Kitchen

Equipment

USD

28 827 218 520

( 189 693)

290

-

-

- (200) 200

( 13 951)

15 166 218 810

( 203 644)

Cellphones

USD

82 2 301

( 2 219)

1 320

-

-

- - -

( 491)

911 3 621

( 2 710)

W.I.P A

ir C

ondition-ers

USD

1 268 496 1 268 496

-

-

-

(1 268 496)

- - -

-

- - -

W.I.P W

ater Tank

USD

627 832 627 832

-

58 422

-

( 686 254)

- - -

-

- - -

TOTA

LS

USD

676 874 461 698 174 792 (21 300 331)

979 375

2 037 466

-

( 15 082)( 46 102) 31 020

(9 145 676)

668 834 206 806 732 592

(137 898 379)

683 984 123 804 268 506

(120 284 383)

1 785 440

126 522

-

- - -

(8 954 374)

676 874 461 698 174 792 (21 300 331)

TOTA

LS

USD

676 874 461

979 375

2 037 466

-

( 15 082)

(9 145 676)

668 834 206 806 732 592

698 174 792 (21 300 331)

( 46 102) 31 020

(137 898 379)

(21 300 331)

( 15 082)

PGH

Ann

ual R

epor

t 2

017

NOTES TO THE FINANCIAL STATEMENTS

31-Dec-17 31-Dec-16 USD USD 5 Inventory Raw materials 1 533 673 1 423 255 Pharmaceutical and supplies 2 335 389 2 627 013 Food stu� s 99 092 69 907 Consumables 943 745 833 171 Construction consumables - 11 885 4 911 899 4 965 231 6 Trade and other receivables Rent receivables 134 448 129 025 SSB rent deductions 86 080 86 080 Sta� debtors 8 052 500 Patient receivables 54 849 140 48 890 253 55 077 720 49 105 858 6.1 Patient service receivables Gross amount 75 691 333 67 313 165 Allowance for credit loss (20 842 194) (18 422 912) 54 849 140 48 890 253 7 Cash and cash equivalents Bank balances 1 721 300 578 337 Cash on hand 186 433 1 721 486 578 770 7.1 � e Hospital maintains a separate bank account for Hospital Advisory Committee which had the following balance: HAC bank balance 7 120 40 016 8 Provisions 1 640 873 1 669 491 Leave pay 1 640 873 1 669 491 9 Trade and other payables Electricity 1 299 835 1 855 791 Medical supplies 3 101 120 3 868 409 Other creditors 95 020 69 522 Pharmaceuticals 1 388 899 1 295 453 Telephone 222 232 134 891 Water and rates - 4 480 962 Trimed sundry creditors 44 287 44 287 6 151 391 11 749 315

31-Dec-17 31-Dec-16 USD USD

Raw materials 1 533 673 1 423 255 Pharmaceutical and supplies 2 335 389 2 627 013 Food stu� s 99 092 69 907 Consumables 943 745 833 171 Construction consumables - 11 885

4 911 899 4 965 231

Rent receivables 134 448 129 025 SSB rent deductions 86 080 86 080 Sta� debtors 8 052 500 Patient receivables 54 849 140 48 890 253 55 077 720 49 105 858

Gross amount 75 691 333 67 313 165 Allowance for credit loss (20 842 194) (18 422 912)

54 849 140 48 890 253

Bank balances 1 721 300 578 337 Cash on hand 186 433 1 721 486 578 770

HAC bank balance 7 120 40 016

8 Provisions 1 640 873 1 669 491 Leave pay 1 640 873 1 669 491

Electricity 1 299 835 1 855 791 Medical supplies 3 101 120 3 868 409 Other creditors 95 020 69 522 Pharmaceuticals 1 388 899 1 295 453 Telephone 222 232 134 891 Water and rates - 4 480 962 Trimed sundry creditors 44 287 44 287 6 151 391 11 749 315

43

PGH

Ann

ual R

epor

t 2

017

NOTES TO THE FINANCIAL STATEMENTS

31-Dec-17 31-Dec-16 USD USD 10 Hospital supplies and services Catering 810 221 802 650 Depreciation of specialised equipment 1 803 801 1 718 844 Fuel, light and water 3 403 055 2 896 570 Laboratory 2 054 956 2 555 864 Laundry services 1 809 514 2 080 497 Medical and surgical 8 888 422 5 349 419 Medical gases 838 407 531 495 Sundry sanitary expenses 54 538 1 981 19 662 914 15 937 321 11 Revenue grant Operational costs 1 157 142 1 598 844 Payroll costs 29 158 102 19 103 423 Retention allowance 670 159 1 035 317 30 985 403 21 737 584 12 Other income Creche 478 3 550 Incinerator 770 4 860 Meals 17 445 35 798 Miscellaneous 1 924 210 394 424 Decrease in provision for leave pay 28 618 - 1 971 520 438 632 12.1 During the � nancial year 2017 the hospital made the following set o� s: Set o� s ZESA/PSMAS & PGH bills 1 612 946 - City of Harare 7 389 421 - HMMAS (against City of Harare) 94 867 - 9 097 234 - 12.2 Deferred income liability Opening balance 13 143 233 14 350 070 Capital grants and donations 141 137 376 521 Armotisation for the year (1 690 775) (1 583 359) Closing balance as at December 31, 2017 11 593 595 13 143 232

31-Dec-17 31-Dec-16 USD USD

Catering 810 221 802 650 Depreciation of specialised equipment 1 803 801 1 718 844 Fuel, light and water 3 403 055 2 896 570 Laboratory 2 054 956 2 555 864 Laundry services 1 809 514 2 080 497 Medical and surgical 8 888 422 5 349 419 Medical gases 838 407 531 495 Sundry sanitary expenses 54 538 1 981 19 662 914 15 937 321

Operational costs 1 157 142 1 598 844 Payroll costs 29 158 102 19 103 423 Retention allowance 670 159 1 035 317 30 985 403 21 737 584

Creche 478 3 550 Incinerator 770 4 860 Meals 17 445 35 798 Miscellaneous 1 924 210 394 424 Decrease in provision for leave pay 28 618 - 1 971 520 438 632

ZESA/PSMAS & PGH bills 1 612 946 - City of Harare 7 389 421 - HMMAS (against City of Harare) 94 867 - 9 097 234 -

Opening balance 13 143 233 14 350 070

Capital grants and donations 141 137 376 521

Armotisation for the year (1 690 775) (1 583 359)

Closing balance as at December 31, 2017 11 593 595 13 143 232

44

PGH

Ann

ual R

epor

t 2

017

31-Dec-17 31-Dec-16 USD USD 13 Administration expenses Advertising and public relations costs 71 787 56 390 Audit fees 29 754 68 493 Board of governors expenses 9 880 9 108 Books and periodicals 7 173 51 410 Cleaning services 554 211 452 332 Depreciation of property, plant and equipment 7 341 875 7 239 525 Hiring and maintenance of vehicles 138 865 114 315 Increase in Allowance for uncollectable amounts 2 419 282 2 972 087 Insurance 893 6 947 Maintenance of medical equipment 672 478 776 892 O� ce and sundry expenses 178 571 79 223 Postage - 2 100 Printing and stationery 79 409 102 935 Repairs and maintenance of buildings 931 041 891 321 Repairs maintenance of o� ce equipment and computers 680 642 733 940 Security services 6 995 13 213 Bank charges 35 678 38 629 Loss on disposal 6 223 34 138 Telephone charges 110 467 114 036 Travelling and subsistence 59 369 40 217 13 334 592 13 797 249 14 Other expenses National Social Security Authority contributions 216 489 215 679 Salaries and bene� ts 23 051 317 21 213 226 Sta� development 25 072 6 126 23 292 878 21 435 032 15 Related party disclosures Non-executive directors � e remuneration charge for the directors for the year ended December 31, 2017 was as follows : Fees 5 340 5 580 Board expenses 3 820 3 528 9 160 9 108 Executive directors � e remuneration charge for the directors for the year ended December 31, 2017 was as follows : Group Chief Executive 53 964 53 964 Director of Clinical services 33 792 33 792 Director of Finance 22 932 22 932 Director of Operations 19 512 19 512 130 200 130 200

31-Dec-17 31-Dec-16 USD USD

Advertising and public relations costs 71 787 56 390 Audit fees 29 754 68 493 Board of governors expenses 9 880 9 108 Books and periodicals 7 173 51 410 Cleaning services 554 211 452 332 Depreciation of property, plant and equipment 7 341 875 7 239 525 Hiring and maintenance of vehicles 138 865 114 315 Increase in Allowance for uncollectable amounts 2 419 282 2 972 087 Insurance 893 6 947 Maintenance of medical equipment 672 478 776 892 O� ce and sundry expenses 178 571 79 223 Postage - 2 100 Printing and stationery 79 409 102 935 Repairs and maintenance of buildings 931 041 891 321

680 642 733 940 Security services 6 995 13 213 Bank charges 35 678 38 629 Loss on disposal 6 223 34 138 Telephone charges 110 467 114 036 Travelling and subsistence 59 369 40 217 13 334 592 13 797 249

National Social Security Authority contributions 216 489 215 679 Salaries and bene� ts 23 051 317 21 213 226 Sta� development 25 072 6 126

23 292 878 21 435 032

Fees 5 340 5 580 Board expenses 3 820 3 528

9 160 9 108

Group Chief Executive 53 964 53 964 Director of Clinical services 33 792 33 792 Director of Finance 22 932 22 932 Director of Operations 19 512 19 512 130 200 130 200

NOTES TO THE FINANCIAL STATEMENTS

45

PGH

Ann

ual R

epor

t 2

017

16 PENSION ARRANGEMENTS 16.1 Parirenyatwa Group of Hospital pension scheme All employees are members of the Public Service Pension Fund. No contributions have been made since functional currency change over. 16.2 National Social Security Authority (NSSA) � e National Social Security Authority was introduced on 1st October 1994 and with e� ect from that date all employees are members of the scheme, to which both the Hospital and its employees contribute as follows: Employees : 3% of the monthly basic salary Company : 3% of the monthly basic salary Amount charged through the income statement during the period under review amounted to $216 489

NOTES TO THE FINANCIAL STATEMENTS

46

All employees are members of the Public Service Pension Fund. No contributions have been made PG

H A

nnua

l Rep

ort

201

7