TENDER NOTICE: Consultancy Services for Institutional Audit of Masanga Teaching Hospital in Sierra Leone-Tonkolili district.
Job Description
TERMS OF REFERENCE (ToR)
Consultancy Services for Institutional Audit of
Masanga Teaching Hospital in Sierra Leone-Tonkolili district.
- BACKGROUND AND HISTORICAL CONTEXT
Origins and Early Years
The Government of Sierra Leone (GoSL) established a leprosy treatment center at Masanga in the Tonkolili District, Northern Province, during the early 1960s. In 1964, GoSL entered into a long-term contractual agreement with the Seventh-Day Adventist Church, Sierra Leone Mission, West Africa Union, tasking the church with staffing, managing, developing, and ultimately integrating the Leprosarium into the country’s broader health infrastructure.
Civil War and Disruption
The well-equipped and modernized Masanga Leprosy Hospital was looted and seriously damaged during the civil war in the 1990s, rendering it non-functional. The agreement between GoSL and the Seventh Day Adventist Church ceased to operate through force majeure during this period.
Revival and New Partnership
On July 13th, 2006, GoSL signed a Memorandum of Agreement (MOA) with two charitable organizations:
- Sierra Leonean Adventists Abroad (SLAA) , registered in the United Kingdom • Association Friends of Masanga (AFOM) , registered in Denmark
This agreement tasked these parties with again staffing, managing, developing, and ultimately integrating Masanga Hospital into the country’s health facilities through:
a)Rehabilitation of the hospital facilities damaged during the civil war
- b) Management of the hospital for an initial period of twenty (20) years.
Following review in 2016, these core mandates have been met and we are now in the terminal phase of the second half of the agreement (14th July 2026)
- c) Management objectives including:
- Providing medical services to patients of all faiths
- Expanding medical treatment capacity
- Training medical staff
- Conducting outpatient treatment in cooperation with other agencies
- Re-establishing specialist treatment of leprosy patients
- Establishing programmes for HIV/AIDS and TB treatment
Recent Developments
Following a meeting in 2024, the supporting partners and Board members of Masanga Denmark handed over to a new Interim Board, comprising current funding partners who now work alongside local hospital management to steer the transition process.
In October 2025, a new Sierra Leonean Medical Superintendent assumed management of the hospital, later joined by three additional management members and the Hospital Matron.
MASANGA HOSPITAL TODAY: ACHIEVEMENTS AND CURRENT STATUS
Masanga Hospital (formerly MHRP-Masanga Hospital Rehabilitation Project) has successfully delivered on all original objectives and now stands as a robust rural healthcare institution.
Healthcare Services
The hospital is a 120+ bed healthcare facility offering secondary and tertiary health services to approximately 440,000 people. Key statistics include:
- 12,000+ patients treated annually (increasing each year)
- 1,200+ surgeries performed annually
- Nationwide referrals for trauma care, wound care, complex abdominal surgery, and 3D printed prosthetics
- Services: emergency, surgical, obstetric, pediatric care, and general healthcare Education and Training
Beyond clinical services, Masanga Hospital hosts several educational programs training healthcare workers who serve nationwide:
CAPACARE: delivers a Surgical Training Program that has graduated more than clinical officers community health officers, and medical officers since 2011. The program focuses on essential surgical and obstetrical emergencies, strengthening district hospitals and aligning with the country’s priorities toward Universal Health Coverage. In recent years, CAPACARE has taken a more active role in resident training, which remains a priority area going forward. As agreed surgical residents from the University of Sierra Leone Teaching hospital complex started rotations in Masanga since 2025 and Surgical residents are also benefit from practical courses organised organised with the Teaching Hospital Complex.
GERMAN DOCTORS: implement the Pediatric Training Program (PTP) in collaboration with the Ministry of Health, aiming to reduce under-five and neonatal mortality through specialist training. Students from the Makeni School of Clinical Science undergo a comprehensive two-year program in Paediatric and Neonatal Medicine, with intensive theoretical and supervised practical work at various training locations. Masanga Hospital serves as the base hospital for the Medical Program Coordinator and
hosts the students’ first clinical rotation. The training delivers up-to-date, evidence-based knowledge, enabling Clinical Officers to work independently in pediatric wards of district hospitals and share their expertise with other healthcare workers. The two-year training is followed by a one-year Housemanship. Currently, 28 students are enrolled in the program.
Partners in Health, in collaboration with Masanga UK, offers an Internal Medicine Training Program that builds capacity for managing medical conditions at district hospitals. Medical training Program Students are also rotated at Masanga Hospital during training and also during their compulsory one year house manship.
The Tonkolili District College of Health Sciences (TDCHS) , founded and hosted by Masanga Hospital, offers a Bachelor of Physiotherapy, a State Registered Nursing diploma, and a Bachelor of Science in Nursing. Since the college opened in 2012, more than 1,000 nurses have been educated. The Faculty of Nursing has been ranked the second best in the country for three consecutive years.
The Masanga Medical Research Unit (MMRU) works with national and international partners to foster clinical research that has tangible impact on patient care—locally, regionally, nationally, and beyond. MMRU creates job and career opportunities primarily for Sierra Leonean health professionals while building durable research capacity as a means of sustainable development. The unit connects Sierra Leonean healthcare professionals with a large network of international partners to conduct medical research together. MMRU’s research activities are closely intertwined with laboratory services and patient care at Masanga Hospital. Recent achievements include scaling up laboratory capacity with a fully functional microbiology laboratory, launching a large prospective clinical-epidemiological study on causes of fever, recently published in the Lancet.
TRANSITION CONTEXT AND RATIONALE
Legal Framework
The existing Memorandum of Understanding (MOU) between Government of Sierra Leone and the current partners of the hospital will automatically cease to exist on July 14th, 2026. Under this MOU, Masanga Hospital should by that date be a fully functional government hospital managed by the Ministry of Health (MOH).
Masanga Teaching Hospital being a hospital under transition seeks to commission and independent third party auditor with the necessary qualifications and experience to conduct a project audit for the financial year 2024-2025 including the assessment of the internal controls of the hospital.
Objective of the Audit
Through this audit, the auditor will confirm the accuracy of the organizations accounts and financial statements. S/he will check if all amounts received by Local Management and cost incurred in the past fiscal year are in accordance with the relevant policies of the organization and Government and or partner regulations. Moreover, S/he will indicate whether financial statements are up to date, error-free, trustworthy, and give an accurate picture of the Hospital’s financial health.
The external auditor will provide a different perspective regarding accounting and financial procedures, optimal resource utilization etc. for the benefit of the hospital as well as partners. At the end of the audit, the auditor will generate a report of findings, which provides an overall picture of the hospital financial standings.
Audit Scope
The scope of the Project Audit is to check the income provided and costs incurred through the original vouchers and other related documents (contracts, agreements etc.). This will review income and expenditures of Masanga hospital for the period January 2024 to the 31st December 2025. The auditor should verify the report by the means of;
- Checking and verifying whether the appropriate supporting documents, records and books of accounts relating to all project activities have been kept and whether these documents clearly relate to the activities they were assigned for.
- Checking and verification of the inventory /fixed assets lists.
- Checking and verifying whether compliance with local applicable laws exists or not, verify the quantitative and qualitative program reports, review of compliance with laws, regulations and other external requirements, management policies and directives and other internal requirements. • The audit should be carried out in accordance with local and international auditing standards.
Additionally, an internal controls assessment should be carried out, thereby
- Determine the hospital income and expenditure process, in line with the financial polices • Ascertain compliance with internal regulations and policies;
- Rating financial planning and monitoring procedures including any existing and functional reporting mechanisms for fraud and hospital misconduct; and
- Establish and evaluate account and cash handling practices, as well as procurement and inventory control processes.
Audit Methodology
For presenting the true and fair view on the financial statement/reports, the auditor shall conduct accuracy checks, observations, review of records and documents including (but not exhaustive):
- Visit the Finance offices of the hospital and review vouchers, invoices and all supporting documents for all the amounts expensed and income receipts;
- Follow up with the previous audit reports and recommendations;
- Review of payroll and tax compliance;
- Review policies and compliances;
- Verify sample invoices and receipts by contacting providers
Procedure
Following the completion of the hiring process, the selected auditor will start the audit process, which includes the following steps:
- Inception/planning: The auditor should propose the plan and agree on timeline B. Auditing:
- Formal introduction of the auditor to the Masanga hospital Management and Partners. • Audit of the financial transactions of the main hospital account for the financial period 01/01/2024 – 31/12/2025
- Draft report submitted to Masanga Teaching Hospital by the audit firm
- Discussion on preliminary findings and draft report with Hospital Management and Partners. • Submission of revised draft report to the Hospital Management and Partners for comments and if necessary, discussion of findings between auditor, Hospital management and Partners
- Final Reporting: The final audit report should be submitted to Hospital Management and Partners no later than ………..
Budget
Interested auditors are requested to submit a full financial proposal detailing itemized fees and all costs related to the work including transport, translation (if required), printing and communication. The maximum budget for this audit is………
. Auditor’s Qualification
The auditor should not have any financial or close business relationships with any senior participant in the management of Masanga Hospital and or Partners. The audit firm must be a Certified Public Accountant (CPA). It should have at least five years of relevant professional experience in the audit of NGOs/INGOs and have adequate staff with appropriate professional qualifications and suitable experience.
Tentative Timetable
The audit assignment will take place from 01/01/2024 to 31/12/2025 (the actual working days are 30, but public holiday, weekend, waiting for management response etc. included) including management letter, debriefing meeting and submission of the final report.
. Responsibilities of the Client
- To formally introduce the auditor to the Masanga Hospital management and instruct them on proper coordination and cooperation during the audit process, in particular to provide access to all books of accounts, documents, personnel, beneficiaries and other related matter that have been part or have participation in the project implementation.
- To provide the auditor with the signed cooperation agreement with the partner and other legal documents that the auditor may request.
- To provide all other relevant information necessary for the completion of the agreed tasks. • To provide support and guidance in contacting the partner ad other stakeholders. • To provide support in sharing of any relevant document/materials available.
- To assist with all reasonable queries which are relevant and necessary for the completion of the agreed task.
- To transfer the agreed payments.
Interested firms or individuals should email their expression of interest including the aforementioned documents not later than 25th October 2026 to the contact person below. In case of any questions, feel free to reach out beforehand.
Name: Mohamed Sama Bangura
Contact: +23279771622
Email: hospitalsecretary@masangahospital.org
CC: medicalsuperintendent@masangahospital.org
Contact: +23278077852