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2023-06-30-accounts

Health Improvement Project Zanzibar

Report and Financial Statements For the Year Ending 30 June 2023

Charity number 1171687 Company number 10168369

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Health Improvement Project Zanzibar (A company limited by guarantee)

Financial Statements For the year ending 30[th] June 2023

Table of Contents

1 LEGAL ANDADMINISTRATIVEINFORMATION ............................................................................................................. 3
1.1 BACKGROUND ................................................................................................................................................................ 4
1.2 THE CONTEXT ............................................................................................................................................................... 4
1.3 OURAIMS ANDOBJECTIVES .................................................................................................................................... 5
1.4 HOW WE WORK ............................................................................................................................................................ 5
1.5 PERFORMANCE ANDACHIEVEMENTS ..................................................................................................................... 7
1.6 STRUCTURE, GOVERNANCE ANDMANAGEMENT ...................................................................................................... 10
1.7 FINANCIALREVIEW .................................................................................................................................................. 11
2 INDEPENDENTEXAMINER’S REPORT TO THE TRUSTEES OFHIPZ (HEALTHIMPROVEMENTPROJECTZANZIBAR)
FOR THE YEAR ENDED30 JUNE2023 ............................................................................................................ 13
3 STATEMENT OFFINANCIALACTIVITIES INCLUDINGINCOME ANDEXPENDITUREACCOUNT ........................... 14
4 BALANCESHEET .................................................................................................................................. 15
5 STATEMENT OFCASHFLOWS ................................................................................................................ 16
6 NOTES TO THEACCOUNTS .................................................................................................................... 17

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1 Legal and Administrative Information

HIPZ (Health Improvement Project Zanzibar)

Report of the Board of Directors for the year ending 30th June 2023. The Board of Directors presents its directors’ and trustees’ report and independently examined financial statements for the year ending 30 June 2023.

Reference and Administrative Information

Charity Name: HIPZ (Health Improvement Project Zanzibar) Charity registration number: 1171687 Company registration number: 10168369

Registered address:

Applecombe Cottage, Wild Oak Lane, Trull Taunton TA3 7JS, UK

Board of Directors/Trustees

Founder and Chair: Dr Ruaraidh MacDonagh Treasurer: Ian Franklin Secretary: Caitlin Farrow Dr Nicholas Campain Susie Moore Michael Sugden Dr Nicola Biggs Helen Rafferty (appointed March 2023)

Senior Management Team

UK Operations and Development Director (UK): Jess Price (resigned Dec 2022) Finance Director (UK): Juliette Webb (appointed January 2023) Fundraising Manager (UK): Kathryn Sheldon (appointed March 2023) Programme Director (Zanzibar): Simon Kühnert Clinical Operations Director (Zanzibar): Jabir Ayindo Partnerships Advisor (Zanzibar): Pamela Allard

External Accountants

SPX Oxford Ltd Peace House 19 Paradise Street Oxford OX1 1LD

Bank

Royal Bank of Scotland (UK), Exim Bank (T) Ltd (Zanzibar)

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1.1 Background

Health Improvement Project Zanzibar (HIPZ) was founded in 2006. It is a Private Company Limited by Guarantee and a charity registered with the Charity Commission for England and Wales. In Zanzibar, HIPZ has a registered branch which is governed by the same Articles of Association and policies.

In the initial years the partnership between the Zanzibar Ministry of Health and HIPZ focused on the development and management of rural hospitals. With time the scope has evolved to strengthen the wider health system in Zanzibar.

1.2 The context

Zanzibar is a semi-autonomous archipelago of the United Republic of Tanzania. It consists of two large islands, Unguja and Pemba and several small islands. Zanzibar has 5 administrative regions with 11 districts. Zanzibar’s population stands at around 1.8 million people. Around half of the population is under 18 years old. Basic needs poverty affects 26% of the population (30% of the under 17s).

The Ministry of Health Zanzibar provides overall stewardship of the health sector.

Zanzibar has made significant gains in human resources for health over the last 10 years. Currently, one doctor serves a population of 4,445 and one nurse serves a population of 1,258. However, these ratios remain far below the World Health Organisation (WHO) recommendations (of 2.5 skilled healthcare workers per 1000). Furthermore, 60% of the health workforce work in urban areas where only 18% of the population resides, meaning there is still significant disparity in accessing healthcare for the majority of the population who live in rural areas.

Zanzibar Performance towards SDG 3 targets

SDG Indicator Zanzibar SDG Target 2030
Under-five mortality rate per
1,000 live births		 56 per 1,000 live births 25 per 1,000 live births
Neonatal mortality rate per
1,000 live births		 28 per 1,000 live births 12 per 1,000 live births
Maternal Mortality ratio per
100,000 live births		 118 per 100,000 live births (only
includes institutional mortality)		 70 per 100,000 live births

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The total health expenditure is approximately 3% of the Gross Domestic Product, falling below the WHO recommendation of at least 5% to achieve Universal Healthcare Coverage. The global COVID pandemic has hit the Zanzibar economy especially hard as the country relies heavily on tourism. The Ministry of Health only implemented 84% of its budget, and as a result there is a gap in the service provision. Therefore, people are frequently forced to spend their own funds on healthcare and out of pocket expenditure on healthcare in Zanzibar is high. This creates a financial risk of pushing households into poverty.

1.3 Our Aims and Objectives

HIPZ aims to strengthen the Zanzibari healthcare system. It is our mission to make it possible for all people in Zanzibar to access high quality healthcare to achieve our vision of a healthy people in Zanzibar.

1.4 How we work

Our HIPZ model has been tried and tested over the past 15 years. This model is our blueprint for how healthcare can be transformed in resource-poor environments. We believe this has the potential to make a difference not just in Zanzibar, but on a global scale.

Our work is derived in line with our values:

Based on these values and our in-depth understanding we have developed our theory of change to improve health outcomes in Zanzibar.

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HIPZ Theory of Change

This model focuses around six pillars:

  1. Build workforces. We train healthcare workers in all areas, equipping them with the knowledge and skills to take ownership of their services.

  2. Expand Services. In line with the Zanzibar Essential Healthcare Package, we listen to the medical needs of the community and find cost-effective, evidence-based solutions to introduce impactful change.

  3. Develop Infrastructure. We improve the structural condition of health facilities and fill gaps in equipment and consumables.

  4. Work with the community. We learn from the community and share our experience to reduce barriers to positive health seeking behaviour.

  5. Invest in research. We invest in locally relevant health research and share it with the global health community to improve health services delivery not just in Zanzibar, but around the world.

  6. Strengthen systems. We co-develop processes, policies and strategies in collaboration with the government, health facilities and other development partners to improve care and create longlasting change.

All this work is delivered in close partnership with the Revolutionary Government of Zanzibar to ensure local ownership, alignment with national policies and priorities as well as sustainability of our programmes.

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1.5 Performance and Achievements

For the first time HIPZ has been able to deliver work in Pemba. We supported over 50 public health facilities and implemented projects across 10 out of the 11 districts in Zanzibar.

In the facilities supported by HIPZ over 5,000 pregnant women received antenatal care and over 6,800 women delivered their babies in these facilities. At the same time, home deliveries reduced from 222 in the previous year to 72.

Through our hypertension project we enabled 15 health facilities to screen over 20,000 people for hypertension and 33% were found with an elevated blood pressure and received appropriate management.

This is a summary of our key achievements, each sectionreflecting the financial categories in note 8 of the financial statements:

  1. Capacity Building

  2. Equipment and Infrastructure

  3. Policy advocacy and system strengthening

  4. Preventive Services and work in the community

Capacity Building

We have continued to build the capacity of the health workforce in Zanzibar. We have trained health workers in various fields including Reproductive, Maternal, Neonatal, Child and Adolescent Health (RMNCAH), Emergency Medicine, Hospital Management, Quality Improvement, Mental Health and Internal Medicine, with a focus on cardiology. We have done this through mentorship, on-the-jobtraining and formal short and long-term training. We have also engaged microbiologists to establish a microbiology department at Makunduchi Hospital. Now the biggest laboratory in Zanzibar?, it will improve diagnostic services and conduct Antimicrobial Resistance Surveillance.

Our maternal and newborn health project trained mentors who conducted over 500 mentorship sessions across primary health care facilities to build capacity of their fellow health care workers and improve referrals for more specialised care. Furthermore, we have established weekly continuous medical education sessions at Kivunge and Makunduchi hospitals and supported Maternal Perinatal Death Surveillance and Response sessions.

Together with the MoH and our project partner, the hypertension project developed a training package on hypertension and trained healthcare workers from all public facilities in North A district.

Our mental health programme involved training healthcare workers from health facilities across Pemba and Unguja to deliver evidence-based care to patients with mental illness and Community Health Volunteers (CHVs) to deliver problem solving therapy within the community.

Equipment and Infrastructure

HIPZ invested in the development of the infrastructure, equipment and provision of pharmaceuticals and equipment.

7

Partnership with International Health Partners

We have formed a 3-year partnership with International Health Partners to strengthen the supply of essential medicines in Zanzibar. A pilot consignment was successfully handed over to the Ministry of Health and the medicines have been distributed through government channels across the health facilities HIPZ supports.

Provision and maintenance of equipment

Through our hypertension project we have supplied medical equipment to 15 facilities in the North of Unguja supporting the early diagnosis and treatment of hypertension. Through our maternal and newborn health project we have supported 28 facilities with equipment supporting antenatal care and delivery services.

We engaged a biomedical engineer to establish pre-planned maintenance plans for Makunduchi and Kivunge hospitals, train local technicians and provide corrective maintenance when necessary across all facilities in North and South districts of Unguja.

Emergency Medicine and Laboratory Block

The old laboratory of Makunduchi Hospital consisted of only two small rooms. Whilst the Hospital team had done its very best to maximize this space, it was evident that the old laboratory was insufficient to accommodate all the laboratory services a District Hospital should provide according to the Essential Healthcare Package. Similarly, the Hospital and the Ministry identified that the provision of emergency care was hampered by the inadequate existing space which did not allow for a good patient flow, was not easily accessible, nor had it the required bed capacity. To address these needs HIPZ partnered with the Lady Fatemah Charitable Trust and Festival Medical Services to construct a new Emergency Medicine and Laboratory Block at Makunduchi Hospital.

When planning the design of this building we followed a human centered approach which builds on the existing standard design from mainland Tanzania. The design was adapted to our context and defined by the population size, the essential service package, availability of human resources for health, the disease patterns and alignment to the patient flow within Makunduchi Hospital, especially in relation to key services such as surgery, imaging, pharmacy, inpatient and outpatient.

The new laboratory will accommodate haematology, parasitology, chemistry and microbiology departments as well as a room for quality control, sterilization and a phlebotomy lab, plus a dedicated waiting area on the ground floor decongesting the hospital. It will also offer a conference room for the hospital.

The Emergency Department provides easy access, an improved patient flow, a dedicated resuscitation area, triage, a consultation room, a treatment area with up to 8 beds and an isolation room.

Ambulance boat

In order to strengthen the referral system and emergency care provision for the 18,000 people living on Tumbatu island, we provided the District Health Management Team with an ambulance boat to easily refer patients from the island to Kivunge Hospital. HIPZ also engaged and trained a captain to ferry patients from Tumbatu to the main island.

8

Policy advocacy and system strengthening

HIPZ has exceptional stakeholder relationships across the health sector, at local, regional, and national government level, as well as in the community.

We have participated in the Zanzibar Development Partners Group for Health and Nutrition, as well as in Technical Working Groups of the Ministry of Health.We have continued to contribute to the Zanzibar Health Basket Fund and have been participating in the Zanzibar Global Fund Country Coordinating Mechanism as a alternate representative of international non-governmental organizations.

We also have been appointed as a member of Zanzibar Multisectoral Coordinating Committee on Antimicrobial Resistance and supported the Ministry of Health through the Zanzibar Health Research Institute to develop a proposal addressing antimicrobial stewardship through an implementation research project based at Mnazi Mmoja and Chake Chake hospitals. HIPZ will now provide an advisory role to the project over the next 3 years.

Preventive Services and work in the community

We trained over 200 Community Health Volunteers (CHVs) in ‘Dawati Rafiki’ across 7 districts in Unguja and Pemba. Dawati Rafiki is an evidence-based, problem-solving therapy devised in Zimbabwe to support beneficiaries with anxiety and depression. The CHVs conducted 2,000 sessions and substantially improved access to basic mental health services at community level.

We have delivered 14 integrated mental health outreach days in Zanzibar in partnership with the Ministry of Health. The outreach days raised awareness of mental health and other NCDs as well as nutrition. Over 5,000 people were screened for NCDs and mental illnesses. We have also partnered with the Rotary Club of Stone Town and Urban Care to deliver Breast Cancer Outreach Camps in every district of Unguja.

In order to further raise awareness and create positive health seeking behavior we delivered radio and TV health talks on mental health and hypertension. In order to support this, together with the Ministry of Health we developed awareness and education materials on hypertension for print, audio and video.

We also delivered community-based activities to support sexual and reproductive health and safe journeys into motherhood. This included Girl mentors and Youth Health Champions conducting 427 sessions with a total of 7,607 youths. We also trained 50 CHVs who reached 3,700 people throughout 800 sessions community sessions. Around 25% of men in the catchment area participated in the sessions delivered by CHVs. This is a significant result, which helps ensure reproductive health and motherhood are safely supported at the household level.

Future plans

In the next year we plan to focus more on antimicrobial resistance which is an emerging public health concern. At Makunduchi hospital we want to establish a surveillance site. We will continue to support the antimicrobial stewardship project of the Zanzibar Health Research Institute at Mnazi Mmoja and Chake-Chake hospitals.

We plan to scale up our hypertension project and continuously build the capacity of Kivunge as a referral site for cardiovascular disease. We plan to support the NCD Unit of the Ministry of Health to tackle the increasing disease burden of NCDs in Zanzibar.

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Our maternal, newborn and child health project in partnership with the Lady Fatemah Charitable Trust, will be scaled up across all of Zanzibar. We will also continuously promote positive health seeking behaviour for RMNCAH services, mental health and NCDs across the islands.

1.6 Structure, Governance and Management

We take our financial and governance responsibilities seriously. This is particularly important to support our work in Zanzibar and ensure the money we spend there is used as effectively as possible. In line with Charity Commission and Companies House requirements our accounts are independently examined annually and published on the relevant websites.

Our Senior Management Team consists of a Programme Director, Clinical Operations Director, Finance Director, Programme Advisor and Fundraising Manager. We have a small fundraising and partnerships team who lead our fundraising activities to ensure incoming funds support the vital activities in Zanzibar. All activities are overseen by the Trustees. Our board of Trustees scrutinise our finances at quarterly meetings and discuss the risks to the charity via our risk register.

We have two sub-committees supporting the work of the Board – the Finance, Audit and Governance Committee and the Medical Advisory Group. These groups report to the Board of Trustees and have been a great support to the trustees over the past year.

This year we have worked with a strategic leadership consultant specialising in the growth of small charities to help support our organisational development and strengthen our governance and management approach. The work has included developing our HR management, staff development, governance structures, finance and funding and strategy development.

Directors/Trustees

Our board of trustees is made up of experienced professionals from a range of backgrounds, including senior clinicians, communications and marketing, finance, charity and business planning.

Since we were incorporated in 2016, the trustees of the charity are also directors of the company. All directors give their time voluntarily and received no benefits from the charity. There were no trustees' remuneration or other benefits paid for the year ending 30 June 2023.

Recruitment to the board of trustees is skills-based, and we regularly review the skills and experience we have represented on the board. In the last financial year, we have recruited a new trustee with expertise in human resources to help support our work.

Trustees gain knowledge from other trustees and HIPZ staff and keep up to date with the role of the trustee using Charity Commission guidance. Trustees are encouraged to oversee specific areas of interest, for example finance, events, fundraising or planning.

Risk Management

Risk is discussed at all levels of the organisation, and at the strategic level is overseen by an organisational risk register. The risk register is discussed regularly at the Finance, Audit and Governance Committee and with the Board of Trustees.

Governing Document

The charity is controlled by its governing document, a deed of trust, and constitutes a limited company, limited by guarantee, as defined by the Companies Act 2006.

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1.7 Financial Review

Financial Performance 2022-23

Income for the year at £898k was +47% higher than budgeted and represented a +79% increase from 2021-22 (£500k). The majority of the additional income (£286k), compared to the previous year, came from Trusts and Foundations and was raised during the year.

Expenditure for the year at £880k was +25% higher than budgeted in total and represented a +69% increase compared to 2020-21. The higher spend (£179K) was mostly in the areas of capacity building and quality improvement as well as equipment and pharmaceuticals (including goods donated in kind), and preventative services, for which restricted funding was raised during the year (incremental to the original budget as noted above).

The small surplus of income vs expenditure at +£18k was higher than budgeted and resulted in a net asset position of £134k at the end of 2022-23 (£115k 2021-22). This represents restricted funds received for ongoing projects in Zanzibar.

Principal Funding Sources

Our income sources for this financial year were:

We continue to work hard to build up a portfolio of long-term supporters from a range of funding sources.

Investment Policy

The charity does not have any investments.

Reserves Policy

The reserves policy is designed to maintain a sufficient level of unrestricted funds to enable the charity to close down should it be required to. It allows for six months of basic operations to continue and would give time for staff in Zanzibar to make alternative employment arrangements. It is based upon the cost of three months’ predictable liabilities.

The policy allows HIPZ to actively manage our finances and ensure we have the capacity to weather unforeseen financial problems. The Trustees have reviewed the position, noting that the yearend reserves are not at the level of the policy, but consider that there are no material uncertainties to continue as a going concern.

Auditors / Independent examiner

Ross Brooke were appointed to conduct the independent examination of these accounts.

This report has been prepared in accordance with the Charities SORP (FRS 102) 'Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their

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accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (effective 1 January 2015)', Financial Reporting Standard 102 'The Financial Reporting Standard applicable in the UK and Republic of Ireland' and the Companies Act 2006.

In Zanzibar, Hybrid Assurance was appointed to conduct the audit of HIPZ in Zanzibar. The audit was conducted in accordance with International Standards on Auditing issued by the International Auditing and Assurance Standards Board of the International Federation of Accountants.

In the opinion of the auditor the financial statements presented for Zanzibar presented a true and fair view of the state of affairs of HIPZ, as at 30th June 2022 and for the period then ended, accordance with International Public Sector Accounting Standards issued by the Public Sector Committee of the International Accounting Standards issued by the International Accounting Standards Board.

Public benefit

The Trustees have complied with the duty in section 17(5) of the Charities Act 2011 and have given due regard to public benefit guidance published by the Charity Commission.

Approved by the directors on 29[th] November 2023 and signed on its behalf by Dr Ruaraidh MacDonagh:

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2 Independent Examiner’s Report to the trustees of HIPZ (Health Improvement Project Zanzibar) for the year ended 30 June 2023

FOR THE PERIOD ENDED 30 JUNE 2023

I report to the charity trustees on my examination of the accounts of the Company for the period ended 30 June 2023, which are set out in pages 14-24.

RESPECTIVE RESPONSIBILITIES OF TRUSTEES AND EXAMINER

As the charity’s trustees of the Company (who are also the directors of the company for the purposes of company law), you are responsible for the preparation of the accounts in accordance with the requirements of the Companies Act 2006 (“the 2006 Act”).

BASIS OF INDEPENDENT EXAMINER’S REPORT

Having satisfied myself that the accounts of the Company are not required to be audited for this period under Part 16 of the 2006 Act and are eligible for independent examination, I report in respect of my examination of your charity’s accounts as carried out under section 145 of the Charities Act 2011 (“the 2011 Act”). In carrying out my examination, I have followed the Directions given by the Charity Commission (under section 145(5)(b) of the 2011 Act.

INDEPENDENT EXAMINER’S STATEMENT

The company’s gross income exceeded £250,000 and I am qualified to undertake the examination by being a qualified member of the Institute of Chartered Accountants in England and Wales.

I have completed my examination. I confirm that no material matters have come to my attention which gives me cause to believe that:

I have no concerns and have come across no other matters in connection with the examination to which attention should be drawn in this report in order to enable a proper understanding of the accounts to be reached.

Caroline Webster FCA

UHY Ross Brooke Windrush Court Abingdon Business Park Suite I Bucklands Way Abingdon OX14 1SY

Date ………………………………

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3 Statement of Financial Activities including Income and Expenditure Account

FOR THE PERIOD ENDED 30 JUNE 2023

Note
Income
Donations and
legacies
3
Other
Total income
Expenditure
Fundraising costs
4
Charitable activities
5
Total expenditure
Net income/ -
expenditure
Transfers between
funds
Net movement in
funds
Reconciliation of
funds:
Total funds brought
forward
Total funds carried
forward		 Unrestricted
£
122,236
3,331
125,567
17,430
152,171
169,601
- 44,034
702
- 43,332
65,173
21,841		 Restricted
£
772,691
-
772,691
33,442
676,472
709,914
62,777
- 702
62,075
49,658
111,733		 Total
2023
£
894,927
3,331
898,258
50,872
828,643
879,515
18,743
-
18,743
114,831
133,574		 Unrestricted
£
100,604
1,636
102,240
26,823
122,176
148,999
- 46,759
22,806
- 23,953
89,126
65,173		 Restricted
£
398,414
1
398,415
47,462
323,812
371,274
27,141
- 22,806
4,335
45,323
49,658		 Total
2022
£
499,018
1,637
500,655
74,285
445,988
520,273
- 19,618
-
- 19,618
134,449
114,831

The Statement of Financial Activities includes all gains and losses in the period and therefore a statement of total recognised gains and losses has not been prepared. All of the above amounts relate to continuing activities. The notes on pages 17 to 24 form part of these financial statements.

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4 Balance Sheet

AS AT 30 JUNE 2023

Note
Tangible fixed assets
7
Current assets
Debtors
8
Cash at bank and in hand
Creditors: amounts falling due
within one year
9
Net current assets
Creditors: amounts falling due in
more than one year
Net assets
Funds
Restricted funds
10
Unrestricted funds general
11
Designated
Total charity funds		 2023
£
31,580
111,332
142,912
- 22,844		 2023
£
13,506		 2022
£
5,527
108,722
114,249
- 12,696		 2022
£
13,278
101,553
-
120,068
-
133,574
111,733
21,841
-
133,574
114,831
49,658
65,173
-
114,831

For the period ended 30 June 2023 the charitable company was entitled to exemption from audit under section 477 of the Companies Act 2006. Trustees responsibilities:

These financial statements were approved by the members of the committee and authorised for issue on ……………………….. and are signed on their behalf by Dr Ruaraidh MacDonagh, Chairman and Trustee.

Trustee:

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5 Statement of Cash Flows

FOR THE PERIOD ENDED 30 JUNE 2023

Note
Cash used in operating activities
14
Cash flows from investing activities
Dividends and interest from investments
Proceeds from the sale of fixed assets
Purchase of fixed assets
Cash provided by (used in) investing activities
Increase (decrease) in cash and cash equivalents in the
year
Cash and cash equivalents at the beginning of the year
Total cash and cash equivalents at the end of the year		 2023
£
11,687
-
-
- 9,077
- 9,077
2,610
108,722
111,332		 2022
£
- 17,734
-
-
- 7,655
- 7,655
- 25,389
134,111
108,722

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FOR THE PERIOD ENDED 30 JUNE 2023

6 Notes to the Accounts

1. ORGANISATION STATUS

HIPZ (Health Improvement Project Zanzibar) is a Charitable Incorporated Organisation.

2. ACCOUNTING POLICIES

Basis of accounting

The charity constitutes a public benefit entity as defined by FRS102. The financial statements have been prepared in accordance with Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS102) with the Charities Act 2011, the Charities and Trustee Investment (Scotland) Act 2005 and the Charities Accounts (Scotland) Regulations 2006.

The financial statements have been prepared under the historical cost convention (SORP 2019), ‘Accounting and Reporting by Charities’, issued by the Charities Commission.

Fund accounting

Unrestricted funds are available for use at the discretion of the trustees in furtherance of the general objectives of the charity.

Restricted funds can only be used for particular restricted purposes within the objects of the charity. Restrictions arise when specified by the donor or when funds are raised for particular restricted purposes.

Income

All income is included in the statement of financial activities when the charity is legally entitled to the income and the amount can be quantified with reasonable accuracy.

Fixed assets

Fixed assets (excluding investments) are stated at cost less accumulated depreciation. The costs of minor additions or those costing below £1,000 in the UK, or £300 in Zanzibar are not capitalised.

Depreciation

Depreciation is calculated so as to write off the cost of an asset, less its estimated residual value, over the useful economic life of that asset. There are currently no assets held in the UK. Our depreciation rates in Zanzibar are based on the Tanzanian Revenue Authority rates and are therefore as follows:

Depreciation rates - Zanzibar

Computers and accessories and motor cycles– 37.5% (reducing balance) Furniture and fixings, office equipment and motor vehicles – 12.5% (reducing balance)

Expenditure

Expenditure is accounted for on an accruals basis and has been classified under headings that aggregate all costs related to the category. Expenditure represents amounts invoiced, including value added tax.

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6 Notes to the Accounts

FOR THE PERIOD ENDED 30 JUNE 2023 (continued)

Taxation

The Charity is exempt from corporation tax on its charitable activities.

Going concern

The trustees consider that there are no material uncertainties as to the charity’s ability to continue as a going concern.

Currency

The accounts are presented in GBP although the functional currency is TZS (Tanzanian Shillings). This is because most of the transactions occur in Zanzibar and are in TZS.

3. DONATIONS AND LEGACIES

Individual Giving
Corporate
Major Donors
Statutory
Community and events
Trusts and Foundations		 Unrestricted
£
52,106
10,910
26,500
-
27,173
5,547
122,236		 Restricted
£
125
78,954
-
26,987
-
666,625
772,691		 2023
£
52,231
89,864
26,500
26,987
27,173
672,172
894,927		 2022
£
45,208
66,009
21,000
44,177
11,352
311,272
499,018

4. FUNDRAISING COSTS

Fundraiser salaries
Other fundraising costs		 Unrestricted
£
8,573
8,857
17,430		 Restricted
£
14,887
18,555
33,442		 2023
£
23,460
27,412
50,872		 2022
£
53,188
21,097
74,285

5. EXPENDITURE ON CHARITABLE ACTIVITIES

Operational costs
Capacity building and quality improvement
Equipment and consumables, Infrastructure
development and Pharmaceuticals
Policy advocacy / government liaison
Preventive Services
Administration
Exchange rate differences		 Unrestricted
£
28,787
36,314
18,672
8,549
3,919
48,016
7,914
152,171		 Restricted
£
18,799
233,966
254,885
17,951
141,785
9,086
-
676,472		 2023
£
47,586
270,280
273,557
26,500
145,704
57,102
7,914
828,643		 2022
£
32,057
226,158
72,899
9,314
67,114
34,346
4,100
445,988

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6 Notes to the Accounts

FOR THE PERIOD ENDED 30 JUNE 2023 (continued)

6. STAFF COSTS

Wages and salaries
Social security costs
Pension costs
Fundraising
Programme mgt & admin
Total		 2023
£
212,257
36,590
818
249,665
2023
2.0
9.6
11.6		 2022
£
144,642
18,876
1,104
164,622
2022
2
10
12

No employee received benefits exceeding £60,000

7. TANGIBLE FIXED ASSETS

Cost
Cost at 1 July 2022
Additions
Disposals
Exchange adjustment and other adjustments
to align to Zanzibar accounts
At 30 June 2023
Depreciation
At 1 July 2022
Disposals
Charge for the period
Exchange adjustment
At 30 June 2023
Net book value
At 30 June 2023
At 30 June 2022		 Motor
vehicles
£
10,884
-
- 1,469
- 1,399
8,016
8,479
- 1,615
514
- 463
6,915
1,101
2,405		 Equipment
£
13,502
9,077
-
- 1,948
20,631
2,629
-
6,376
- 779
8,226
12,405
10,873		 Total cost
£
24,386
9,077
- 1,469
- 3,347
28,647
11,108
- 1,615
6,890
- 1,242
15,141
13,506
13,278

19

FOR THE PERIOD ENDED 30 JUNE 2023 (continued)

6 Notes to the Accounts

8. DEBTORS

Trade debtors
Staff loans
Other debtors
Prepayments		 2023
£
16,810
761
10,782
3,227
31,580		 2022
£
-
2,127
-
3,400
5,527

9. CREDITORS

Trade creditors
Accruals
Other creditors		 2023
£
1,594
9,804
11,446
22,844		 2022
£
-
4,465
8,231
12,696

20

6 Notes to the Accounts

FOR THE PERIOD ENDED 30 JUNE 2023 (continued)

10. RESTRICTED INCOME FUNDS

Restricted funds
AstraZeneca
BNITM
CM Lemos Foundation
Dornenburg Stiftung
Ethicall
Evan Cornish
Festival Medical Services
Grant Bradley Foundation
Geoff Harrington Foundation
Guernsey Overseas Aid
Commission
ICARS
IHP donated goods
James Tudor Foundation
The Lady Fatemah Charitable Trust
Pharmanovia
Rotary Club of Stone Town
Rotary Global Grant (Makunduchi)
Scott Bader
St James Place Foundation
Todos Juntos
USAID
HIPZ Christmas Fundraiser
ZIDO
Other		 Balance
at 30 June
2022
£
-
-
- 43,165
702
16,729
- 925
20,400
-
-
10,169
-
-
-
14,595
5,925
-
- 2,272
-
-
5,000
-
5,969
16,531
-
49,658		 Income
£
54,054
46,758
181,318
-
-
9,916
-
6,000
5,060
26,987
8,171
35,414
4,120
302,404
24,900
3,068
1,971
4,000
2,500
-
51,326
125
3,929
670
772,691		 Expenditure
£
- 27,816
- 6,248
- 138,153
-
- 14,322
- 8,991
- 12,206
- 5,861
- 4,729
- 53,637
- 8,171
- 35,414
-
- 294,480
- 30,825
-
301
- 4,000
-
- 3,528
- 44,440
- 6,094
- 10,630
- 670
- 709,914		 Transfer
(to) / from
unrestricted
funds
£
-
-
-
- 702
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
- 702		 Balance
at 30 June
2023
£
26,238
40,510
-
-
2,407
-
8,194
139
331
- 16,481
-
-
4,120
22,519
-
3,068
-
-
2,500
1,472
6,886
-
9,830
-
111,733

There is a negative fund balance on the Guernsey Overseas Aid Commission. This is due to the funds being paid in arrears. In this case, an invoice to GOAC for £22k was raised in July and paid by the donor in July.

21

FOR THE PERIOD ENDED 30 JUNE 2023 (continued)

6 Notes to the Accounts

Purpose of restricted funds:

ZIDO is registered non-profit charitable organisation based in Canada. The registered name is Reaching out to Zanzibar International Development Organization and its mission is to improve the lives of the people of Zanzibar

Rotary Zanzibar is the short form of Rotary Club of Zanzibar - Stone Town based in Zanzibar Town, Tanzania. It is an organisation to bring together business and professional leaders in order to provide humanitarian services and to advance goodwill and peace. It is a non-political and non-religious organisation open to all.

Comic Relief. Comic Relief is supporting us to implement a mental health project in North A and South Districts benefiting 180,000 people with the aim of improving access to mental health services in the community, improving quality of mental health services, improving awareness of mental health in the community.

Dorenburg Stiftung is a private family foundation funding medication and consumables for our paediatric work.

Evan Cornish Foundation is a UK based grant-giving organisation. They awarded HIPZ funding to deliver mental health community outreach days.

Ethicall i s a historic partner of HIPZ and they reached back out to us in 2020, and generously offered to support our work. They donated £17,000 towards our surgical work which included renovating and equipping the operating theatre in Kivunge Hospital and purchasing a new theatre bed for Makunduchi Hospital.

The Lady Fatemah Charitable Trust is funding HIPZ to deliver a new maternal and new-born health programme in the hospitals and Primary Health Care Units we work in.

The Costas M Lemos Foundation is a private foundation supporting HIPZ’s fundraising and operations functions.

22

6 Notes to the Accounts

FOR THE PERIOD ENDED 30 JUNE 2023 (continued)

11. UNRESTRICTED INCOME FUNDS

Unrestricted funds
General unrestricted funds		 Balance
at 30
June
2022
£
65,173
65,173		 Income

£
125,567
125,567		 Expenditure
£
- 169,601
- 169,601		 Transfer
(to) / from
unrestricted
funds
£
702
702		 Balance
at 30
June 2023
£
21,841
21,841

12. ANALYSIS OF FUNDS BY ASSET TYPE

Fixed assets
Net current assets		 Restricted
£
-
111,733
111,733		 Unrestricted
£
13,506
8,335
21,841		 Total cost
£
13,506
120,068
133,574

13. TRUSTEE REMUNERATION, KEY MANAGEMENT PERSONNEL & RELATED PARTY TRANSACTIONS

No member of the board of trustees received any remuneration or were reimbursed for any expenses during the reporting period.

The key management personnel are the voluntary trustees and so there is no expenditure on key management personnel during the reporting period.

There were no related party transactions during the reporting period.

14. RECONCILIATION OF NET MOVEMENT IN FUNDS TO CASH FLOW FROM OPERATING ACTIVITIES

Net income/expenditure for the year (as per
the Statement of Financial Activities)
Add back depreciation charge
Investment income
Loss on disposal of fixed assets
Decrease (increase) in stock
Decrease (increase) in debtors
Increase (decrease) in creditors
Net cash used in operating activities		 2023
£
18,743
6,890
-
1,959
-
- 26,053
10,148
11,687		 2022
£
- 19,618
1,819
-
- 854
-
- 822
1,741
- 17,734

23

6 Notes to the Accounts

FOR THE PERIOD ENDED 30 JUNE 2023 (continued)

15. COMPARATIVE STATEMENT OF FINANCIAL ACTIVITIES FOR THE PERIOD ENDED 30 JUNE 2022

Total Total
Note Unrestricted Restricted 2022 Unrestricted Restricted 2021
£ £ £ £ £ £
Income
Donations and
legacies		 3 100,604 398,414 499,018 265,440 99,976 365,416
Other 1,636 1 1,637 813 - 813
Total income 102,240 398,415 500,655 266,253 99,976 366,229
Expenditure
Fundraising costs 4 26,823 47,462 74,285 45,422 - 45,422
Charitable activities 5 122,176 323,812 445,988 207,053 93,117 300,170
Total expenditure 148,999 371,274 520,273 252,475 93,117 345,592
Net income/ -expenditure - 46,759 27,141 - 19,618 13,778 6,859 20,637
Transfers between funds 22,806 - 22,806 - - - -
Net movement in funds - 23,953 4,335 - 19,618 13,778 6,859 20,637
Reconciliation of funds:
Total funds brought forward 89,126 45,323 134,449 75,348 38,464 113,812
Total funds carried forward 65,173 49,658 114,831 89,126 45,323 134,449

24