GOVERNMENT OF THE PUNJAB

PLANNING & DEVELOPMENT BOARD

(HEALTH SECTION)

WORKING PAPER FOR PRE-PDWP

Part-A
Project Profile
1. Project Title Establishment of 200 Bedded Mother & Child
Hospital and Nursing College in District Layyah
2. Location Approx. 2 Km from General Bus Stand and 1.5 Km
from existing DHQ Hospital, Layyah
3. Sponsoring Agency Primary & Secondary Healthcare Department,
Government of the Punjab
4. Executing Agency Infrastructure Development Authority of the Punjab
(IDAP)
5. Operation and Primary and Secondary Healthcare Department, Govt.
of the Punjab, Lahore through District Health
Maintenance
Authority, Layyah
6. Cost Category Amount (Million)
Capital 4555.04
Revenue 813.12
Total 5368.16
10. Estimated Cost in
Rs.4000.00 M
ADP 2019-20.
11. Allocation ADP
2019-20 Rs. 185.000 M (Revenue)
(G.Sr.No.758)
12. Gestation Period 01.07.2019 to 30.06.2021 (24 Months)
13. Brief Description of Project

Layyah is one of the districts in the province of Punjab with a total population of
1.616 million (Pakistan Bureau of Statistics – 2017). The total covered area of
District Layyah is 6,291 Sq. Km with population density of 178 people per Sq. Km.
Currently, there is one DHQ Hospital and six THQ Hospitals along with seventy
primary level health facilities. The Mother & Child Hospital in this district will
comprise bed strength of 200 beds with a total plot area of 206 kanal - 10 Marlas.
The approximate covered area of the hospital building is 260,000 sq. ft (approx.)
and staff accommodation is 200,000 sq. ft (approx.). This project is targeted to
general public in order to boost their confidence in the primary health care system.
This will also enable them to obtain the requisite medical treatment to enable them
to live a healthy life and can play a positive role in the progress of the country.
The addition of this hospital in District Layyah would improve maternal and child
health services to the desired level, easing the maternal, neonatal and children
mortality indices.
14. Project Justification
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 Pakistan is one of the developing countries suffering from high maternal and
infant mortality rates. Beside other reasons, one of the major reasons causing this is
the lack of access of women and children to modern healthcare services. Delivery of
good maternal medical care to patients is one of the ultimate goals of health care
system. Achievement of this goal is possible by creation of state-of-the-art medical
facilities with modern equipment and technologies.
This facility will ensure the availability of qualified teams of physicians,
technicians, nurses and administrative staff who are well skilled to offer best of their
services to expecting mothers, facilitate them in labor and delivery and treat other
health problems of women and children (in-patient).
Apart from providing high quality medical services, this hospital will also provide
employment to many people, including training for doctors, nurses and paramedics.
Furthermore, tremendous public benefit will be accrued from this institution
specially:
• Maternal and infant mortality rate will be decreased.
• Health standard of public will enhance.
• Better Health Facilities to mother and child.
• Prompt and scientific facility for surgical procedures.
• Provision of better health facilities at doorsteps
This all will decrease load of patients on the acute care hospitals and specialized
institutions by promoting physical and mental health. By adopting preventive and
Hygienic principles, the number of patients and diseases will decrease.
The idea behind MCH is not only provide health facilities but to run awareness
and educating campaigns too. People in rural and undeveloped regions need to be
educated. This is one of the core objectives for MCH to educate people within their
vicinities and districts.
15. Objectives

Mother & Child Hospital:

 To improve access of marginalized communities to quality maternity and
immediate new born care.
 To provide high quality EmONC services to widely scattered population of
low socio-economic group.
 To provide routine medical and surgical services to mother and children of
the catchment population.
 To strengthen preventive services (immunization, nutrition and family
planning) to children and mother of the catchment population.
 To achieve optimum respective SDG health indicators.
 To ensure service delivery by trained skilled and well-equipped staff with
provision of consultant / expert opinion from disciplines of obstetrics,
gynecology, pediatric and neonatology.
 To implement IT-based solutions (EMR, QMS) for better service delivery
and resource management.

Nursing College:
 To overcome shortage of general nurses in hospitals and faculty
requirement in training institutes through B.Sc. (Nursing) for general
nursing (100 Students seats annually).
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16. Availability of Land:

206 Kanal 10 Marlas

17. Scope of Work

 Main Hospital Building

o 01 Floor Building
o Fire Safety System
o Queue Management System
 03 Floor Doctor Apartments
o 01 Beds 18 No.
o 02 Beds 12 No.
o 03 Beds 04 No.
 Nursing College
o 03 Floor Nursing College
o 02 Storey two Beds Quarter 10 No.
o 02 Story single bed Quarter 12 No.
o Single Storey Nursing Hostel 15,396 Sq.ft.
 Sarai (Waiting Area) 3,921 Sq. ft.
 Revenue

18. Bed Plan

Block No. of
Sr. Ward Name
Name Beds
Gynae Emergency 20
Labor Room 20
Antenatal Ward 20
Gynae Block

Postnatal Ward 20
1.
HDU 10
ICU 5
Gynae Ward 20
KMC (adjacent to labor room) 5
Emergency (Paeds & Neonatal) 10
Paeds Block

Paeds Indoor 24
2. Nursery / Neonatology 20
Paeds ICU 6
Neonatal HDU / ICU 20
Total 200

19. Human Resource

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 Following HR is required for 200 bedded Hospital
Sr. Type of Post Number
No
1 Management Staff 5
2 Specialist, Medical, Nursing & Paramedic 310
Staff
3 Non-Medical Specialist Staff 34
4 Other Supporting Staff 190
Total Staff 539

Furthermore, following HR will be required for Nursing College:

Sr. Type of Post Number

No
1 Faculty 16
2 Admin Staff 54
3 Staff for Hostel 31
Total Staff 101

20. SUMMARY OF COST

Sr. Total Cost

Description
No. PKR Million

1 Hospital Building and External Infrastructural

3908.29
Works.
A. Sub Total (1) 3908.29
 2 Punjab Revenue Authority (PRA) Sales Tax on
Construction Services @ 5% 195.41

3 Medical Equipment & Furniture Cost+FF &E Cost 813.12

B. Sub Total(2&3) 1008.53
Total (A&B) 4916.82
  IDAP & Medial Equipment execution Agency Fee
147.50
3%
  Consultancy Supervision @ 3% 147.50
  Contingencies @3% of A 117.25
  Environmental Impact Assessment, Topographic
and Geo Tech Investigation, Structural / MEP,
Design Vetting etc. @ 1% 39.08

Grand Total 5368.17

21. FINANCIAL PHASING

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 Descriptio
Initial Cost Year 1 Year 2 Year 3
n
Grand
5368.17 711.76 2444.63 2211.77
Total

22. a) Sector Issues

Health sector needs institutional reforms for the improvement and betterment
of existing facilities.

b) Sector Strategy
The Sectoral strategy is to provide better health services in the form of
expansion of Primary & Secondary healthcare facilities.

23. Relationship of the project with Sector Issues

The main objective is to achieve SDGs through major interventions in the health
service delivery with significant reduction in incidence of diseases. The sectoral
strategy focuses on preventive healthcare and improved Primary, Secondary &
tertiary healthcare.

24. Other major ongoing & potential projects in the Sector

ADP 2019-20 reflects various schemes regarding Provision of missing facilities at

Govt City Hospital, Talagang, District Chakwal, and Establishment of 500 bedded Wah
General Hospital Tehsil Taxila District Rawalpindi and Establishment of DHQ Hospital
Mandi Bahauddin etc. Up-grading / up-lifting of existing capacity of hospitals with
improved infrastructure will definitely play its role in improving health indicators in
Punjab.
25. Annual Recurring Expenditure

Rs. 530.865 Million

26. Requirement of vehicles / staff/ consultancy (with justification)

Coaster 32 Seater, 01 No., Motor Cycle 70 Cc 4 No., Pick Up Small 2 No., Staff Car
1300 CC 01 No. and Truck Small 01 No. for transfer of staff and routine tasks.

Part-B

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 First Pre-PDWP was held 19.02.2020 at 11.00 am under the chairmanship of
Member (HNP) wherein observations of Technical & Health section of P&D Board were
discussed. In result of the discussion, it was decided that P&SH Department would
submit the requisite information as required by Technical and Health section of P&D
Board in the form of amended PC-1. The department submitted the amended PC-1
along with annotated replies on 28.02.2020 vide letter. No. PO(D-II)1-235/2018.

After examining the same by technical & health section following observations
are noted.

Observations / Comments by Technical Section P&D Board:-

In continuation of technical section’s comments dated 06.02.2020 RCE & reply of
IDAP has been examined and observations are as follows:-

1. In amended RCE composition of MRS items and N.S items have been changed from
original rough cost estimate. Some items like reinforced concrete has been deleted
from MRS items and included in NS items. Cost difference is explained as under:-
As Per Cost
Amended RCE per
  As Per Original RCE Sft
area
(Rs)
N.S N.S
Items MRS Items
Description (A) (Rs.in Items (Rs.in
MRS Items Million (Rs.in Million
(Rs.in Million) ) Million) )
Hospital Building- (Civil
works)
excluding HVAC,
Firefighting, Plumbing
Work. Electrical work,
523.96
Elevator, Generator, Fire 767.951 318.52 551.03 4,166
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alarm, Nurse call System, (29%) (51%)
Building signage, Que
management System,
External works (258,040
S.Ft)

Policy decision is required regarding percentage cost of N.S items which may be
taken in rough cost estimate. Government Executing Agencies follow compulsory
binding of application of MRS item in any type of construction during preparation of
rough cost estimate, however, N.S item is only added in RCE either MRS item is not
available or certain technical requirement of the item for construction is encountered.
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IDAP has used design parameters/ items of work for construction by their own choice
and rates derived by them. Consequently, construction cost of building is increased as
high as Rs.4199 per Sft for civil works only, in comparison to MRS based estimation.
Overall cost of Hospital building only including all allied works comes to Rs.12,376 Per
S.ft (excluding medical equipment furniture, PRA Tax, contingency and other IDAP
charges). Whereas, cost of residence building comes to Rs. 3404 per S.ft which IDAP
has submitted on plinth area rates. Similarly cost of external works is Rs. 942.718 M
which is 87% of civil works against 15% normally adopted.
2. Standard parameters/specifications for design/works and accordingly Plinth Area
Rates are to be notified by IDAP for preparation of Rough Cost Estimates as per
format adopted by P&DB
3. In the amended rough cost estimate N.S items used are prepared by IDAP.
Following conditions are to be ensured/certified by the executing agency:-
i) Approved format / template and guidelines of Finance Department are
used for preparation of rate analysis.

ii) Rate analysis of Non- standardized items are to be signed/approved by

the competent authority and a copy is to be submitted to Finance
Department.

iii) Quantities of input material, labour, equipment and their rates are correct
and notified by labour and finance department, if any input market rate is
used then certificate of reasonability of the market rate is required by
Engineer having delegation of financial power for approval of rate
analysis.

iv) Contractor profit and overheads adopted in the estimate are as

prescribed by Finance Department.

v) N.S item taken in the estimate does not have similar or equivalent item
notified in MRS.

vi) Saving from one head shall not be utilized under any other head unless
approval by the competent forum.

4. Responsibility for correctness of detailed quantities and their actual requirement lies
with executing agency.

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5. Non-standardized items be approved by the authority as per financial
rules/guidelines.
6. IDAP may notify its plinth area rates & corresponding specifications.
7. Responsibility of Rates, Quantities and their requirement /design shall rest with the
authority/forum competent to accord sanction.

Observations / Comments by IT Section P&D Board:-

1. The Department may incorporate the generic specifications of the IT Equipment

(Color Printer, Computer (Thin Client), Laptop etc.) for better cost estimations The
Department may incorporate details of Data Bank (Component wise) for better cost
estimations which is lumpsum Rs. 2,034,062.50.
2. The Department may incorporate details of HIMS whether it will develop in house or
in case if purchase from the market then incorporate the licenses details in shape of
subscription fee.
3. The Department may incorporate details of Modular digital Exchange 20/200 with
respect of Software & Hardware.
4. The Department may incorporate details of Server Mail / Main / Backup including
Hardware (CPU, HDD, RAM etc.) & Software (O.S etc.)

Observations / Comments by Health Section P&D Board:-

1. In previous Pre-PDWP meeting, it was asked AD to calculate IDAP Design

/Execution and Consultancy supervision fee after excluding the cost of Punjab
Revenue Authority Sales Tax on construction @ 5% which was not corrected.
2. In previous Pre-PDWP meeting, it was also asked AD to calculate Consultancy
supervision fee after excluding the cost of fixed furniture & equipment which is not
corrected.
3. The Sponsor may rationalize the 120 No. of LCDs as per need.
4. The sponsor may rationalize the 20 No. Steel Shelving Heavy of cost Rs. 66,666/-
each in the presence of 100 no. Shelving Steel of cost Rs.23,333/- each.

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