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Project Evaluation Report
“Purchase of 128 Slice C.T. Scan for Radiology Department
Nishtar Hospital Multan”
Directorate General Monitoring & Evaluation
Planning & Development Department, Government of the Punjab
November 2018
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Contents
1. INTRODUCTION ......................................................................................................................................... 5
1.1Description ........................................................................................................................................... 5
1.2 Project Brief ........................................................................................................................................ 5
1.3 Project Objectives ............................................................................................................................... 6
1.4 The Evaluation Report: Purpose & Structure ...................................................................................... 6
2. EVALUATION METHODOLOGY .................................................................................................................. 6
2.1 Team Formation .................................................................................................................................. 7
2.2 Documents Review ............................................................................................................................. 8
2.3 Identification of Key Indicators ........................................................................................................... 8
2.4 Ethical Consideration .......................................................................................................................... 8
2.5 Copyright ............................................................................................................................................ 8
2.6 Project Site Visit .................................................................................................................................. 9
2.7 Interviews with Project Officials ......................................................................................................... 9
3. DGME ASSESSMENT: PROJECT PHYSICAL & FINANCIAL ACHIVEMENTS .................................................. 9
3.1 General Assessment ............................................................................................................................ 9
3.2 Physical Targets & Achievements ..................................................................................................... 10
3.3 Project Cost Analysis ......................................................................................................................... 10
4. PROJECT TARGETS, PERFORMANCE AND DGM&E ASSESSMENT ........................................................... 12
5. OBSERVATIONS ....................................................................................................................................... 14
6. RECOMMENDATIONS .............................................................................................................................. 15
Annex – Pictorial Evidence
3
List of Figures
4
1. INTRODUCTION
1.1 Description
Nishtar Hospital Multan (NHM) is one of the biggest hospitals of the province, delivering medical
facilities to the people of Southern Punjab and some districts of Sindh, Balochistan & Khyber
Pukhtunkhawa. This hospital caters health care needs of huge population (more than 40 million)
of above said areas. About two lac (0.2 Million) patients are treated as indoor per year in this
institution.
The existing CT-scanner installed at Nishtar Hospital, Multan is very old and providing services
to 1700 bedded hospital. This scanner is quite insufficient to cope with the work load of the
Radiology Department Nishtar Hospital, Multan. The new proposed CT-Scanner is of 128 slice
CT scanner and required urgently to provide the diagnostic facility to the patients.
1.2 Project Brief
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1.3 Project Objectives
The main objective of the project is
To provide better diagnostic facilities to patients coming from across Southern Punjab and
adjoining areas of Sindh, Balochistan & Khyber Pukhtunkhawa provinces.
1.4 The Evaluation Report: Purpose & Structure
This evaluation report is divided into 5 different parts. The first part starts with an introduction
giving details about the project domain and structure of the project evaluation report. The second
part of this report focuses on evaluation methodology, followed by documents review, selection
of performance indicators, project site visit plan, etc. The third part of the report depicts the
DGM&E’s assessment pertaining to the actual status of the project performance against its planned
objectives and data analysis based on project cost. The fourth part of the report consists of
observations regarding the project activities made by the evaluation team of DGM&E, P&D
Department.
The fifth and the most critical part reflect recommendations for the effective usage of the project
outcomes and resources. This section addresses the suggestions for improvement in project
planning and execution as well as, identifying matters requiring follow up actions. The rationale
for the recommendations is clearly explained and linked with the information collected during the
evaluation.
2. EVALUATION METHODOLOGY
Following criteria has been used to carry out an evaluation of the project as elaborated in flow
chart as given in Figure 1.
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2.1 Team Formation
The evaluation team was constituted at a meeting held in the office of DGM&E for evaluation of
the project having expertise in the project’s domain, data collection methods, data analysis and
interpretation along with preparation of the evaluation report. The project was assigned to Ms.
Aroos Munir Industrial & Environmental Specialist for evaluation purposes.
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2.2 Documents Review
2.3 Identification of Key Indicators
i) Project cost
ii) Project duration
iii) Procurement record & Quality of procured items (Machinery & equipment and
furniture/fixture)
iv) Project achievements against its approved objectives & targets.
v) Procurement of machinery & equipment
vi) Successfully operation of procured Machinery & Equipment
2.4 Ethical Consideration
The evaluation was conducted in-line with the UN Ethical Guidelines for Evaluation. During the
evaluation process, the following ethical considerations have been observed:
The purpose of the evaluation was explained to participants.
The participation was voluntary and participants had the right to withdraw from it at any part
of the evaluation process.
Informed consent of participants was obtained and privacy and confidentiality were
maintained.
2.5 Copyright
The DGM&E office has the copyright on all the documents / material collected and produced as
part of this evaluation.
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2.6 Project Site Visit
For data collection and evaluation the project site was visited by the Evaluation Team of the
Directorate General, Monitoring & Evaluation, Planning & Development Department. Detail has
been given in the table below;
Table 1: Plan for Evaluation along with detail of Team Members
2.7 Interviews with Project Officials
Face to face interviews and telephonic conversation were conducted with the following project officials.
Table 2: Detail of the Project Officials interviewed
3. DGME ASSESSMENT: PROJECT PHYSICAL & FINANCIAL ACHIVEMENTS
3.1 General Assessment
The DGM&E assessment has been carried out regarding the planned objectives as well as planned targets
of the project as following.
1
To provide better diagnostic facilities to Achieved
patients coming from across Southern
Punjab and adjoining areas of Sindh,
Balochistan & Khyber Pukhtunkhawa
provinces.
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3.2 Physical Targets & Achievements
The DGM&E assessment has been carried out regarding the planned objectives as well as
planned targets of the project as following.
3.3 Project Cost Analysis
Following data shows the initial approved cost of the project and its subsequent revised costs of
the project respectively.
10
140
128 128
120
100 94.302
Rs in Million
80
60
40
20
0
2015‐16 PC‐1 Phasing
Financial Phasing Releases
Actual Expenditure
Figure 2: Project PC‐I Phasing, Releases and Expenditure
The Year-wise ADP allocation of project, releases and expenditure of funds are shown in Table
below and graphical illustration is presented in Figure 2. Department has shown good
performance/financial utilization against the released funds i.e. 73.6%.
Item-wise Planned & Actual Expenditure
Sr. No. Items PC-I Estimates Quantity Actual
Expenditure
1. 128 slice C.T. Scan 1 94.302
128
Machine
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4. PROJECT TARGETS, PERFORMANCE AND DGM&E ASSESSMENT
Achieved (100%) Partially Achieved (50%)
Physical
Targets Not achieved (< 50%)
There is an increasing trend in number of CT scan test performed in Nishat Hospital as shown in
graphs below. The new CT scan machine was operational on 1.12.2017 and up till 31.10.2018 the
tests performed was 12,439. While the old machine performed 25,925 tests up till 31.10.2018.The
old machine was placed in emergency so it is operational round the clock. The total 38,364 tests
performed in 2018.
No. of tests performed
40000 36206
32459 32698
No. of CT scan tests
35000 29044
30000
22936 24550 26609
25000 20023
20000 17394
15109
15000 10225
10000 6644
5000
0
Year
Figure 3 Trend of CT scan Tests
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Percentage Increase in CT scan tests per year
14% 13% 2006‐07
12% 12% 2007‐08
12%
11% 2008‐09
C T Scan Test %age 10%
10% 9% 2009‐10
8%
2010‐11
8% 7%
6% 2011‐12
6% 6% 2012‐13
4% 2013‐14
4%
2% 2014‐15
2% 2015‐16
2016‐17
0%
Years 2017‐18 ( till Oct)
Figure 4 Trend of Ct Scan Tests ( in Percentage)
Comparison of Old & New CT Scan Machine
45000
Number of test performed
38364
40000
35000
30000 25925
25000
20000
15000 12439
10000
5000
0
Jan 2018‐Oct 2018
Duration
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5. OBSERVATIONS
The observations recorded during evaluation of the project are given in the
ensuing paragraphs:
CT scan machine was properly installed and fully functional, and trained
human resource was available to operate the equipment.
Given the largest tertiary care hospital in Southern Punjab, the turnover of
patients is very high at all departments/facilities of Nishtar Hospital Multan
(NHM). The NHM has two CT Scan machines. One of them is 12 years old
and placed at emergency department, while new machine is placed at
Radiology Department. Both machines operate round the clock. New CT Scan
machine operates between 8am-11pm in two shifts. During last 10 months
(January-Oct 2018) a total of 38,364 tests were performed on two CT Scan
machines. This corresponds to 3836 tests per month or 128 tests per day.
These figures indicate that there is a huge burden on the facility.
Old CT scan machine often remains out of order and in these situations burden
is totally shifted to new machine, therefore old machine needs replacement.
Power backups were available at NHM, however frequent electricity
breakdown/ fluctuation affects the performance of equipment such as CT Scan
machines.
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6. RECOMMENDATIONS
On the basis of observation recorded during project evaluation following are the
recommendations:
1. Proper Standard Operating Procedures (SOPs) should be formulated, followed
and displayed in the vicinity of CT scanner.
2. NHM administration & WAPDA ensures and take measures to provide
uninterrupted power supply to Radiology department, NHM.
3. For better working and treatment environment, HVAC/Centralized air-
conditioning system should be installed at Nishtar Hospital.
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Annex
Pictorial Evidence
Approved rate for CT scan Duration for issuance of CT scan report
The CT scan machne was operational on 29.11.2017 Monitor showing the CT scan image
128 slice CT scan Machine DGM&E team examining CT scan machine
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Connected panels of CT scan machine
CT scan Report Mission & vision statements of Radiology
department
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Directorate General of Monitoring and Evaluation, Planning and Development Department, Govt.
of Punjab (October, 2018)
\\nas\Evaluation\Reports - PC-IV Evaluation
Soft form of the report and corresponding MOM may be downloaded from www.dgmepunjab.gov.pk
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