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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 

Directorate General Monitoring & Evaluation, Planning & Development Department


65-Trade Centre Block 4th floor, Ayub Chowk, Johar Town, Lahore
Ph.: +92(42)99233182, www.dgmepunjab.gov.pk
 
   

This page is intentionally left Blank  

   


 
   

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  
   


 
   

List of Figures 
 

Figure 1: Flow chart/ Schematic diagram for project evaluation .................................................................. 7 


Figure 2: Project PC‐I Phasing, Releases and Expenditure .......................................................................... 11 
Figure 3 Trend of CT scan Tests .................................................................................................................. 12 
Figure 4 Trend of Ct Scan Tests ( in Percentage) ........................................................................................ 13 
Figure 5: Comparison of Number of Tests for Old and New CT scan Machines ......................................... 13 
   


 
   

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 

For this particular project brief is given below in Table 1.


Project Title “Purchase of 128 Slice CT Scan for Radiology Department
Nishtar Hospital Multan”
Sponsoring Agency Specialized Healthcare & Medical Education (SHC&ME)
Department, Govt. of Punjab
Execution Medical Superintendent, Nishtar Hospital Multan
Operation and Maintenance SHC&ME Deptt/MS Nishtar Hospital Multan
PC-I Original Cost Rs. 128 million @ DDSC on 10th August 2015

Released Funds Rs. 128 Million

Actual Expenditure Rs. 94.302 million


Percentage Utilization over 73.6 %
Releases
ADP Fiscal Year 2015-2016
Planned Gestation Period August 2015- June 2016
Actual Gestation Period As planned
Beneficiaries Patients/ Students/Staff of Nishtar Hospital Multan
 

 
   


 
   

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.


 
   

Figure 1: Flow chart/ Schematic diagram for project evaluation 

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.

Project Site Visits to Nishtar Hospital Multan

I. Dr. Muhammed Navid Tahir, Health Consultant (DGM&E)


 
   

In-house Data Analysis & Report Writing

I. Ms. Aroos Munir, Industrial & Environmental Specialist (DGM&E)

2.2 Documents Review 

Following project documents, evaluation tools and techniques were consulted.

1. Planning Commission Form-I (PC-I, Original & Revised) of the Project


2. Planning Commission Form-IV (PC-IV) of the Project
3. DGM&E approved Evaluation Guidelines

2.3 Identification of Key Indicators  

Project performance parameters are defined in the following term;

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.


 
   

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 

Sr # Location Date of Visits Team Members

1. Multan 16th August, 2018 I. Dr. Naveed Tahir, Health Consultant


(M&E)

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 

Sr. Name Designation


No.
1. Dr. Abdul Hafeez Medical Superintendent
2. Dr. Rashid Irshad Rao Admin Registrar (Radiology Department)
3. Mr. Muhammad Aslam Chief Technologist
4. Dr. Akram Hussain Admin Registrar (Cardiology Department)
5. Mr. Maqbool Ahmed Office Assistant

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.

Sr. No. PROJECT OBJECTIVES DGM&E ASSESSMENTS

1
To provide better diagnostic facilities to Achieved
patients coming from across Southern
Punjab and adjoining areas of Sindh,
Balochistan & Khyber Pukhtunkhawa
provinces.


 
   

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.

Sr. Planned Actual


ITEMS (As Per PC-1) Status
No. Quantity Achievements

128 slice C.T. Scan


1. 1 Achieved Purchased and
Machine
Operational

3.3 Project Cost Analysis  
Following data shows the initial approved cost of the project and its subsequent revised costs of
the project respectively.

1. Total Planned Cost (Original):


 Original Cost Rs. 128 Million
TOTAL Rs. 128 Million
2. Total Actual Cost
 Revenue Cost Rs. 94.302 Million
Rs. In million

Years PC-1 Releases Actual Percentage Utilization Over


Phasing Expenditure Releases
2015-16 128 128 94.302 73.6 %

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

Grand Total 128 94.302


   

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4. PROJECT TARGETS, PERFORMANCE AND DGM&E ASSESSMENT 
Achieved (100%) Partially Achieved (50%)
Physical
Targets Not achieved (< 50%)

& Unit Results Quality


Achievements Remarks
A PA NA

Purchased and fully


128 slice C.T. Scan √ satisfactory
Machine
1 functional

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 

Old CT scan Machine New CT scan Machine Total


 
Figure 5: Comparison of Number of Tests for Old and New CT scan Machines 

   

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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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