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PROJECT PROPOSAL
FOR
O.P.E.C. ASSISTED HOSPITAL
AT RAICHUR
DEPARTMENT OF HEALTH AND FAMILY WELFARE
GOVERNMENT OF KARNATAKA,BANGALORE
MAY 1996
CONTENTS
1. INTRODUCTION
2. PROFILE OF KARNATAKA
3.
PROFILE OF RAICHUR DISTRICT
4
11
4. PROFILE OF EXISTING DISTRICT HOSPITAL
14
5. PROFILE OF NEW HOSPITAL
18
6. FACILITIES PLANNING
7. EQUIPMENT PLANNING
24
8. MANPOWER PLANNING
29
9. FINANCIAL IMPLICATION
32
INTRODUCTION
The primary responsibility for health care & family welfare is with the state
Government under the department of Health & Family Welfare.
The access to public health facilities in the state is uneven. Even where physical
facilities exist, the quality and range of services are poor. Typically, in areas of
the state where health status is poor, the gaps in infrastructure are large.
There is need to have a significant increase in the bed capacity in poorly served
regions. Only in 18 percent of the taluks, the bed availability is equal to or more
than the norm of 1679 persons per bed, determined on the basis of
epidemiology. In 35 percent of the taluks, the persons per bed, ranges between
1,700 to 5,000. In 29 percent of the taluks, the bed availability ranges between
5,000 to 10,000 persons per bed. Persons per bed exceeds 10,000 in 18 percent of
the taluks.
There is also a major urban-rural divide with most of the well equipped
hospitals located in a few urban agglomerations of the state. The rural poor
have limited access for obtaining critical health referral services. In the urban
areas also, there are imbalances. In major metropolitan cities such as Bangalore,
there are glaring inadequacies in the first referral network.
The availability of infrastructure is inadequate, as it has to not only cope with
fast rising urban population, but also with pressure from rural areas.
The Northern district of Gulbarga, Bidar, Raichur , Bellary, Dharwad and
Bijapur have a relatively poorer developed health infrastructure. Gulbarga and
Bellary in particular have hospitals with teaching facilities attached to them
1
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resulting in relatively better infrastructure facilities than Raichur. Raichur is a
fairly large town with relatively higher population than other towns but with no
advanced medical facilities. Most of the people from Raichur go to Hyderabad
for their medical treatment because of non-availability of advanced medical care.
Raichur being a backward area in terms of health infrastructure, it was decided
to plan a new multispeciality hospital with the OPEC assisted funds.
Ibis
hospital will cater not only to the district but even four districts of the
neighbouring state service there is no hospital with all facilities in that region.
2
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PROFILE OF KARNATAKA
2.1.
Area and Administrative Divisions
Karnataka is located in the South-West part of India and lies between latitudes
11° 5" N and 19° N and longitudes 74° E and 78° E. It is bounded, in the
clockwise direction, by the States of Goa, Maharashtra, Andhra Pradesh, Tamil
Nadu, Kerala and the Arabian Sea. The area of the State is 191,791 sq. km. and
constitutes 5.38 percent of the area of the country. The twenty districts of the
State are grouped into four Revenue Divisions with head quarters at Bangalore,
Belgaum, Gulbarga and Mysore.
Table 2.1: Administrative Division of the State of Karnataka
DIVISION
Bangalore
DISTRICT________________________________________________________
Bangalore, Bangalore (Rural), Chitradurga, Kolar, Shimoga and Tumkur
Belgaum
Belgaumz Bijapur, Dharwadz Uttara Kannada
Gulbarga
Bellaryz Bidar, Gulbarga and Raichur
Mysore
Chikmagalur, Dakshina Kannada, Hassan, Kodagu, Mandya and Mysore
2.2.
Socio-economic Characteristics
The population of the State in 1991 was 44.98 million and accounted for 5.31
percent of the population of India. In terms of population, size and area,
Karnataka ranks eighth among the States.
Kannada is the mother tongue of 65.7 percent of the population. There are
regional concentrations of linguistic groups. Tulu and Konkani are the mother
tongues of 59 percent of the population of Dakshina Kannada, while Konkani is
4
the mother tongue of 22 percent of the population of Uttara Kannada. Kodata is
the mother tongue of 28 percent of population of Kodagu. The Telugu speaking
population is concentrated in Kolar district (52 percent) and is also present in
sizeable numbers in Bangalore, Chitradurga, Tumkur and districts of Gulbarga
Division bordering Andhra Pradesh. Marathi is spoken in the districts bordering
Maharashtra namely, Belgaum (21 percent) Bidar (19 percent) and Uttara
Kannada (9 percent). People with Malayalam as mother tongue are concentrated
in Kodagu (22.9 percent) and Dakshina Kannada (12.9 percent), bordering
Kerala. The Tamil speaking population is concentrated in Bangalore (16 percent),
Kolar (9 percent) and Mysore (5 percent). The Urdu speaking population is
distributed in all districts but they form only 5 percent of the population of
Mysore division while in other divisions the Urdu speaking population ranges
between 10 to 14 percent.
Hindus, including Jains, Buddhists and Sikhs form 86 percent of the population
of the State, while 11 percent are Muslims and 2 percent are Christians.
In 1992-93, the per capita net domestic product for Karnataka was Rs. 5898 at
current prices which is marginally higher than that for India (Rs. 5583). The per
capita income varied between districts. Kodagu district has the highest per
capita income of Rs. 10,810 and Bidar the lowest per capita income of Rs. 3,725.
Table 2.2: Per Capita Income 1992-1993
CAPITA
PER
INCOME
Over Rs. 9,000
DISTRICT
Kodagu (10,810), Bangalore (9,190).
-------------------------------- - ---------
Rs. 6,000 to 9,000
Belgaum (6,206),Uttara Kannada(6,339),Mysore (6,400), Bangalore Rural,
Dakshina Kannada (7,203), Chikmagalur (8,065)------------------- -----------
Rs. 5,000 to 6,000
Tumkur (5,045), Dharwad (5,108), Chitradurga (5147), Bellary (5,293),
____________
Shimoga (5,812)
Below Rs. 5,000
Bidar (3,725), Kolar (4,151), Raichur (4,159), Bijapur (4,414), Gulbarga (4,732),
I Mandya (4,827), Hassan (4,924).
5
In 1991, the literacy rate among those aged seven years and above was 67
percent among males and 44 percent among females, which is marginally higher
than that for the country (64 percent for males and 39 percent for females).
The proportion of workers to total population in 1991 was 53.9 percent among
males and 29.3 percent among females. The corresponding rates for 1981 were
54.6 among males and 25.3 among females. There has been a three percent shift
away from agriculture and household industry to other occupations. However,
agriculture continues to be the occupation for 63 percent of the male workers.
A requisite to disease control is access to a safe water supply and proper
sanitation facilities.
In regards to the former, the majority (70%) of the
population in Karnataka now have safe drinking water (TABLE 2.3) compared to
about 34% a decade ago.
This substantial increase has been achieved by a
concerted effort by the state authorities to identify and provide bore wells to
communities. The increased coverage is particularly
substantial in the rural
areas. In addition, treated water for drinking is also supplied by the municipal
council to urban and some semi-urban areas either directly to homes or to public
water tanks. In fact, the increase in provision of safe drinking water is higher in
this state than for India as a whole.
TABLE 2.3: Percentage with Access to Safe Water Supply
Urban & Rural
Rural
Urban
SAFE DRINKING WATER
1991
1981
71.7
33.9
62.3
38.2
67.3
17.6
55.5
26.5
81.4
74.4
81.4
75.1
Karnataka
India_____
Karnataka
India____
Karnataka
India
6
2.3.
Demographic Characteristics
The compound annual growth rate of the population of Karnataka was 1.93
percent in the decade 1981-91. The decline in population growth rate has been
more rapid in Karnataka than in India. While in Karnataka, the compound
annual growth rale declined from 2.40 percent during the decade 1971-81 to 1.93
percent in 1981-91, that for India declined marginally from 2.23 percent to 2.16
percent.
In 1991, the urban population accounted for 30.91 percent of the population of
the State as compared to 25.71 percent for India. Nearly 30 percent of the urban
population of the State lives in Bangalore Urban Agglomeration and another 35
percent in twenty urban agglomerations with population over 100,000. The
remaining 35 percent of the urban population live in 233 towns. The rural
population is distributed over 27,024 villages.
The sex ratio expressed as the number of females to thousand males declined
from 963 in 1981 to 960 in 1991 in the State. Similar decline occurred at the
national level (934 in 1981 to 927 in 1991).
The mean age at marriage of females in Karnataka was estimated for the year
1981 at 19.2 years as compared to 18.3 years for the country.
Scheduled Castes and Scheduled Tribes formed respectively, 16.4 and 4.0 of the
total population in 1991.
7
u
The Crude Birth Rate (CBR) for Karnataka is estimated at 25.5 for the year 1993.
The CBR for urban Karnataka was 23.1 while for rural Karnataka it was 26.7.
Estimates of birth rates by district for the year 1993 reveal that Chikmagalur had
the lowest birth rate of 19.9 and Raichur the highest birth rate of 35.1.
Table 2.4: Crude Birth Rate (CBR) by District (1993)
CBR
1000
PER
POPULATION
CBR over 29
DISTRICT_____________________________________________
Raichur (35.1), Bidar (34.9), Gulbarga (33.3), Bijapur (32.0), Bellary (29.2).
Between 24-28
Kolar (27.2), Dharwad (27.1)z Chitradurga (26.9), Bel gaum (28.9).
Between 22 to 24
Uttara Kannada (23.5), Tumkur (23.2), Shimoga (22.4) Bangalore (22.3).
Below 22
Mysore (21.6), Mandya . (21.0), Kodagu (21.0), Hassan (20.6), Dakshina
Kannada(22.3), Chikmagalur (19.9).
The crude death rate for the year was 8.5 for the State while it was 6.0 for urban
Karnataka and 9.4 for rural Karnataka. The infant mortality rate estimate for the
year 1993 was 67 for the state, 41 for urban Karnataka and 73 for rural
Karnataka.
2A.
Regional Variations
As mentioned, the population of Karnataka is distributed in twenty districts and
four revenue divisions. There are wide variations in the demographic
characteristics across the four divisions as may be seen in Table 2.5.
8
Table 2.5 Demographic Characteristics of Districts
Thousand
Persons
1991
Density
sq. km.
1991
Annual
Growth
Percent
1981-91
Sex
Ratio
1991
Mean a ge
at
Marriage
1981
Percent Male
Urban
1991
85.8
20.2
903
2,210 3.31
3angalore _______ 4,839.2
18.2
N.A
950
1.43
288
3a n gal ore Rural ,673.2
67.0
9.2
944
2.06
.63
2,180.4
Chitradurga
23.3
19.1
966
1.53
224
Kolar __________ 2,216.9
26.5
20.5
961
1.43
351
Shimoga_______ 1,909.7
16.6
19.2
959
1.55
135
Tumkur________ 2,305.8
416
19.8
939
2.12
281
15,125.2
Bangalore
Division________
23.9
19.4
959
1.87
498
Belgaum_______ 3,583.6
23.6
17.3
965
2.00
270
Bijapur_________ 2,928.0
35.0
19.2
945
1.75
415
Dharwad_______ 3,503.2
24.2
21.2
967
1.29
89
Uttara Kannada I, 220.3
27.3
19.0
957
1.80
II, 235.0
279
Belgaum
Division________
29.9
18.1
957
2.41
116
Bellary_________ 1,890.1
19.5
17.6
953
2.35
184
Bidar __________ 1,255.8
23.5
.962 17.5
2.18
629
Gulbarga_______ 2,582.2
20.8
17.5
978
2.62
281
Raichur________ 2,309.9
23.6
17.7
964
2.39
227
8,037.9
Gulbarga
Division_______
16.9
20.8
977
205
1.10
1,017.3
Chikmagalur
28.3
1063 22.4
1.26
225
2,694.3
Dakshina
Kannada_______
17.4
1.47
1000 20.2
112
Hassan________ 1,569.7
16.1
21.8
989
0.56
46
Kodagu ________ 488.5
16.2
18.5
962
1.49
155
Mandya _______ 1,644.4
29.8
19.3
953
2.00
308
Mysore ________ 3,165.0
23.6
20.4
993
1.49
170
Mysore Division 10,579.1
30.9
19.2
960
03
235
Karnataka _____ 44,977.2
* Literacy percent among population aged 7 years and over
83.1
61.1
43.5
63.0
71.1
66.6
7L6
Female
69.0
38.9
36.2
38.1
51.4
42.1
51.1
Scheduled
Caste Tribe
s
s
% of % of
Total Total
1991 1991
14.7 1.1
19.5 3.0
19.8 14.6
25.7 6.9
17.7 3.9
17.7 7.3
18.4 5.4
43.5
11.4
17.4
11.7
7.5
12.6
2.3
1.4
3.0
[0.8
2.1
59.3
59.5
52.3
49.7
54.4
32.5
31.0
24.9
22.3
26.9
19.3
20.7
23.7
17.2
20.3
8.8
8.3
70.6
84.7
51.5
68.3
19.3 2.6
6.5 3.9
68.9
74.5
45.1
17.4
65.5
70.6
7\.7
76.1
69.9
38.7
41.3
45.5
59.1
56.1
67.8
67.3
56.7
61.4
36.9
37.9
49.3
44.3
4.1
7.8
6.9
1.1
12.1 8.3
13.8 0.7
18.9 3.2
14.4 2.9
16.4 4.3
Generally, Gulbarga Division, comprising the districts of Gulbarga, Bellary,
Bidar and Raichur along with Bijapur district in Belgaum Division, is the most
backward in terms of health and socio-economic indicators. These above five
9
n
H
districts show higher growth rates over the ten year period for the years 1981-91.
The highest growth was, however, registered in Bangalore District, reflecting
rural-urban migration and rapid urban growth. The population growth rate for
the decade 1981-91 declined in all districts excepting Bidar, Bijapur, Gulbarga
and Raichur. The annual compound growth rate of the population of these four
districts increased from 1.99 percent in the decade 1971-81 to 2.25 percent in the
decade 1981-91, suggesting that the decline in mortality has been more than the
decline in fertility. On the other hand, the annual compound growth rate
declined in the remaining sixteen districts from 2.50 percent during the decade
1971-81 to 1.85 percent during the decade 1981-91.
The sex-ratio is the most favorable in Mysore Division, with Dakshina Kannada
and Hassan boasting of a female to male sex- ratio of over 1.0. This division also
has the highest mean age at marriage. Conversely, the lowest mean age exists in
the four districts of Gulbarga Division together with the adjacent Bijapur district
Crude birth rate is also significantly higher in this part of the State and female
literacy is lowest in the Gulbarga Division. Similarly, the Gulbarga Divisions
Districts have relatively lower per capita income levels.
In general, one can state that there is a North South divide with the Southern
parts of the State, being somewhat better placed in demographic status,
compared to their Northern counterparts.
10
RAICHUR DISTRICT
Raichur District is a developing district in the northern part of Karnataka which
is still relative poor in health facilities. Raichur, district headquarters is located
about 20 km from Andhra Pradesh boundary, 515 km from Bangalore, capital of
Karnataka and 220 km from Hyderabad capital of Andhra Pradesh.
Raichur
District adjoins, apart from Andhra Pradesh, the districts of Bellary, Dharwad,
Bijapur and Gulbarga of Karnataka. Hence the proposed 500 bed hospital in
Raichur can serve as a Regional Hospital with specialized medical facilities.
Raichur city is located at latitude 15" 12 north and longitude 77 21' east at an
altitude of 399.45m(1311 ft) above sea level. Krishna and Thungabadra Rivers
flow within a distance of 20 km in the north and 30 km in the south respectively
from Raichur. The city has good communication with other towns in Karnataka
and Andhra Pradesh by road as well as by rail. A map of Karnataka showing
the location of Raichur is shown separately.
The climate is very hot and rain fall is scanty as the pre-dominantly wind
direction is West and South West.
Raichur city has a population of 1,70,463 in 1991 with a decadal growth of 36.6
percent. The population is expected to reach about 2,40,000 by 2001.
The
residential density is about 165 persons per hectare.
The district population of 2.3 million has the lowest ratio of population per bed
in the state of Karnataka. The district with 78% of rural population is one of the
poorest and is also typical for the region with the majority of the population
working as agricultural workers. The literacy levels for all talukas in this district
are lower than the state average.
11
c
Socio Demographic Indicators Raichur District - 1992
BIRTH
RATE
District Raichur
TK Devandurga
TK Gangawati
TK Koppal
TK Kushtagi
TK Lingsugur
TK Manavi
TK Raichur
TK Sindhur
TK Yelbarga
DEATH
RATE
26.2
24.0
21.0
21.5
26.3
20.9
24.7
21.2
20.5
24.4
8.5
8.8
8.4
8.6
8.8
8.5
8.9
8.3
8.8
8.1
LITERACY
IMR
MMR
35.96
21.61
36.25
42.39
35.34
35.19
29.14
43.62
34.48
39.10
73
79
71
70
72
72
81
69
72
71
3.61
4.26
3.71
3.13
3.79
3.27
4.19
3.89
3.58
3.75
POPULAT1O
N
2,309,887
176,889
255,551
207,111
189,891
211,096
241,193
201,295
240,383
196,080
Presently the majority of the patients go to Hyderabad for advanced medical
care the inpatient to outpatient ratio is poor due to lack of facilities in Raichur.
The present inpatient record is 4218 cases in 6 months whereas the outpatient
load is 101, 1923 cases for the last 6 months. The major surgeries conducted are
562 in number and normal deliveries being 788. It is thus seen that there is a
urgent need to renovate and expand the existing district hospital with the help of
OPEC assistance. The plans to build a modern 350 bed new super speciality
hospital at Raichur with all the specialties will reduce the ratio of population to
bed from the present 5420 to 2030.
Health Services Facilities Raichur District
District Raichur
TK Devandurga
TK Gangawati
TK Koppal
TK Kushtagi
TK Lingsugur
TK Manavi
TK Raichur
TK Sindhnur
TK Yelbarga
ACTUAL
CHCs/GH's
BEDS
NO.
13
425
30
1
3
42
1
17
1
30
2
56
1
30
1
130
1
30
2
60
PHC's
NO.
BEDS
69
414
5
30
10
60
9
54
6
36
10
60
9
54
6
36
8
48
6
36
12
NEW
BEDS
NO.
213
20
70
33
20
50
20
FUTURE
CHCs/GH's
NO.
BEDS
13
638
1
50
3
112
I
50
1
50
2
106
1
30
1
130
1
50
2
60
/
N
KAICHUR
/
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3USINESS
AREA
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EXISTING DISTRICT HOSPITAL
Raichur is situated on the Krishna river approachable by road on state highway
no 30 and National highway no 13. Approachable by railway also connecting
Bangalore via Guntakal to Bombay.
The present District hospital is located around 5 kms from the main town. The
facility not only covers nearby villages & districts, also caters to across Andhra
Pradesh border areas.
The existing District Hospital, Raichur is functioning as a referral Hospital is not
able to cope with all the cases in the absence of necessary infrastructure facilities.
So it was decided to modernize and expand the Hospital and also setup a new
Hospital in addition to the old with OPEC assistance.
To this effect an
agreement for a loan o£9 Million U.S. Dollars has been signed with OPEC on
6.6.1991. .
The existing 250 bedded Hospital has the following Departments
Medicine
40
Surgery
40
Obstetrics and Gynecology
30
Orthopedics
40
Pediatrics
20
E.N.T.
20
Ophthalmology
20
Emergency
40
Dental
Radiology
Skin and STD
250
14
M
From the above mentioned departments the following will be shifted to the
NEW HOSPITAL complex:
1. Medicine
2. Surgery
3. Orthopedics
4. E.N.T.
5. Ophthalmology
6. Dental
7. Emergency/Trauma
The existing hospital will be exclusively Women and Children hospital with skin
and psychiatry.
The additional beds mentioned below will be retained in the old hospital
Additional Beds Available
Leprosy
20
T.B
20
Isolation
10
Prisoners
5
63
15
The distribution of the 250 beds in the existing hospital will be as follows :
OBG
120
Post Partuin
20
Pediatrics
50
Neonatology
20
Psychiatry
20
Skin
20
250
U
•
INDEX
MAP
NEW HOSPITAL SITE
a.
-J CQ
I
J
CIVIL HOSPITAL
S. P. OFFICE
rn
0
rs
AT
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POTT ICF
CQlJONy
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'SQOd B
P
un
□0
a m HDD aoaoDli
NEW HOSPITAL
Raichur has the potential to grow due its strategic location, being on the National
highway & closer to district borders. A modern hospital located at Raichur can
very well cater to not only its own district but to neighbouring districts and the
transborder district of Andhra Pradesh. There is a long felt need for a modem
state of the art hospital at Raichur as there is no such hospital in the entire
region.
It is proposed to build a new 350 bed multispeciality hospital at Raichur close to
-----
~
"
““—
—
-
the existing district hospital. Land has already been acquired for this purpose.
The bed distribution of the 350 beds is given as an annexure. The hospital apart
from general medicine & emergency will also have super speciality departments
like
Cardiology/
Gastroenterologyz Neurology/ Neuro surgery & Urology,
Plastic surgeryjrauma.
The present plan will include TScjuarters & some of these will be located in the
premises of the old hospital.
18
DEPARTMENTS AND BEDS DISTRIBUTION AT NEW HOSPITAL RAICITUR
Beds
Out-Patient Department
Casualty
8
ICE (Intensive care Unit)
6
1CCU (Intensive Coronary Care Unit)
6
Medical
72
Surgery
72
E.N.T.
12
Orthopedic & Physiotherapy
60
Cardio Vascular & Thoracic Surgery
6
Ophthalmology
24
Nephrology & Urology
24
Neurology/Neuro Surgery
36
Burns Ward
12
Gastroenterology
12
4 No.
O.T. (Major O.T, Minor O.T.)
Bio-Chemistry-Pathology & Micro Biology Laboratory
Radiology
C.S.S.D.
350
19
New Facilities
The phase consists of a new Hospital Complex with the following facilities,
in consultation with the Directorate of Health and Family Welfare,
Government of Karnataka, are as follows :
The in-patient block of 350 bed capacity, including 48 special beds.
The out-patient block for consultancy and administration with a staff
canteen, and a basement for stores and parking facility for Ambulances.
A Diagnostic and Treatment Block with 4 Operation theatres, ICU + ICCU
in the first floor.
A Casualty and Emergency Block with Laboratories, Blood Bank.
Kitchen, Electric Substation and Generator room in the rear of the hospital
complex.
A Public Canteen.
Incinerator,
overhead water tank and a septic tank for waste water
treatment.
Staff quarters- 73 dwelling units of 6 categories as per state government
scales and standards.
20
kxternal and ink'in.il services like waler supply, sanitary and ekvlric.d
works required for the entire campus including the staff quarters and
future use.
Lavout:
J
Land
has
been
purchased
from
Agricultural
Produce
Marketing
Committee, Raichur in two installments - 50 acres were acquired in 1990
and an additional 23 acres 2 guntas in 1992 i.e. a total of 73 acres 2
guntas(29.25 hectares) at a cost of Rs 35 lakhs. In addition, about Rs 5 lakhs
is spent by the State PWD for clearing shrub jungle and upkeep of the site.
The new hospital complex with some staff quarters is proposed in this site
with sufficient area reserved for the future extension. All the buildings of
the new hospital complex and ancillary buildings are located with a
setback of 155 meters from the center line of Raichur-ITydcrabad Highway.
Proper circulation pattern within the site is proposed for easy movement of
men, materials and equipment. The main feature in the layout of the
Hospital has been to segregate the Casualty Block, the OPD, the Treatment
Block and the various functions within the hospital run smoothly.
The orientation of the In-patient Block and staff quarters is north and south,
so that western sun as well as summer sun is avoided and sunlight is
allowed into the rooms from south during winter. The street pattern and
space between buildings so designed that the east-west wind is allowed to
flow freely along roads, corridors and the intervening open spaces.
An incinerator is proposed on the east to avoid air pollution in the hospital
area. Over-head water tank is located on the highest point in the east of the
site with necessary sump lank and pumping facility. Waste water treatment
unit(septic tank) is proposed at the lowest point of the site near the road
(Sjov iO 0
IJ
(1
21
s'-------------
>-
bridge, so that the treated sewage can be let into the nallah nearby,
avoiding environmental pollution.
Buildings :
All the buildings in the hospital complex are designed as RCC framed
structures with modules of 6.8m x 6.8m - center to center. Brick mullions
are provided a 3.4m in-between on the exterior of
buildings to
accommodate down-water pipes and to provide vertical treatment to the
outer surface of buildings. The RCC frames have an in-filling of brick or
hollow block masonry in cement mortar. Foundations have been designed
as per standard specifications. The buildings have sufficient waiting areas
and corridors .The necessary architectural drawings have been prepared.
The cost of the civil works is shown below:
Unit
Rs(million)
1.
OPD
10.3
2.
Diagnostic
28.1
3.
Inpatient
37.7
4.
Kitchen
2.9
5.
Mortuary
1.3
6.
Canteen
0.8
7.
Electrical Substation
2.0
Services
Internal Services(Hospital)
10.0
External Services
12.0
Air Conditioning
10.0
Formation of Layout
6.0
Staff Quarters
18.9
Total
140.0
22
The project is expected to be completed in 3 years.
The new hospital plans to accommodate the list of departments and their bed
strength as indicated earlier. In addition provision is made to accommodate
cardiology, trauma, burns and plastic surgery in appropriate places in the OPD
and Diagnostic blocks. Copies of the plans are enclosed . The total plinth area of
the hospital complex(stage-l) is furnished below.
Plinth area in Sq. m
Name of Building
1.
Out-patient Block
3,904.00
2.
Diagnostic Block
7,574.48
3.
In-patient Block
11,523.00
4.
Kitchen Block
781.00
5.
Mortuary & Post mortem
364.36
Grand Total
24,146.36
The present proposal includes only 73 quarters to accommodate the following
staff.
Type
No. of Dwellings
1.
Medical Superintendent
01
2.
Surgeons
04
3.
Asst Surgeons
08
4.
Nurses
24
5.
Para -Medical
12
6
Group-D staff
24
73
Total
23
LIST or EQUIPMENT FOR RAICHUR HOSPITAL UNDER O.P.E.C. ASSISTANCE.
Name of the Equipment
1.
RADIOLOGY
a) Ultrasound machine with colour doppler
b) 800 mA X-Ray Unit with IITV/Motorised table
c) C.T. Scanner
d) 300 mA with motorised table
e) C-arm Image Intensifier
f) Mobile 60 mA X-Ray
g) Automatic processor
h) X-Ray Accessories
II.
5.0
3.6
12.5 .
0.95
2.0
0.18
0.25
0.15
24.63
DENTAL
0.6
0.2
0.6
0.2
OZ
2.3
a) Dental Chair
b) Dental X-Ray
c) Other Dental Instruments
d) Dark Room equipment .,
e) Orthopentomograph
HI.
Cost in Rs. (Millions)
CARDIOLOGY
a) Computerised Tread mill with Analyser
b) ECG Machine (3 Channel) - 3 Nos
c) Ecko Cardiography (with colour doppler)
d) Central Cardiac monitor with 6 bed
side monitors (colour)
e 1CU Ventilators (two) Adult & paed
f) Ward Instruments
g) Miscellaneous
h) Defibrillator
I) Holter monitoring
0.8
0.135
5.0
2.5
2.8
0.4
0.3
0.3
0.6
12.835
24
IV.
OPERATION THEATER
a) Operating Lamps (4 OT's)
b) Operation tables (Four section with
Radiology back and accessories)
c) Anaesthesia Equipments
d) Microsurgical Instruments
e) Ordinary surgical Instruments' (IND)
f) Operating Microscope with Accs.
g) Motor driven syringe pumps
h) Volumetric Infusion pumps
i) Cell seperators
j) Surgical Diathermy with Accs. (4 Nos)
k) Adjustable Recovery room trolleys
transfer trolleys
l) Standby Electrical Suction Machine
m) Ventilators (2 Nos)
n) Central gas supply 02, n2, Vaccum
o) OT head light (4 Nos)
p) Mobile OT lamps (2 Nos)
q) Flash sterilizer (2 Nos)
r) OT monitors (4 Nos)
s) Defibrilator (2 Nos)
t) Pulse Oximeter (4 Nos)
1.0
1.2
0.8
0.8
1.2
0.5
0.3
0.3
0.4
1.5
0.5
.0.05
2.0
0.8
0.008
0.1
0.15
0.2
0.15
0.4
12.358
V.
NEUROLOGY
a) E.E.G. Machine
b) Ward Instruments
c) Infusion Syringe Pumps
d) Others like suction machines, trolley
e) E.M.G. Machine
1.5
0.5
0.3
0.4
1.0
3.7
VI.
A.
B.
LABORATORY
a) Computerised Haemotology Analyser
b) Computerised Bio-Chemistry Analyser
c) Microbiology & Histopathology equipment
d) Others Lab. Instruments, test tubes. Refrigerators etc.,
e) Blood gas analyser
f) Elisa reader
g) Electrolyter
h) Micro scope (2 Nos)
I) Semi Auto analyser
BLOOD BANK EQUIPMENTS .
1.0
2.0
0.5
0.5
1.5
0.15
1.0
0.5
0.2
0.55
7.9
25
0
VII.
ORTHOPAEDICS & PHYSIOTHERAPY
a) Various Implants (Surgical)
b) Physiotherapy equipments (Gonimeter, Ecp,
Ne metrome etc.,)
c) Plaster room equipments
d) Monitors, ECG & other instruments
e) infusion pumps (Syringe)
1.5
3.0
0.5
0.3
0.2
5.5
VIII.
NEPHROLOGY/UROLOGY
1.5
0.5
0.2
0.3
0.1
0.3
1.0
a) Haemodialysis equipment
b) Water treatment system
c) Infusion pumps & monitors
d) Ward instruments
e) Humidifier
f) Urodynamic studies equipment
g) Cysto scopes and Accessories
3.9
IX.
GAESTROENTEROLGY
1.0
0.3
0.1
0.1
0.5
a) Various Endoscopes
b) Ward instruments
c) Infusion pumps
d) Monitors
e) Miscellaneous
2.0
X.
ENT
0.3
1.2
0.1
0.15
0.2
a) ENG (Multi channel)
b) Operating Microscope
c) Monitors, Infusion Pump & etc.,
d) Audio metery
e) Others
1.95
26
XL
PLASTIC SURGERY & BURNS WARD
a) Ventilators (Adult & paediatrics)
b) Pulse Oximeter
c) Four channel monitor
d) Micro instrument set
e) Sink bank
f) Infusion pumps
g) Ward instruments
h) Head light illumination
i) Humidifier
j) Zimmer mesher
k) Feeding pump
l) Liposuction
m) De rm o to me
n) Suction machine
0.5
0.15
0.5
0.2
0.2
0.2
0.2
0.4
0.1
0.1
0.1
0.1
0.1
0.05
2.9
XU.
QPTHALMOLOGY
a) Keratometer
b) Indirect opthalmoscope meter
c) Opthalmic chair
d) Opthalmoscope (2 Nos)
e) Slit lamp
f) Instruments
g) Miscellanaeous
0.025
0.015
0.1
0.1
0.060
0.2
0.2
0.7
Xlll.
GENERAL FURNITURE/EQUIPMENTS.
1) 350 Beds
2) 1CU Beds(15)
3) Emergency trolley Beds (12)
4) Other Equipments - Bed side lockers,
stands, trolley (Instruments, Dressing trolley.
5) Generator 65 kVV A
6) Administration
7) Ambulance (2 Nos)
8) C.S.S.D.( Autoclaves etc,.)
5.5
0.3
0.250
1.0
0.3
0.6
0.8
0.5
9.2.5
27
ABSTRACTS
1)
2)
3)
4)
5)
6)
7)
8)
9)
10)
11)
12)
13)
Radiology
Dental
Cardiology
O.T.
Neurology
Laboratory
Orthopaedics/ Physiotherapy
Nephrology
Gaestroenterology
E.N.T.
Plastic surgery & Burns Ward
O pthalm ology
Ge neral F u rn it u re/ Eq u i p m e nts
24.63
2.3
12.8
12.358
3.7
7.9
5.5
3.9
2.0
1.95
2.8
0.7
9.25
89.923
The euipments are further classified into imported and indigenous.The imported
equipment are 100% financed by OPEC funds and the indigenous 70% by OPEC
and 30% by the state.
28
STAFFING NORMS FOR 350 BED
SUPERSPECIALITY HOSPITAL :
Category
Grade
No.
I
Administration
1.
District surgeon
3300-5300
1
2.
RMO
3300-5300
1
3.
Nursing Supdt Grade I
2150-4200
1
4.
Nursing Supdt. Grade II
1900-3700
5
5.
Lay Secretary
1900-3700
1
6.
Office superintendent
1720-3370
2
7.
Senior Asssistant/FDA
1280-2375
2
8.
Junior Assistant/SDA
1040-1900
3
9
Computer Programmer
1280-2375
2
10
Stenotypists
1280-2375
2
11.
Ty pist-c um-c ler k
1040-1900
2
12.
Medical Record Technician
1400-2675
2
13.
Electrician
1400-2675
1
14.
Carpenter
870-1520
1
15.
Plumber
870-1520
1
16.
Cook
870-1520
2
17.
Helper to Cook
840-1340
4
18.
Group D
840-1340
60
19.
Driver
1040-1900
4
29
II
Paramedical Staff
1
Staff Nurse
1520-2900
80
2
Pharmacist Grade I
1400-2675
3
3
Pharmacist Grade II
1280-2580
3
III
Technical staff
1
Physiotherapist
1520-2900
2
2
Senior Lab Technician
1400-2675
2
3
Junior Lab Technician
1280-2375
2
4
Refrac tioni st
1280-2375
1
5
Radiographer
1400-2675
2
6
X-Ray Technician
1280-2375
2
7
Dark Room Assistant
840-1340
1
8
ECG Technician
1280-2375
2
9
Technicians
(Superspeciality 1400-2675
5
870-1520
2
Departments)
10
Lab attendants
Contract for security and maintainence of sanitary and general cleanliness
of hospital to be given to outside agencies.
30
ii
DOCTORS BY SPECIALIZATION FOR 350 BED SUPERSPECIALU Y
HOSPITALS
I
Senior Specialists
Grade
No
1
Physician
3300-5300
2
2
General Surgeon
3300-5300
2
3
Dental Surgeon
3300-5300
1
4
Anaesthetist
3300-5300
10
5
Opthalmologist
3300-5300
1
6
Orthopaedics Surgeon
3300-5300
2
7
E.N.T. Surgeon
3300-5300
1
8
Radiologist
3300-5300
1
9
Pathologist
3300-5300
1
10
Forensic Expert
3300-5300
1
11
Microbiologist
3300-5300
1
12
Biochemist
3300-5300
1
II
Super specialists
Grade
No
1
Cardiologist
3300-5300
2
2
Thoracic Surgeon
3300-5300
1
3
Neurologist
3300-5300
1
4
Neuro Surgeon
3300-5300
1
5
Urologist
3300-5300
1
6
Nephrologist
3300-5300
1
7
Plastic Surgeon
3300-5300
1
8
Gastro Enterologist
3300-5300
1
III
G.D.M.O.
Grade
No
1
General Duty Doctors
2375-4450
8
Gr. Total
178
31
J
%
FINANCIAL IMPLICATIONS OF THE PROJECT
The soft loan is extended to Civil works, Medical Equipment's, consultancy
services and contingencies. Out of total cost, 90% of cost will be met by OPEC
and the rest 10% of the cost of the Project has to be borne by the State
Government and apart from this the State Government has to meet recurring
expenditure for running the Hospital.
Presently the total project cost is estimated at Rs. 263.90 million for the new
hospital plus 28.60 million for the expansion and renovation work of the old
hospital building, which will be completed in Phase I of the Project The project
cost will be as follows
Rs. (million)
New Hospital
Civil Construction
140
Equipment
90
Land preparation
4
Consultancy services
4.9
Contingencies
25
263.9
Total
The total project cost of Rs. 292.5 million is including Phase I covering the old
hospital and Phase II of the new hospital. Rs. 29.25 million (10% of total project
cost) to be borne by the State Government and this expenditure is to count as
part of the State Government contribution to the whole project.
OPEC has
agreed to fund 90% of the entire project cost. Thus, the State Government has
only to fund 10% of the total project cost. This has been a major gain for the
State Government through current negotiations with GOI and OPEC.
32
The OPEC has agreed to reimburse 90% of Rs. 28.6 million (spent by the State
Government on Phase I) - or Rs. 25.74 million to the State Government and has
requested the Central Government to submit withdraw! application for this
amount and transfer this amount to State Government immediately.
It is
proposed to use this amount by the State Government as bridge finance for
execution of project activities. The phase I of the Project would cover the entire
cost of the renovation and expansion of the old hospital.
The recurring cost will have to be borne by the State Government. The project is
expected to be completed within 3 years that is by 31.12.1998.
The annual
recurring cost for the new hospital is Rs. 35 million . The details are enclosed as
annexure.
33
TOTAL PROJECT COST
(In Rupees Millions)
Items
SI
No.
I Phase
II Phase
Total
cost
OPEC
Share
State
Share
17.70
15.93
1.77
Total
cost
OPEC
Share
Grand Total
(Phase I + II)
State
share
Total
OPEC
Share
State
Share
17.70
15.93
1.77
1.
CIVIL WORKS.
a
Existing Hospital
b
New 350 Ded Hospital
121.10
108.99
12.11
121.10
108.99
12.11
c
Residencial Quarters
18.90
17.01
1.89
18.90
17.01
1.89
Total
17.70
15.93
1.77
140.00
126.00
14.00
157.70
141.93
15.77
2
Medical Equipments
(Imported & Indian)
5.40
4.86
0.54
90.00
81.00
9.00
95.40
85.86
9.54
3
Land
4.00
3.60
0.40
4.00
3.60
0.40
4
Consultancy Services
a
Building
0.40
0.36
0.04
3.50
3.15
0.35
3.90
3.51
0.39
b
Equipments
0.10
0.09
0.01
1.40
1.26
0.14
1.50
1.35
0.15
Total
0.50
0.45
0.05
4.90
4.41
0.49
5.40
4.86
0.54
Contigental &
Miscellaneous
5.00
4.50
0.50
25.00
22.50
2.50
30.00
27.00
3.00
Grand Total
28.60
25.74
2.86
263.90
237.51
26.39
292.50
263.25
29.25
5
Note : - OPEC share 90% and State Share 10% of Project Cost.
34
YEAR WISE FLOW OF FUNDS (Rs. IN MILLIONS)
Items &
Particulars
SI
no
I phase
II Phase
Grand Total
( Phase I + II)
1 Year
96-97
1 Year
96-97
IIYear
96-97
Illyear
97-98
Total
I Year
96-97
II Year
97-98
Illyear
98-99
Total
44.01
40.50
41-49
126.00
59.94
40.50
41.49
141.93
32.40
48.60
81.00
4.86
32.40
48.60
85.86
3.60
3.60
4.41
2.97
1.89
1
CIVIL WORKS
15.93
2
Medical Equipment
4.86
3
Land
4
Consultancy Services
0.45
2.52
1.89
5
Contigencies & Misc.
Charges
4.50
7.20
7.20
8.10
22.50
11.70
7.20
8.10
27.00
Total
25.74
57.33
81.99
98.19
237.51
83.07
81.99
98.19
263.25
3.60
35
3.60
4.86
(Rs. In Millions) PROJECT COST ANNUAL BREAKUP OF FOR 3 YEARS
Grand Total
(Phase I + II)
II Phase
I Phase
Total
Cost
lycar
96-97
17.70
17.70
Total
cost
lyear
96-97
11 Yr.
III Yr.
Total
Cost
lYr.
17.70
17.70
II
Yr.
Ill
Yr.
Sl.No
CIVIL WORKS
1
Existing Hospital
b
New Hospital
121.10
40.00
40.00
41.10
121.10
40.00
40.00
41.10
Residence Qurters
18.90
8.90
5.00
5.00
18.90
8.90
5.00
5.00
48.90
45.00
46.10
157.70
66.60
45.00
46.10
36.00
54.00
95.40
5.40
36.00
54.00
4.00
4.00
Total
17.70
17.70
140.00
2
MEDICAL
EQUIPMENTS
5.40
5.40
90.00
3
LAND
4
CONSULTANCY
b
5
4.00
4.00
Building
0.40
0.40
350
1.80
1.70
3.90
220
1.70
Equipments
0.10
0.10
1.40
1.00
0.40
150
1.10
0.40
Total
050
050
4.90
2.80
2.10
5.40
3.30
2.10
CONTIGENCY &
MISCELLANEOOUS
CHARGE
5.00
5.00
25.00
8.00
8.00
9.00
30.00
13.00
8.00
9.00
28.60
28.60
263.90
63.70
91.10
109.10
292.50
92.30
91.10
109.10
NOTE:
I Phase Programmed for 1 year
36
fl
RECURRING CO ST
The annual recurring costs will be as follows and the State Govmment will
meet entire recurring cost to run the 350 bedded Hospital.
Sl.no
Items
Rs.Millions
1
Salaries
17.81
2
Travelling Allowance
0.05
3
Office Expenses
1.00
4
Drugs & Chemicals
5.00
5
Diet Expenses
2.00
6
X-Ray films
0.30
7
Electricity & Water charges
0.60
8
Building Maintenance
0.80
9
Equipment Maintenance
1.60
10
Other Expenses
5.84
Total
35.00
The annual recurring cost for the new superspeciality hospital will be Rs. 35 million.
37
PROJECT IMPLEMENTATION COMMITTEE
All the project related activity decisions will be taken by two committees,
one at the State level and another Implementation committee at the district level.
STATE LEVEL EMPOWERMENT COMMITTEE
The composition of the empowered committe at the State level will be
Additional Chief Secretary as Chairman and will have the following members
a) ACS and Principal Secretary-Finance Department.
Member
b) Secretary - I - to Government, HFW Department
Member
c) Secretary to Government, Planning Department.
Member
d) Secretary to Government, PWD Department.
Member
e) Chief Engineer, PWD C & B (North)
Member
f) Chief Engineer (Health Systems Project)
Member
g) Director of H & FW Services.
Member Secretary
DISTRICT IMPLEMENTATION COMMITTEE
The Implementation Committee at the district level will have the Divisional
Commissioner of Gulbarga as the Chairman with the following members
a.
Deputy Commissioner, Raichur.
Member
b.
Executive Engineer , PWD, Building Div, Raichur
Member
c.
Divisional Joint Director, Health & FW Services
Member
d.
Joint Director,Health Systems Project
Member
e.
District Surgeon, Raichur
Member
f.
Deputy Director Medical/Project Officer
Member Secretary
38
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No.361/GF.7thCross1stBlock
Jayanagor,
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Position: 597 (7 views)