A Proposal

For
Expansion of the OPD Building

OF

Primary Health Care and Resource

Center
Chapagaun, Lalitpur, Nepal

Submitted To:

1. Background
Primary Health Care and Resource Center (PHCRC) located in the suburb of
south Lalitpur, about 20 KMs south
from
downtown
Kathmandu
experience the opposite scenario to
the statements mentioned above.
Established by the United Mission to
Nepal;
a
Christian
missionary
organization, more than 40 years
ago, it has become the most popular
and appreciated community run
health facility in the country for its
quality
of
care,
team
of
compassionate staff sustaining the
Existing OPD Building 1; Medical
Records, OPD, Emergency, Routine
theme patient first. The most
Procedure,
striking challenge it has been facing
for last four decade is the inadequate infrastructure.
In 2007, with the generous grant support from the Finnish Evangelical
Lutheran Mission (FELM), the building was constructed to start the first
community birthing center in the district of Lalitpur. This building did not only
become a milestone for PHCRC in expanding its services, but also increasing
its revenue and providing a place for the different cadres of health workers to
get exposed to a quality learning environment. The building occupies an
operating room, a delivery room, nurses on-call room, four bedded postnatal
beds, and six bedded general beds.
2. Analysis of Current Situation
2.1. Increment in Service Utilization
After construction of the new birthing center in 2006, more than 1000
mothers received safe delivery
services with no maternal
mortality
through
four
postnatal beds. Moreover the
availability of in-patient service
was also made available
through six in-patient beds.
More than 5000 patients were
admitted in the general wards.

Existing OPD Building 2; Laboratory,

Medical Store, Male on-call Room

An operating room was built

with the support from the Asia

Foundation, USA, inside the new birthing center building where surgical
delivery service was also made available in elective basis, and minor surgical
services were also made available.
The students of different faculties of nursing and paramedical fields are
utilizing the health center as an ideal
learning site for more than thirty
years. The number of the students
also increased significantly in recent
years. The reports show that about
600 students from more than 14
schools are practicing in the health
center in both residential and
concurrent basis that also supports
the health centers internal income.
Since the numbers of students are
increasing, the existing training block
Existing Administrative Block
has also become congested and is not
in the condition to ensure the quality of learning.
2.2. Supports from Local and Central Government
District Public Health Office (DPHO) is providing grants for providing the
institutional delivery facility which is inadequate. The District Public Health
Office (DPHO) also supplies some essential medicines and supplies to carry
out the maternal and child health services. The local Village Development
Committee (VDC) provides a sum of NPR 50000.00 as an annual grant. There
are no other physical or monitory supports received from the central and
local government authorities.
2.3. Limitation of Existing Infrastructure
In 2004, when the United Mission to Nepal handed over the program to the
local government, the total number
of annual service users was around
11000 which in increase to 24000 in
the recent years. Not only the total
service users were increased, the
range of services was also increased
to specialized care; gynecology
service and EYE/ENT clinic requiring
more physical spaces to render the
services. The training building has
also
become
more
congested
Existing Maternity Building; Delivery
Room, Operating Rom, Wards, CSSD,
compared to the demand of facility
Laundry, Female on-call Room
users.

Two old and mud-tiled buildings are being used to render the general hospital
services that include; medical records,
OPD, emergency, routine procedure,
dental clinic, pharmacy, laboratory, and
medical store. The congested working
spaces and a waiting lobby are not only
inadequate to provide medical services for
around 25000 every year, but also
challenges to retain the quality of care
and facility to the patients.
2.4. Increasing Health Demands
As a rapidly urbanizing village, Chapagaun
and surrounding villages increased the
Inner View of the
demand of more sophisticated and
Maternity Building
specialized health services. The health
center data shows that there is significant increase in non-communicable
diseases among the villagers required more specialized investigations and
treatment. In other hand, the hospitals in the nearby cities are expensing and
the villagers are not able to pay.
3. The Needs and Utilization of the Desired Infrastructure
The health center had developed its master infrastructure plan in 2005 to
give directions to the future development that comprised of 25 bedded inpatient bed facilities, a well equipped OPD block, a training building that can
accommodate 50 students and a conference hall with occupancy of 100+
people.
The proposed expansion of infrastructure is based on the master
infrastructure plan and its continuation after a maternity building was built in
2006.
The following structure is proposed;
a. A new OPD building that can accommodate all basic services required
for the general hospital services
b. A new training building that can accommodate residential facilities for
50 students, a conference hall with a capacity to accommodate 100+
people, a well equipped cafeteria within the building.
4. Future Impact

The proposed OPD building will be providing quality in-patient services with
15 beds to the people of more than ten villages surrounding Chapagaun.
Moreover, this will be an important development to increase the internal
income of the health center. The training block will not only be useful for the
increasing number of students but also a strong source of income. Increment
in income from these two sources will be the pillars of financial sustainability
of the health center in the future.
5. Construction Procedures
All construction procedures will be conducted as per the prevailing financial
administration policy of PHCRC, and the government of Nepal, abiding the
code of conduct for construction of pubic building. The building will ensure
the special provision for disabled and senior citizens as well.
6. Estimated Cost
6.1.

OPD Building

Particular

Amounts in NPR

A) Construction Civil Works (RCC, PCC, Walling, Painting, plaster)

27235502.26

B) Biomedical Equipments & Instruments

2000000.00

C) Electrification (5%of civil cost)

1361775.1

D) Water supply and Sanitation Works (5% of Civil Cost )

1361775.1

E) Furniture and Fixture

1200000

Total Cost

33159052.46

6.2.

Training Building

Particular

Amounts in NPR

A) Construction Civil Works (RCC, PCC, Walling, Painting, plaster)

1,63,66,292.89/-

B) Kitchen and Canteen Utilities

5,00,000/-

C) Electrification (7%of civil cost)

1145640.50/-

D) Water supply and Sanitation Works (7% of Civil Cost )

1145640.50

E) Furniture and Fixture

10,00,000/-

Total Cost

20157573.89/-

Estimated Cost includes cost of overhead and contractors profit. All rates of
construction works has been calculated based on standard Nepal government
norms and current market price of construction materials and labor cost.
PREPARED BY :
PHCRC, Chapagaun, Contact: 05574035, 9841243802

EMAIL:, phcrc@wlink.com.np
November, 2015

ANNEX
Building Layout