Ethiopian Catholic Church Social And Development

1

Ethiopian Catholic Church Social

And Development Commission Robe

1 NEURO-PSYCHIATRIC SPECIALITY CENTRE OF ROBE CATHOLIC CHURCH

Mental health and development:

Targeting people with mental health conditions as a vulnerable group

Date: April 2014

2

Index

1 NEURO-PSYCHIATRIC SPECIALITY CENTREOF ROBE CATHOLIC CHURCH .................................................. 1

2 Project Profile ............................................................................................................................................ 6

3 ExecutiveSummary .................................................................................................................................... 7

4 Foreword ................................................................................................................................................... 8

4.1 Background and justification ............................................................................................................. 8

4.2 Justification ........................................................................................................................................ 9

4.3 Location ........................................................................................................................................... 10

4.4 Target Groups .................................................................................................................................. 10

4.5 Duration ........................................................................................................................................... 10

5 Project Objective and Goals .................................................................................................................... 11

5.1 Main Objective ................................................................................................................................ 11

5.2 Specific Objectives ........................................................................................................................... 11

6 Project Strategies..................................................................................................................................... 11

6.1 Intersectional Collaboration ............................................................................................................ 11

6.2 Health Education ............................................................................................................................. 11

6.3 Effective use of Resources ............................................................................................................... 11

6.4 Community Mobilization ................................................................................................................. 12

7 Expected Out Put/Results ........................................................................................................................ 12

7.1 Immediate ....................................................................................................................................... 12

7.1.1 Preventive Health Services ...................................................................................................... 12

7.1.2 Curative Health Services .......................................................................................................... 12

7.1.3 Rehabilitative Health Services ................................................................................................. 12

7.1.4 Integration Health Services ..................................................................................................... 12

7.2 Long Term ........................................................................................................................................ 12

8 Project Activities ...................................................................................................................................... 13

8.1.1 Preventive Services .................................................................................................................. 13

8.1.2 Curative Services ..................................................................................................................... 13

8.1.3 Rehabilitative Service Physiotherapy ...................................................................................... 13

3

8.1.4 Reintegration ........................................................................................................................... 13

8.1.5 Laboratory and medical exams................................................................................................ 13

8.2 Eligible populations ......................................................................................................................... 14

8.3 Major diagnostic activities ............................................................................................................... 14

8.4 Major curative activities .................................................................................................................. 14

8.5 Other Activities ................................................................................................................................ 15

8.6 Physical Activities ............................................................................................................................ 15

8.7 Trainings .......................................................................................................................................... 15

8.7.1 Long Time ................................................................................................................................ 15

8.7.2 Short time ................................................................................................................................ 15

8.8 Free patients service........................................................................................................................ 16

9 Risks and Assumptions ............................................................................................................................ 16

10 Organization and Management ........................................................................................................... 16

10.1 Responsibility for funding and implementation .............................................................................. 16

11 PROJECT INPUT/COSTS ........................................................................................................................ 17

11.1 Human resources input ................................................................................................................... 17

11.2 Material resources ........................................................................................................................... 19

11.2.1 Block 01 – Psychiatry Ward, Neurology Ward and Social Reintegration ................................ 19

11.2.2 Block 02 – Reception, Pharmacy, Administration and Personnel ........................................... 20

11.2.3 Block 03 – Ambulatory, Inside Kitchen and Laboratory .......................................................... 20

11.2.4 Block 04 – CT ............................................................................................................................ 21

11.2.5 Block 05 – Morgue ................................................................................................................... 21

11.2.6 Block 06 – Outside Kitchen and Laundry ................................................................................. 21

11.2.7 Block 07 – Public WC ............................................................................................................... 22

11.2.8 Block 08 – Main Store and Generator ..................................................................................... 22

11.2.9 Block 09 – Incinerator .............................................................................................................. 22

11.2.10 Block 10 – Watchman .......................................................................................................... 22

11.2.11 Medical Equipments ............................................................................................................ 23

11.2.12 Non-medical Equipments .................................................................................................... 24

11.3 Financial resources .......................................................................................................................... 24

12 Monitoring and Evaluation .................................................................................................................. 25

12.1.1 Health Sector Office ................................................................................................................. 25

12.1.2 Bale Zone Health Office ........................................................................................................... 25

12.2 Participation Community ................................................................................................................. 25

12.3 Responsibility in assigning health professionals ............................................................................. 25

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13 Reporting ............................................................................................................................................. 25

14 Sustainability and phase out strategy ................................................................................................. 25

14.1 Responsibility for Project and Project property transfer on Project termination ........................... 26

15 ANNEX .................................................................................................................................................. 26

Acronyms

BOFED Bureau of Finance and Economic Development

ECC SDCO Robe Ethiopian Catholic Church Social and Development Commission Robe

FMHACA Ethiopian Food, Medicine and Healthcare Administration and Control Authority

HSDP Health Sector Development Programme

NPSCRCC Neuro-Psychiatric Speciality Centre of Robe Catholic Church

OPD Outpatients Department

RHB Regional Health Bureau

5

Article 32 of the UN Convention

on the Rights of Persons with

Disabilities requires that:

States Parties recognize the

importance of international

cooperation and its promotion, in

support of national efforts for the

realization of the purpose and

objectives of the present Convention,

and will undertake appropriate and

effective measures in this

regard…ensuring that international

cooperation, including international

development programs, is inclusive of

and accessible to persons with

disabilities…

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2 Project Profile

Name of the project: Neuro-Psychiatric Speciality Centre of Robe Catholic Church

General Objectives: Preventive, curative and rehabilitative, with a continuous monitoring of the

efficiency, quality and accessibility to the more vulnerable population of the

Bale region.

Duration of the Project: 2014-2018 (5 years)

Date of Agreement: April 2014

Location of the Project: Federal Republic of Ethiopia

Oromia Regional State

Bale Zone

Robe Town

Type and number of

beneficiaries: Vulnerable mental health people (main target)

Direct beneficiaries: Male: 2,632

Female: 2,968

Total: 5,600

Indirect beneficiaries: Male: 15,792

Female: 17,708

Total: 33,600

Implementing Agency: ECC-SDCOR

Executive Agency: 1) Bureau of Finance and Economic Development (BOFED)

2) Ethiopian Food, Medicine and Healthcare Administration and Control

Authority (FMHACA)

Project Holder and

Funding agency: Apostolic Prefecture of Robe

Ph./Fax 0226651955

P.O.Box 45

Project Budget: Direct project cost:

Administrative cost:

Contact person: Father Angelo Antolini

e-mail: [email protected]

Phone number: 0226651955

Obbo Feyisa Gemmeda

e-mail: [email protected]

Phone number:0916581659

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3 ExecutiveSummary

This Project document is prepared to describe the health services provided by the Neuro-Psychiatric

Speciality Centre of Robe Catholic Church (NPSCRCC) in order to screen, treat, relieve, rehabilitate and

reintegrate those suffering frommental and neurological diseases.

The Project activities would be carried mainly in Bale Zone,Oromia Regional.

The project intends to serve a total of around ### beneficiariesin a total population of 3,500,000, for five

years beginning from 2015 to 2019.

The Hospital has all the necessary medical equipment, essential drugs, diagnostic reagents, medical

supplies, furniture andoffice equipment, as well as a large technical and support staffwhich would be

needed to fulfilboth the Project Holder’s responsibilitiesand those of the Ministry of Health, which

arerequired by the standard of FMHACA.

The foreseen budget of ### Eth.Birr, needed to develop the Project in five years, would be considered

sufficient for an effective achievementof all the expected goals.

The Neuro-Psychiatric Speciality Centrewould provide preventive, screening, curative, rehabilitative and

reintegrativehealth services. Considering the large number of people in the target area affected by mental

and neurological diseases, great results are expected in order to improve the general health conditions.

The Project would realize a Speciality Centre for Neurology and Psychiatry abiding by the Ethiopian

Standard ES3619:2012 Speciality Centre Requirements.

Concerning Neurological aspects and taking into account the location of the Centre (430 km far from Addis

Ababa) which doesn’t allow a reasonable access to a Higher Referral Hospital and the consultation of

neurosurgical experts, the Project will deal only with medical aspects of neurological illnesses (ref. par.

2.1.3 of the Standard ES3619:2012).

Due to the fact that Psychiatry is not directly considered in theStandards ES3619:2012, the Project adapts

requirements of the Ethiopian Standard ES3620:2012 Speciality Centre Requirementsto the ones of the

Standard of Speciality Centre.

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4 Foreword

4.1 Background and justification

For the last26 years, the Catholic Church has already carried out a wide and admirable health, hosting and

rehabilitative services to destitutes and mentally affected people in the Bale Zone, Goba Town, by the

Nursing Home cared by Missionaries of Charity (Blessed Mother Teresa’s Sisters).

Mother Teresa herself founded the Nursing Home,during the Communist Regime, bringing four sisters of

her Congregation from Addis Ababa to start this charitable health institution. Since then, the service has

continued with more than 250 residential patients.

Recently the Catholic Church has strengthened her presence in the Bale Zone with the erection of an

Apostolic Prefecture made directly by the Roman Pope and an Apostolic Prefect has been appointed in

Robe Town.

Consequently the intention of the Catholic Church has been immediately enlarged, strengthening the

already existing, above mentioned charitable rehabilitating activities carried on by the Sisters.

On a plot of land (10,000 sq. mts) already assigned by the Government to the Catholic Church for some

health care activities several years ago in Robe Town, the Catholic Church plans to create a Neuro-

psychiatric Speciality Centre to support the already existing Nursing Home of the Missionaries of Charity

and to reach out also many other people affected by mental and neurological diseases.

The reasons of the project, (focussing only on the two related health sectors i.e. neuro-psychiatric)are:

• The existing of two General Hospitals in Robe and Goba Towns,1 and 10 km respectively far from

the proposed Speciality Centre.

• The existing of a Nursing Home in Goba Town run by the Missionaries of Charity;

• The possibility of improving with specialized services the existing neuro-psychiatric health

servicesprovided by public Hospitals;

• The world-wide experiences of the Catholic Church in dealing with these delicate and demanding

health sectors by providing international cooperation with Experts and Councillors.

The Speciality Centrehas been planned with ambulatories for outpatients (OPD), wards (40 beds) for

inpatients for medical cases, lab department, pharmacy and drugstore, Computerized Tomography (CT),

Ultrasound, Electroencephalogram (EEG) and electromyography (EMG), electrocardiogram (EKG) and

Automatic Defibrillation, Emergency and Isolation department, Counselling, Gymnastic and Physiotherapy,

Health Education and Social Rehabilitation and Reintegration.

The Project would operate in the following different directions:

• Training;

• Epidemiology;

• Prevention;

• Medical treatment (diagnosis and pharmacological therapy);

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• Rehabilitation;

• Social Reintegration.

The Speciality Centre, with its premises in Robe Town (10,000 sq.m), has as its main aim: Ambulatory

Service, Counselling, Training, Screening, Short Admission for Medical Treatment and First Rehabilitation

and Reintegration.

The Speciality Centre will attend to the formation of inpatients, outpatients, as well as society at large,

regarding the prevention of mental diseases, the awareness of risk laden behaviour, general sensitivity and

concern about mental health and neurological illness in order to educate and changethe presentcommon

way of thinking about mental illness and disturbance which often leads to current unpleasant and

dangerous taboos, particularly in this area.

The aim of the whole project is both curative and rehabilitative, with the objective of full reintegration of

patients into the normal life of families and society, through a synergetic approach between the Speciality

Centre and Nursing Homes which are planned together in this project proposal.

A Nursing Home is already fully functioning at Goba, run by the Catholic Church through the Missionaries of

Charity. The ambitious intention of this Project is to apply in the future with a different formal request to

the Government for a large space where other Nursing Homes may be built, functioning as rehabilitative

and re-integrative Centres.

This large plot of farming land, which the Catholic Church intends to apply for from the Government, should

be both a rehabilitative place, as well as an incoming generating project in order to facilitate the running of

the Speciality Centres and the project as a whole.

At the beginning of the Project, almost all the project running costs, including the construction of the health

infrastructure, purchasing of medicaland office equipments, furniture, drugs and medical supplies, payment

of personnel's salaries, etc. are funded by Private Donors, Faithful of the Catholic Church and Catholic and

non-CatholicOrganizations abroad.

It is our resolute intention to make the projectrun graduallyby means of a localincome in order to be

reliable and feasible in the face of anynegative circumstance and/or international economic crisis.

4.2 Justification

Ethiopia occupies the 169th place out of 177 countries in the Human Development Index (HDI1) and it is one

of the world's poorest countries, with a pro capita income of 1,000USD per year and about 47% of the

population below the poverty line.

The Ethiopian population is young with approximately 47.7% under the age of 15 years. The 24% of women

is of childbearing age (between 15 and 49 years). The fertility rate (TFR) is 5.4.7 deliveries for woman. The

Oromia Region holds the record in this regard, with a TFR of 6.2. At the same time, 86% of the working-age

population fails to be self-supporting. This situation is worsened by the spread of HIV/AIDS which has

affected mainly the people of working age.

The institutional structure is based on a Federal system with regional Governments which obtained a

significant degree of autonomy with the Constitution of 1995. For the health sector the Regional Health

1UNDP (2007). Human Development Index 2007

10

Bureau (RHB) was established. Moreover, in the process of decentralization, the woreda (district) was given

the role of planning and of local administration.

The goals of the health sector are identified in the national Health Sector Development Plan (HSPD) and

are then detailed to lower administrative levels. The HSDP has been in place in the country since 1997/8

and entered its third five-year phase in 2005. In recent years the Government has increased the proportion

of the budget earmarked for this area, but the annual pro capita expenditure on health (5.6$) remains far

below the average of African countries and there is no further increments. The health sector also suffers

from severe shortcomings in human resources, especially among doctors and specialists.

The Oromia Region is the largest region of Ethiopia. It has a population of more than 30 million inhabitants.

There are 41 hospitals, including academic hospitals, 1090 Health Centres (HC) and more than 6000 Health

Post (HP) with many others under construction, as well as 492 private clinics2.The coverage of health

services and their use in Oromia is 60.98%, with 0.38 yearly visits per head, below the national average.

The Bale Zone, located in the South-Eastern part of Ethiopia, is one of the 14 administrative zones of the

Oromia Region, the second as extension, with a surface of 67,330 km2. According to the Population and

Housing Census 2007, published by the Central Statistical Agency in 2010, the population of Bale is

estimated to be 1.4 million inhabitants. The population density is of 27 inhabitants per km2. The capital city

is Robe which is about 428 km from Addis Ababa. The Bale area is predominantly mountainous with an

agricultural economy. Administratively it is divided into 18 woreda (districts) and 534 kebele (villages) of

which 500 rural and 34 urban.

In regard to the health system structure, in Bale there are 4 hospitals (Goba, Robe,Ginnir and Dallo Mena),

870 functional HC, 359 HP3. There are many drug retail outlets, drug store and clinics run by private

owners. Also one red cross pharmacy is at service in the zone.

The geographical vastness involves substantial distances with a local transport system deficient (there are

no paved roads and some HC remain isolated for about 4 months a year). Health care personnel are only

70% of the expected one.

4.3 Location

Robe Town, Bale Zone in Oromia Regional State, Federal Republic of Ethiopia.

4.4 Target Groups

• All the Provinces (Woreda) of Bale Zone.

Considering the increased access to Bale Zone trough the new tarmac roads, the West Arsi Provinces may

easily benefit of the Speciality Centre.

4.5 Duration

Five years, starting from the date of signing the project document agreement (2014-2018).

2FMOH (2003/4). Health and Health-Related Indicators

3The structure of the health system in Ethiopia provides for the existence of a Primary Health Care Unit at woreda level that includes one HC and at

least 5 satellites HP every 25,000 inhabitants; District Hospitals; Zonal Hospitals offering services in 4 specialties; and Specialised Hospitals offering

specialized care and training to doctors.

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5 Project Objective and Goals

5.1 Main Objective

To achieve full functioning of the Speciality Centreservices with the objective of full reintegration of

patients, with, in the normal lives of families and society, through a synergetic approach between the

Speciality Centre and the Nursing Homes which are planned together in this project proposal: preventive,

curative and rehabilitative, with a continuous monitoring of the efficiency, quality and accessibility to the

more vulnerable population of the Bale region.

5.2 Specific Objectives

1) Provide prevention services in the Centre with training and information;

2) Establish full curative services for beneficiaries with neuro-psychiatric illness;

3) Establish full rehabilitative services for beneficiaries with physical problems;

4) Establish full analysis laboratory open for the entire population;

6 Project Strategies A therapy whereby the patients will be introduced to making different items which then could be sold as a

money making venture, at the same time as providing them occupation, and developing their contact with

reality. Different occupations could be weaving and recycling oil tins into different household items,

embroidery for both women and men… In fact any art and craft work.

To provide effective integrated health services to the community in the Project areas, the Speciality Centre

shall adopt the following strategies:

6.1 Intersectional Collaboration

The Speciality Centre would try to establish effective link with the District Health Office, Zonal Finance

Economic Development and Health Departments during planning, implementation and evaluation of the

activities.

The health personnel of the Speciality Centre would attend different meetings, workshops and seminars to

be held at the Speciality Centre , District and Zonal level offices.

6.2 Health Education

The remedy of most mental and neurological health problems is not only treating the illness, but it is also

preventing the root causes of it, creating awareness of the psychological and physical danger of use of

drugs, abuse of alcohol, as well as teaching the benefits of a sound behaviour, holistic family life, peaceful

approach to life, friendly relationships, etc.

Health education would be given regularly at the Speciality Centre, the Nursing Homes and Schools .

6.3 Effective use of Resources

Medical equipment, furniture, office equipment, diagnostic reagents, medical supplies, medicines, health

personnel and support staff categorized in the project document, would be utilized effectively.

12

For any deficit of all these resources, the Speciality Centre would fill the gap through mutual

communication with the Ethiopian Catholic Church Social and Development Commission Robe (ECC SDCO

Robe) and co-signatories.

6.4 Community Mobilization

Community mobilization is mandatory for an actively participating community during the planning,

implementing and evaluation of the activities.

7 Expected Out Put/Results

7.1 Immediate

By providing curative and preventive health services in the Speciality Centre and its catchment areas, the

following output in each component of activities would be expected.

7.1.1 Preventive Health Services

The target population sited in the Project document would get an access to training and screening through

seminars, congresses, guided visits to the Centre and its Schools and by generating social awareness.

7.1.2 Curative Health Services

The target population sited in the Project document would get s access to curative health service in the

Speciality Centre for the diseases commonly prevailing in the area through the outpatient department, in

patient department, Laboratory services and others.

7.1.3 Rehabilitative Health Services

The target population sited in the Project document would get an access to gym space and the play room.

7.1.4 Integration Health Services

The target population sited in the Project document would get an access to work laboratories and social

spaces with the support of the Nursing Home.

7.2 Long Term

By the joint effect of preventive, curative, rehabilitative and integrative health services, the following

improvement in the health status of the project areas would be expected:

• Prevention of recurring mental disturbances and illnesses in those which are possible to treat with

drugs and close observation by professionals

• Recovery of:

o motor and sensorial activities;

o motor coordination;

o normal or healthy posture;

o strength;

o equilibrium;

o communication ability (speech, gestures, graphic).

• Social reintegration;

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• The lessening of common fears, prejudices and taboos.

A new understanding and awareness of people about health problems will be created through community

participation and involvement.

8 Project Activities The Centre takes care of the whole course of human life, considering the neurological and psychiatric

alterations that occur to human beings and tries to diagnose and cure them.

Considering that sciences like neurology and psychiatry are evolving day by day, treating a disease may be

challenging and not always possible. Nevertheless, a thorough knowledge of the single disease is important

for formation and prevention.

8.1.1 Preventive Services

o Formation of inpatients and outpatients with specific education and training in the Speciality

Centre;

o Formation of students, families and people through education, training and a guided visit to the

Speciality Centre to dismiss common fears, prejudices and taboos;

o The Screening of people at risk;

o Personal and private counselling.

o The availability of family counselling, and mentoring once the patient is rehabilitated (this in the

scope of follow up visits by qualified staff to the home of the patients and the availability to both

patient and family members of counselling services in moments of crisis)

8.1.2 Curative Services

o Only required Pharmacological therapy;

o Pain relief therapy.

8.1.3 Rehabilitative Service

Physiotherapy

o Psychotherapy;

o Psychomotor therapy;

o Play therapy;

o Speech therapy;

o Ergo therapy;

o Counselling;

o Social therapy.

o Occupational Therapy

8.1.4 Reintegration

o Nursing Home programs;

o Families and environment interactions;

o Families and society training;

8.1.5 Laboratory and medical exams

o Malaria test

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o Blood test

o Urine test

8.2 Eligible populations

All people living in Bale, but also coming from other regions

8.3 Major diagnostic activities

The Centre wants to deal with the following diagnostic activities:

• Diagnosis of Genetic Neuropsychiatric diseases

• Diagnosis of

o prenatal,

o perinatal,

o postnatal

o neonatal neuropsychiatric diseases

• Diagnosis of child neuropsychiatric diseases

o epilepsy,

o autism

• Early diagnosis of youth drug addiction

• Diagnosis of drug addiction

• Diagnosis of

o Infectious

o neoplastic,

o immunologic

o degenerative neurological diseases

• Early diagnosis of behavioural disorders

• Early diagnosis of cyclothymiacs disorder (depression, euphoria)

• Early diagnosis of depressive disorder

• Early diagnosis of schizophrenia

• Early diagnosis of neurosis disorders

• Early diagnosis of paranoid disorders

• Early diagnosis of mental retardation

• Early diagnosis of dementia

8.4 Major curative activities

The Centre wants to deal with the following treatment activities:

• Treatment of genetic neuropsychiatric diseases by means of replacement therapy

• Treatment of

o perinatal hypoxical neurological diseases,

o preterm and

o post-term neurological diseases and infantile cerebral paralysis

• Treatment of epilepsies

• Treatment of autism

15

• Treatment of youth drug addiction

• Treatment of drug addiction

• Treatment of infective, neoplastic, immunologic and degenerative neurological diseases

• Treatment and care of patients with behavioural disorders

• Treatment of cyclothymiac disorders

• Treatment and care of patients with depressive disorders

• Treatment of schizophrenia

• Treatment of neurosis

• Treatment of paranoid disorders

• Treatment and care of patients with mental retardation

• Treatment and care of patients with dementia

8.5 Other Activities

The Centre also includes the following services:

• Psychoanalysis

• Psychomotricity

• Physiotherapy

• Social assistance

8.6 Physical Activities

2014 2015 2016 2017 2018 Remarks

Building Construction 30% 70% See attached

Design

Fencing 100%

Compound Arrangement 40% 40% 20% Implanting,

Gardening,

Layout

The Project, considering the preliminary geological survey and the need for sufficient green area for

inpatients activities, foresees a multi-story building construction. The main building will be ground plus two

and two satellite buildings ground plus one. Minor service buildings will be ground zero.

8.7 Trainings

8.7.1 Long Time

The Speciality Centre plans to train neurophysio-pathologists and neuro-radiologists.

8.7.2 Short time

The Speciality Centre plans to train neurophysiopathology and neuroradiological technicians and nurses for

neurological and psychiatry healing.

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8.8 Free patients service

Some of the patients are coming from the project area, adjacent zones and RHB are unable to cover service

fees, for instance, delivery mothers, under-five children and the most needy ones will be treated with low

flat fee. This accounts 2% of the total patients expected in a year.

9 Risks and Assumptions - Community willingness and cooperation would be in place

- Favourable policy of Health, generally on what we propose would be in place

- The political conditions and the security of the area would be encouraging

- The source of regular funds availability and flow would be kept normally

- Human resources availability on the profession of neuro-psychiatric would be in place

10 Organization and Management

10.1 Responsibility for funding and implementation

The Ethiopian Catholic Church Social and Development Commission Robe shall provide the Speciality

Centre with basic supplies, medical equipment and furniture in accordance with the standard set by the

Ministry of Health and be responsible for the running costs, medicines and salaries of the personnel in the

first five year period as well as to carry out all the activities of the Centre under the Health Sector

Development Programme(HSDP).

Board of Governors

of Speciality Centre

Management Committee

Advisory Body

Chief Executive

Officer (CEO)

Chief Clinical Officer

(CCO)

Health Sector Officer Bale Zone

Health Department

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11 PROJECT INPUT/COSTS

11.1 Human resources input

The Speciality Centre is staffed with medical, paramedical, administrative and support personnel

comprising a manager and medical director.

It is anticipated and it is hoped that in the course of the project, thanks to the extensive collaboration with

the local health care facilities, in order to overcome the economic difficulties and the difficulty of finding

qualified personnel, it is expected that the staff can be progressively taken over by the Ministry of Health.

S/n Technical Staff Qty Nationality Monthly salary

(ETB)

Total salary in the

four years (ETB) Remarks

1 Psychiatrist 1 7,200.00 345,600.00

2 Neurologist 2 7,200.00 691,200.00

3 Internist 1 7,500.00 360,000.00

4 Paediatrician 1 7,500.00 360,000.00

5 Radiologist 1 7,200.00 345,600.00

6 Physiotherapist 1 4,500.00 216,000.00

Nurses

7 • Emergency 5 Ethiopian 4,500.00 1,080,000.00

8 • Ward/Inpatient 10 Ethiopian 4,500.00 2,160,000.00

9 Laboratory Technologist 2 Ethiopian 4,500.00 432,000.00

10 Therapists 4 Ethiopian 4,500.00 864,000.00

11 Social assistants 2 Ethiopian 5,000.00 480,000.00

12 Pharmacist 2 Ethiopian 5,200.00 499,200.00

13 Radiographer 2 Ethiopian 7,200.00 691,200.00

Trainings

14 neuro physiopatology 2 30,000.00 60,000.00

15 neuro radiologist 2 30,000.00 60,000.00

16 short term trainings

16 neurolocical healing 6 6,000.00 36,000.00

17 psychiatric healing 6 6,000.00 36,000.00

TOTAL

34

148,500.00 8,716,800.00

18

S/n Supportive Staff Qty Nationality Monthly

salary (ETB)

Total salary in the

four years (ETB) Remarks

1 General manager 1 10,000.00 480,000.00

2 Administrative manager 1 Ethiopian 10,000.00 480,000.00

3 Chief accountant 1 Ethiopian 4,490.00 215,520.00

4 Cashier 2 Ethiopian 2,228.00 213,888.00

5 Secretary 2 Ethiopian 2,228.00 213,888.00

6 Receptionist 2 Ethiopian 2,228.00 213,888.00

7 Cook 2 Ethiopian 1,110.00 106,560.00

8 Guard 8 Ethiopian 1,110.00 426,240.00

9 Cleaner/laundry 14 Ethiopian 1,110.00 745,920.00

10 Porter/runner 10 Ethiopian 1,110.00 532,800.00

11 Driver 2 Ethiopian 2,228.00 213,888.00

12 Gardener 2 Ethiopian 1,110.00 106,560.00

13 Multipurpose technician 2 Ethiopian 1,110.00 106,560.00

TOTAL 49 40,062.00 4,055,712.00

19

11.2 Material resources

The premises of the Neuro-Psychiatric Speciality Centre will be:

Block N. Building

floor

Main Activities Overall Surface

sq.mts.

Cost Summery for

Building

01 0 Psychiatry Ward 720 11,496,810.45

1 Neurology Ward 720 11,496,810.45

2 Social Reintegration 720 11,496,810.45

02 0 Reception and Pharmacy 230 3,672,592.23

1 Administration and Personnel 230 3,672,592.23

03 0 Ambulatories and Inside

Kitchen

230 3,672,592.23

1 Laboratories 230 3,672,592.23

04 0 Computerized Tomography (CT) 102 1,628,714.81

05 0 Morgue 60 958,067.54

06 0 Outside Kitchen and Laundry 94 1,500,972.48

07 0 Public WC 41 654,679.48

08 0 Main Store and Generator 106 1,692,585.98

09 0 Incinerator 25 399,194.81

10 0 Watchman 12 191,613.51

Total Surface 3,520sq.mts 56,206,628.86

In particular the Project foresees as in the following

11.2.1 Block 01 – Psychiatry Ward, Neurology Ward and Social Reintegration

Stories Main Activities Rooms Surface

sq. mts.

0 Psychiatry Ward

4 Patients Rooms

10 beds male

10 beds female

204

2 Isolation Rooms 30

2 Emergency Rooms 30

2 Examination Rooms 25

Nurse (include WC) 21

Sterilization 25

Treatment and injection room 14

2 Duty rooms (male/female) 25

Clean utility and linen room 6

Soiled utility room 6

5 Stores 17

Toilets wards 2x4=8 (1+1 disable) 41

Common Toilets 4 (1+1 disable) 25

Janitor 5

1 Neurology Ward

4 Patients Rooms 204

20

10 beds male

10 beds female

2 Isolation Rooms (include WC) 36

Emergency Room (include WC) 25

2 Examination Rooms 37

Nurse (include WC) 15

Treatment and injection room 14

2 Duty rooms (male/female) 25

Clean utility and linen room 6

Soiled utility room 6

7 Stores 34

Toilets wards 2x4=8 (1+1 disable) 41


Janitor 5

2 Social

Reintegration

4 Counselling rooms 73

Gym 80

Social Integration 80

Meeting Room 80

Physiotherapy 80


2 Wardrobes 39

2 Stores 6

Janitor 5

11.2.2 Block 02 – Reception, Pharmacy, Administration and Personnel


sq.mts.

0 Reception

Waiting Area 43

Registration and recording room 21

Cash desk 9

Counselling Room and

Automatic Defibrillation - EKG

10

Bar 25

0 Pharmacy

Dispensing 21

Office (include WC) 14

Store 29

1 Administration

3 Offices 76

2 WC (1 male + 1 female) 10

Personnel

2 Dressing Rooms (male + female) 25

Kitchen and cafeteria 18

11.2.3 Block 03 – Ambulatory, Inside Kitchen and Laboratory


21

sq.mts.

0 Ambulatory

2 Ambulatories 47

Waiting area 23

Common WC 2 (1 disable - shower) 9

Specimen Collection 9

Store 5

0 Inside Kitchen

Kitchen 49

Store 21

1 Laboratory

Laboratory (open platform) 64

EEG Room 12

Nerve Conduction Test Room 12

Ultrasound Room 12

Waiting area 34

Office 15

Common WC 2 10

Store 12

11.2.4 Block 04 – CT


sq.mts.

0 Computerized

Tomography (CT)

Waiting Room (+1 WC) 17

Sub-Waiting-Room 9

CT Room 29

Doctor Room (+1 WC) 19

11.2.5 Block 05 – Morgue


sq.mts.

0 Morgue

Office 5

Morgue 20

Autopsy 20

11.2.6 Block 06 – Outside Kitchen and Laundry


sq.mts.

0 Outside Kitchen

Kitchen (2 Rooms) 24

Store 16

Laundry

Laundry 28

Store 12

22

11.2.7 Block 07 – Public WC


sq.mts.

0 Public WC

Common WC 12 (6 male + 6 female) 37

11.2.8 Block 08 – Main Store and Generator


sq.mts.

0 Main Store

Store 30

Generator

2 Generator Rooms 62

11.2.9 Block 09 – Incinerator


sq.mts.

0 Incinerator

Incinerator 22

11.2.10 Block 10 – Watchman


sq.mts.

0 Watchman

Watchman 12

23

11.2.11 Medical Equipments

S/n List of items Qty Unit Price Total price

BIRR BIRR

1 PET scanner (duty free) 1 951,600.00 951,600.00

2 Echograph with Ecodoppler (duty free) 1 326,716.00 326,716.00

3 Electroencephalograph (EEG) 1 48,400.00 48,400.00

4 Electromyography 1 47,580.00 47,580.00

5 Electrocardiograph (ECG) 1 46,000.00 46,000.00

6 Microscope 4 2,520.00 10,080.00

7 Centrifuge 2 12,530.00 25,060.00

8 Autoclave 1 31,720.00 31,720.00

9 Spectrophotometer 1 50,117.00 50,117.00

10 Analizer reading reagent (duty free) 1 137,050.00 137,050.00

11 Test tube 4 635.00 2,540.00

12 Pressure gauge 6 1,270.00 7,620.00

13 Stetoscope 10 280.00 2,800.00

14 Thermometer 20 175.00 3,500.00

15 Straight and bowed scissors 10 100.00 1,000.00

16 Kocher 3 175.00 525.00

17 Klemmer 3 290.00 870.00

18 needles case 3 930.00 2,790.00

19 Straight and bowed needles 10 840.00 8,400.00

20 Surgical pincers 10 160.00 1,600.00

21 Oto-ophthalmoscope 2 4,425.00 8,850.00

22 Cervical neck collar 3 620.00 1,860.00

23 Ortophedic corset 3 5,075.00 15,225.00

24 Oxigene tank for aerosol therapy (duty free) 1 36,180.00 36,180.00

25 naso-gastric feeding tube 2 3,965.00 7,930.00

26 Tongue depressor 4 130.00 520.00

27 Laringescope 2 2,700.00 5,400.00

28 Bladder catheter 20 605.00 12,100.00

29 Rectal probe 20 150.00 3,000.00

30 Ambu bag 3 480.00 1,440.00

31 Medical refrigerateur (duty free) 3 39,510.00 118,530.00

32 Stretcher 4 7,612.00 30,448.00

33 Wheelchair 4 5,780.00 23,120.00

34 Neurological hammer 4 135.00 540.00

35 TOTAL 1,971,111.00

24

11.2.12 Non-medical Equipments

S/n List of items Qty Unit Price Total price

BIRR BIRR

1 Vehicle (Toyota land cruiser 4WD) (duty

free) 2 2,700,000.00 5,400,000.00

2 Laundry machine 2 60,000.00 120,000.00

3 Photocopier 1 50,000.00 50,000.00

4 Computer with accessories 3 24,800.00 74,400.00

5 Laptop with accessories 6 12,500.00 75,000.00

6 Digital photo camera 1 4,000.00 4,000.00

7 Video camera 1 10,000.00 10,000.00

8 LCD projector 1 30,000.00 30,000.00

9 TV 1 9,000.00 9,000.00

10 Furniture’s and Fixtures

Chair 100 1,100.00 110,000.00

Bed 50 3,160.00 158,000.00

Table 25 2,000.00 50,000.00

Office desk set 6 14,000.00 84,000.00

Computer stand 6 7,600.00 45,600.00

Shelves 40 3,321.00 132,840.00

File cabinet 10 8,000.00 80,000.00

Sofa set 4 25,000.00 100,000.00

11 Stationeries lump

sum 100,000.00 100,000.00

Total

5,772,400.00

11.3 Financial resources

With regard to the economical sustainability, apart the moderate contribution of inpatients and

outpatients, almost all the project running costs, including the construction of the health infrastructure,

purchasing of medical and office equipment, furniture, drugs and medical supplies, payment of personnel

salaries, etc. are funded by Private Donors, Faithful of the Catholic Church and Catholic and non-Catholic

Organizations abroad.

It is our resolute intention to make the project run gradually by some local income generating projects. In

particular, the Church has in mind a productive farm according to Ethiopian regulations and laws.

25

12 Monitoring and Evaluation

12.1.1 Health Sector Office

The Health Coordinator in the development coordination office of the Ethiopian Catholic Church Social and

Development Commission Robe shall supervise and coordinate all the work and different aspects of the

Speciality Centre’s activities according to the policies office SDCO Robe.

12.1.2 Bale Zone Health Office

The Bale Zone Health Department and the Bale Zone Finance and Economics Development Departments in

corporation with regional project signatory bureaus.

The staff of the above mentioned offices will jointly monitor and evaluate the activities based on their

program and at the end (terminal evaluation).

12.2 Participation Community

The participation of the community is mandatory for effective delivery of health services, for Resource

Monitoring and Evaluation of the project which is achieved by building the awareness of the community

until they have imbued a more clear understanding of mental health and its disturbances. This will be

effected by using static and outreach sites as a mode of interaction.

12.3 Responsibility in assigning health professionals

Bale Zone health office shall be monitoring those staff Listed in this document under human resource input.

13 Reporting The Hospital shall submit monthly, quarterly and annual reports of activities to the Bale Zone Health Office

and the Health Sector Coordination office of the Ethiopian Catholic Church Social and Development

Commission Robe and quarterly and annual reports to Zone Finance and Economic Development and

Health Departments.

14 Sustainability and phase out strategy For the last26 years, the Catholic Church has already carried out a wide and admirable health service,

hosting and rehabilitative services to destitute and mentally affected people in the Bale Zone, Goba Town,

by a Nursing Home cared by Missionaries of Charity (Blessed Mother Teresa Sister’s).

The Catholic Church has world-wide experience in dealing with these delicate and demanding health

sectors and could provide international cooperation with Experts and Councillors.

For many years the Catholic Church has started several initiatives in Ethiopia in the field of Health, and can

rely upon several experts already operating in the country for physicians, technique and economic-

management.

To the scope of this Project the Catholic Church has already an international network of experts in both

neurology and psychiatry, involving Catholic and non-Catholic associations and part-time volunteers.

26

14.1 Responsibility for Project and Project property transfer on Project termination

The Speciality Centre shall carry out the activities listed on the project proposal according to the standard

and design of health service activities set by Ethiopian National and local Authorities.

The existing movable and fixed properties in the Speciality Centre are properties of the ECC SDCO Robe.

The church has disposed these properties to the Speciality Centre on as provisional basis. Basically the ECC

SDCO Robe wishes to continue the program on an on-going basis, but if ECC SDCO Robe desires to

terminate the Project on/or before the agreed time all movable and irremovable properties including the

buildings remain as the property of ECC SDCO Robe. However ECC SDCO Robe is responsible to handover to

the Government those materials and vehicles imported duty free.

15 ANNEX

The following details and brief data are included in the annex part of this document

Activity plan

Budget detailed breakdown plan

Human resource plan

Logical Framework

Documents

Ethiopian Catholic Church Social And Development