PROJECT PROPOSAL FOR THE ESTABLISHMENT

OF DIAGNOSTIC AND IMAGING CENTER

PROJECT TO BE IMPLEMENTED IN ADDIS ABABA
CITY .

PROMOTER: RUTH KEBADE AYANA

June, 2025

Addis Ababa,Ethiopia
Contents
I. Executive Summary .......................................................................................................... 3
1. Background............................................................................................................................. 4
2. Project Justification ................................................................. Error! Bookmark not defined.
3. Profile of proposed investment ................................................ Error! Bookmark not defined.
3.1 Project title............................................................................ Error! Bookmark not defined.
3.2 Project owner(s) .................................................................... Error! Bookmark not defined.
3.3 Project location .................................................................... Error! Bookmark not defined.
3.4 Project type ........................................................................... Error! Bookmark not defined.
4. Objectives of the project ....................................................................................................... 14
5. Services provided by the Diagnostic and imaging Center ...................................................... 15
5.1 Estimated annual service rendering of the project at full capacity .......................................... 2
6. Organization and Human Power .............................................................................................. 3
6.2 Organizational Structure (Governance) ................................................................................. 5
6.2.1 Board of Directors....................................................................................................... 5
6.2.2 Management committee .............................................................................................. 6
6.2.3 Chief Excutive Officer ................................................................................................ 6
6.2.4 Chief clinical director .................................................................................................. 7
6.3 Human Power ....................................................................................................................... 7
6.3.1 Professional ( Medical) ...................................................................................................... 7
6.3.1.1 Professionals (medical) staff at full capacity by type .............................................. 8
6.3.2 Administrative (support) staff at full potential .................................................................... 8
6.3.2.1 Administrative (support) staff at full potential by type ............................................. 8
7. Marketing Strategy and Promotion .......................................... Error! Bookmark not defined.
8. Utility requirements of the Diagnostic and imaging Center at full capacityError! Bookmark not
defined.
9. Total Initial Investment Cost ................................................... Error! Bookmark not defined.
9.1 Source of finance .................................................................. Error! Bookmark not defined.
10. Project implementation plan/ Action plan .............................. Error! Bookmark not defined.
10.1 Details of project activities and their date of completion ...... Error! Bookmark not defined.
11. Future Development .............................................................. Error! Bookmark not defined.
12. Environmental Impact and Mitigation strategies .................... Error! Bookmark not defined.
13. Physical Plant Standards ....................................................... Error! Bookmark not defined.
 I. Executive Summary

No Titles Description
1 Name of the Project Diagnostic and imaging Center
2 Project owners Ruth kebade Ayana

3 Nationality American Diaspora (USA)

4 Project location Addis Ababa City
5 Project services Provision of medical services

6 Total Plot area required 5000m2

7 Total Initial capital The total of birr 500,000,000is required.

From this 30% (birr 150,000,000) will be covered by the promoter of

the project, While the rest 70% (birr 350,000,000) `will be covered by
bank loan. Loan Repayment Period:- 5 years Interest Rate:- 9-12 %

The total manpower requirement for the plant will be 70 employees at

8 Total employment full capacity.
opportunity at full
 Permanent Workers 41
potential
 Skilled and Unskilled 41

 Temporary Worker 29

 Skilled and Unskilled 29

Provision of quality medical services, revenue source, employment

opportunity, technology and knowledge transfer , social services,
9 Project benefits for the medical tourism,
city Image of the city
 1.

Introduction

Ruth Kebade Ayana will be established Diagnostic And Imaging center is a privately owned

center that provides comprehensive reproductive (obstetrics and gynecology) and

child (pediatric) health service. The field of obstetrics and gynecology are the two
surgical–medical specialties dealing with the female reproductive organs in their
pregnant and non-pregnant state, respectively. The field is adept at the surgical and
medical management of the entire scope of clinical pathology involving female
reproductive organs, and to provide care for both pregnant and non-pregnant clients.
On the other hand, the field of pediatrics is to provide care for both healthy and sick
children including healthy life style promotion, disease prevention and curative care.
Reproductive health as defined by WHO is a state of complete physical, mental, and
social well-being and not merely the absence of disease or infirmity, in all matters
related to reproductive system and to its function and process. On same note, Sexual
health is defined as a state of physical, emotional, mental and social well-being in
relation to sexuality; it is not merely the absence of disease or infirmity.
Reproductive Rights embrace national and international human rights and basic right of
all couples. This include the right of the couples and individuals to decide freely &
responsibly the number, spacing and timing of their children and to have the
information and means to do so; have the right to attain the highest standard of sexual
and reproductive health care; and make decisions concerning reproduction free of
discrimination, coercion and violence.
The components of sexual and reproductive health had been redefined in Cairo
conference, 1994, and the term comprehensive reproductive health care encompasses
all service related to reproductive health areas shown in the figure below.
According to reports from WHO, there have been significant reductions in maternal and
new born mortality over the last two decades. Yet in 2018, still there were approximately
287 000 maternal deaths, 2.6 million stillbirths and neonatal deaths, resulting mostly from
complications during and following pregnancy and childbirth. Particularly in Central
Asia, Sub-Saharan Africa and Southern Asia, the rate of decline is still not enough to save
16 million lives by 2015 as set in the MDG goals.
Effective interventions to prevent and treat reproductive health problems including
maternal and perinatal complications are well known and include contraceptive use,
safe abortion/post-abortion care, skilled attendance during childbirth, and improved
access to emergency obstetric care. Most maternal and perinatal deaths are
preventable if life-saving preventive and therapeutic interventions are provided at the
right time (1).
However, there is huge unmet need in reproductive health service delivery in most
developing countries and Ethiopia is not an exceptional. This high unmet need, as per
the national health and health related indicator of 2012, can be exemplified by
maternal mortality rate of 681/100,000livebirth, gross fertility rate of 4.8, skilled birth
attendance rate of 32% and higher stage at first presentation in case of reproductive
organ cancer(2).
The public sector faces many constraints (e.g., growing and changing disease burdens,
lack of health personnel, and scarce financing) and must rely on participation from the
private sector to assist in health system capacity-building and improvement of health
outcomes. In addition to large scale expansion, the public sectors need to leverage the
private health sector to meet the progressively increasing demand for modern health
care. To this end, the government of Ethiopia created an enabling environment that
encourages private sector participation and had issued a guideline for governance of
private health service in the year 2012(3).

Ruth Kebade Diagnostic and imaging center is envisioned with this background
knowledge of the favorable national policy that encourages private investment in the
area to support the national stride to meet the unmet need in maternal and child health
services. The MCH center will focus on creating shared value that simultaneously
addresses both social and economic objectives through investment in the area. By
addressing all the components of reproductive health programs mentioned above and
running well and sick baby clinic, DOSHA MCH center will contribute to general health
and wellbeing of women of reproductive age, couples and children in the catchment
area and beyond. Ruth Kebede Diagnostic and imaging Center had been operational
for the last years in Addis ababa City Administration and served more than 50,000clients
and attended nearly 3000deliveries has respectful reputation

PROMOTER PRIOFILE

Ruth Kebade Ayana Diagnostic and imaging Centre is to be directed by senior

obstetrician and gynecologist and is established with both motive of doing social good
and wealth creation. The investments are not only financial, but also lifelong dedication,
knowledge and skill of the owners in provision, directing and coordinating public sector
functions both at national and international level. Likewise, the returns expected are
both improved access to quality maternal and child health service for the targeted
beneficiaries and wealth creation as outlined in the diagram below.
Adaptation of global best practice and modeling others by upholding the morale of
center of excellence is another drive for establishment of the MCH center. The long term
goal of the center is to rise to the level of model MCH center network that one can find
in almost every regional/zonal capital of Ethiopia. The establishment is purely private for
profit subject to all regulation that governs commercial entrepreneurs in health sectors.
Vision:
To be a center of excellence and choice in maternal and child health service delivery in
Ethiopia
Mission:
To provide safe, effective, evidence based and affordable maternal and child health
services that meet national standards and client’s expectation.
Promise
1. The utmost priority for us is client’s safety. We apply approaches and interventions
which are up-to-date, proven to be effective and acknowledged as best
practice.
2. We respect client’s informed choice as far as s/he is eligible, strive to meet and
exceed client’s expectations, and treat everyone with respect and dignity.
3. We shall be timely and make ourselves available for continuum and continuance
of care.
4. We shall be abided by clinical guidance provided by FMOH Ethiopia and shall
serve as praiseworthy unit for private-public partnership in health care delivery.
5. We acknowledge our remit and depend on referral care for those services which
are not in the limit of our skill sets or licensees.
Values
1. Trustworthiness, sincerity and integrity: we are truthful to our client and ourselves in
all what we are doing.
2. Excellence: we strive to offer the best possible clinical care that has the highest
probability of yielding the most desired outcome
3. Cleanliness and order: Tolerate no lack of cleanliness in clinical setting, clothing,
instrument and what we do. We do first thing first and shall be procedural and
protocol bound.
4. Up-to-date and knowledgeable: we benefit ourselves and our client by applying
up-to-date and accredited interventions.
5. Respectful of client’s informed choice and decisions: We provide our client with
information on all possible options and shall strive to respect their informed choice.
6. Impartiality and Justice: we treat our entire client as equal. We shall not submit to
injustice to/from anyone.
7. Resolution and Tranquility: Resolve to perform what you ought; perform without fail
what you resolve. Be not disturbed at trifles, or at accidents which are common or
unavoidable
8. Frugality: Make no expense but to do well to others or yourself
9. Industry: Lose no time; be always engaged in something useful; cut off all
unnecessary actions.
Service Package
1. Gynecological service
1.1. Outpatient level diagnostic and treatment service on gynecologic
conditions
1.2. Screening and ablative treatment for precancerous lesions of the cervix.
1.3. Training of individual client on self-examination of the breast for early
detection of breast lump
1.4. Minor gynecological procedure: cervical punch biopsy, endometrial biopsy,
cryo-therapy, marcipulization for Bartholin’s abscess, treatment for imperforate
hymen and other minor vaginal reconstructive surgery under local
anaesthesia.
 1.5. Major Gynaecologic operative care: Total Abdominal Hysterectomy,
Myomectomy, Salpingo-oophorectomy, vaginal hysterectomy and
anterior/posterior colporaphyfor pelvic organ prolapse, and other major
gynaecologic surgery.
1.6. Treatment of peri/postmenopausal symptoms
2. Obstetric care
2.1. Ante Natal Care (ANC) including PMTCT service
2.2. Care for other medical conditions complicating pregnancy
2.3. Delivery care: spontaneous vaginal delivery, assisted vaginal delivery,
caesarean section.
2.4. Inpatient/outpatient management of obstetric complications.
2.5. Post Natal Care (PNC),
2.6. Post abortion care
2.7. Comprehensive safe abortion care as far as permitted by law
2.8. Treatment and follow-up care for molar pregnancy.
2.9. Diagnosis and treatment of ectopic pregnancy
3. Family planning service,
3.1. Short acting methods(OCP, Injectable, Patches, male and female
Condoms)
3.2. Implant insertion and removal
3.3. IUD insertion and removal
3.4. Tubal ligation by Minilapartomy under local anaesthesia
3.5. Vasectomy under local anaesthesia
4. Infertility work up and treatment at site and at referral centre
5. Counseling and treatment on sexuality
5.1. Counseling and treatment on sexual dysfunction
5.2. Counseling, investigation and treatment of STI
5.3. Adolescent friendly reproductive health service
6. Paediatric care
6.1. Well baby clinic: growth monitoring, advise on breast feeding and healthy
dieting, immunization
 6.2. Sick baby clinic: outpatient and inpatient care
6.3. Immunization services: National EPI package, TT, HBV, and HPV
7. Service at Referral Hospital with which we shall have memorandum of
understanding for collaborative care.
7.1. ICU care
7.2. Treatment of gynaecologic cancers
7.3. Other service like paediatric surgery, medical, general surgical, dental,
psychiatric….care
8. Laboratory service
8.1. Haematology: Hgb, Blood group and RH, CBC, blood chemistry(Renal
function test, Liver function test, coagulation profile…) and serology
8.2. Wet mount and gram-stain of body fluids and discharge
8.3. Urinalysis: chemistry and microscopy
8.4. Stool examination: Microscopy
9. Imaging: ultrasound.
10. Pharmacy service: Level of hospital pharmacy as dispensary

2.1. Land Use Plan

The total land plot size requirement proposed for the project is 5000 m2. The overall building
construction area with its accessories requires around 3000 m2 and the remaining 2000 m2 will be
parking and green areas. A summary of the land use plan for the project is presented as follows:

Table 1: Proposed Land Use Plan

No. Description Size (m2) Remarks

1. Main building 2000 Health service
2. Administration building 1200 Administrative service
3. Utilities building 1600 General services
4. Other facilities 200 Others auxiliary
services
Total 5000

2.2. Market Prospect

Considering possible inclusion of necessary utilities for health services to avail for sale in
response to customers demand, certain main lists are only included for analysis purpose. The
residents of the Addis Ababa and its surroundings are considered as potential customers of for
the proposed services. The market volume of the expected customers pull is expected to expand
further as socio- economic interaction of project location with others is strengthened fromtime to
time.

The demand for health services in the area dynamically increased in the past few years. The reason
for this could be rapid economic growth and supporting public infrastructural developments.
Other factors relevant in the specific case of health services are the increase in businesses,
particularly firms in the industrial sector.

The major marketing strategies to promote the proposed health services are keeping the quality
of our services and facilities, consistently improving in adaptation to changing situations and
promotion in association with the demand from the local community and nearby businesses. In
other case, working on target customers, business community, nearby business organization like
banks and insurances companies, government and non-government organizations will be the
major marketing promotion strategy of the project.
3. Project Establishment
The financial resource is a prime resource for undertaking any activities. Therefore, for implementing this
“recreation building estimated it needs a total of Birr 500,000,000of which 30% (Birr 150,000,000) will be
covered by the promoter of the project whereas the rest 70% (Birr 350,000,000) will be covered by a loan from a
financial institution.

This project will be implemented using materials and services to be procured entirely from the domestic market in
local currency, except for some medical equipment. The fixed investment costs on building construction, medical
equipment and furniture are summarized in Table 3 below.

3.1. Project Buildings

The proposed project has been well-studied, analyzed and designed and expected to provide attractive health
services of its kind. When the construction phase of the project is completed, the building will consist of the
following units:
 Main building
o 3 consultation rooms
o 3 pre-consultation/investigation rooms
o 1 X-ray room
o 1 Laboratory
o 1 Patient journal archive room
o 1 Casher office
o 1 Patients’ waiting hall
o 1 Staff room with wardrobes and lockers
o 1 storage room
o 1 Toilet for employees (male/female separated)
o 1 Toilet for patients (male/female separated)
 Administration building
o 1 Administrator office
o 1 Secretary office
o 1 Finance officer office
o 1 Meeting room
o 1 Staff room with wardrobes and lockers
o 1 Toilet (male/female separated)
 Utilities building
o 1 Canteen with complete functionality
o 1 Toilet for canteen guests
o 1 Guards’ post
o 1 Septic tank
 Other facilities
o Green area
 o Parking area
The detailed specification of the dimensions of each building units will be worked out in consultation with
both building expert and health services expert.

3.2. Construction Process

The construction of the project buildings is a three stages development by which the conceptualization need of
the promoter of this project is translated into a functional facility that will meet the specifications in terms of
time, cost and quality.

Based on the construction idea and vision of the promoter, a qualified engineering firm is going to be hired to
make site studies, develop structural designs, prepare drawings and detailed specifications, determine
quantities involved and estimate the total cost. All these activities will be done in the first phase of the project,
which is design stage after the documents are produced by the designers have been received, and the works
secured the project is supposed to enter the tendering stage. At this stage contractors study the project
document analyze and subsequently determine the construction methods, build up their unit rates and submit
their bids and award the contract for the lowest responsible bidder. After the award is made and the contract
signed between the project owner and the contractor, the project contractor is expected to prepare and submits
a detailed construction schedule which includes material and manpower requirements and cash flow forecast.

The project owner researched typical architectural layouts for laboratory and executive office spaces. The
structural design of the building will be coordinated with the layout of the building. The frame will made up of
a grid with repeating standard structural bays included in the structural system are by size, shape and size of
structural members, floor compositions and curtain walls.

These elements will be established to resist gravity and lateral loads as appropriate. The structural steel frame
was chosen for further design based on cost per square foot, local availability of material and constructability
considerations, such as erection and fabrication. Foundation of the design takes more into consideration the
applied loads, the loading from the columns, while the main part of the project focused on the structural frame
and its alternate designs, preliminary foundation plan was designed based up on maximum loads carried from
the supper structure through the columns.

Establishment Phase

It is expected that project will be operational 3 years after signing agreement with the licensing authority.
The major activities after completion of the license acquiring process are the following:

1. Site preparation
2. Specify/design buildings
3. Construct buildings
 4. Purchase medical equip.
5. Purchase furniture
6. Recruiting manpower
7. Mobilization
8. Start operation
Vision: To see Diagnostic and imaging Center as one of the leading private Diagnostic and imaging Center in the
East region in 2030.
Mission:
Improving the health and well-being of individuals, families and our community through innovation and pursuit of
excellence.
 To be a provider of high quality patient-focused health care that is readily accessible, cost effective and meets
the needs of the communities we serve.

Values

Service: We provide every patient with proper service in an environment that is both responsive and healing.

Respect: We promise to honor the dignity, individuality and rights of everyone, and to pay particular attention to
patients' rights to privacy, confidentiality and information.

Quality: We strive to exceed the expectations of all of our customers by committing to deliver quality and value in
every aspect of our work.

 Trust: Honest and open communication with patients and among staff.
 Innovation: We are committed to a supportive environment that encourages new ideas and creativity.
Objectives of the project
To participate in the private health sector by taking the advantage the conducive and supportive investment policy
of the government.
To create access to quality medical service to the population
To generate revenue for the government.
To create more than 90 permanent job opportunities during the full operation of the project.
 Expansion of medical tourism
 Economic benefit for the smallholder up to Medium level business sector
 Technology transfer
 Building image of the city
 Social and economic vitality (spend on goods and services )
  To play a role for the achievement of the government health policy vision which is “To see healthy, productive
and prosperous Ethiopians”

5. Services provided by the Diagnostic and imaging Center

 Out patient
 In Patient
 Maternal and child care and delivery
 Nursing
 Surgical
 Emergency
 Anesthesia
 Rehabilitation services
 Radiology services
 Medical Laboratory
 Pharmaceutical
 Ambulance
 Infection Prevention
 Medical Recording
 Food and Dietary Services
 Sanitation and Waste Management
 Housekeeping, Laundry and Maintenance Services
 Social Work Services
 Morgue Services ( according to patient religion and culture )

Moreover, providing information, education and communication (IEC) and behavioral change communication
(BCC) service to the general population on major public health intervention areas such as the following:
 Environmental health
 Nutrition
 Family planning, MCH and immunization
 STI and HIV diseases
 TB, leprosy, malaria, etc.
 Chronic diseases (Hypertension, diabetics, mental, etc)
 Substance abuse (alcohol, tobacco, etc)
 Prevention and control of out-breaks and epidemics
 Medication use
 Department 2014/15.

3.1.1. Health

An employment opportunity is created by the health sector in the Addis ababa City is
identified as one factor that increases the demand of transport. In the year 2014/2015 there is
1 government hospital and 2 private hospitals. There are also 6 health centers and 110 private
owned clinics. The following table shows the number of health professional in the city that
has increased the number of urban dwellers, there by the demand of urban transport.
 Table 10 Health Information.

Cate Nu Number of Health Workers

gory mb
Exten Mid Hea Labora Phar Supp
er
sion wifer lth tory mac ortive
y y
Nurse Off Techni Staff
s icer cians
s
Healt 6 93 28 26 39 29 50
h
Cent
er
Source: Addis ababa City Health Department, 2014/15.

Table 11 Health Workers and Professionals.

Category N Number of Health Workers and Professionals

u Medical N Mid He Laborat Phar Radiogr
ur wifer alt ory macy aphy
mDoctors
se y h
Techni
b s
off cians
ice
rs
e
r
s
Governmen 1 165 1 20 4 18 18 -
0
t Hospital
8
Private 2 27 8 9 8 20 9 8
0
owned
Hospitals
Source: Addis ababa city Hospital, Addis ababa General Private Hospital

Infrastructure of the area is well developed (Road, Electric power, at the area and banking,
insurance, health facilities, education, etc at the town of Addis ababa). Some of the reasons
behind selecting the area are:-
 Proximity to the major potential market for the out put
 Availability of relatively raw material and infrastructure facilities such as

 Transportation networks which connect it to Addis Ababa and all the regional parts of the
country.
 Public utilities such as electricity, telecommunication, services, financial institutions, and
other social infrastructures such as schools, hotel, health centers and the like.
 Availability of skilled and semi-skilled man power,
 Prospective of future development.

THE ALLOTMENT OF THE PRIMES IS PRESENTED AS FOLLOWS.

No Description Land Requirement M2

1 General Medical Service Room 900

2 Minor Surgical Service Room 100

3 Nursing Service Room 100

4 Emergency Service Room 100

5 Delivery and MCH Service Room 100

6 Laboratory Service Room 100

7 Pharmaceutical Service Room 50

8 Patient Flow Room 250

9 Health Promotion Service Room 100

10 Medical Recording Room 150

11 Morgue Service Room 500

12 Infection Prevention Room 100

13 Sanitation and Wasted Management 100

14 Housekeeping ,Launder and Maintenance Service 100

15 Cafeteria and/or Break room(TV and other Recreation

equipment) 50
 16 Green area and Parking 100

17 Library 50

18 Adequate toilet and Shower facilities 50

Total 2000

5.1 Estimated annual service rendering of the project at full capacity

No Type of service Unit Quantity Remark

1 Out patient No 28800
2 Surgical No 2200
3 Maternal and child care and No 2160
delivery

5 Emergency No 2160
6 Ambulance No 2520
7 Laboratory No 32400
Total 70180

1.4
PART THREE

3. MARKET STUDY AND SERVICE CAPACITY

3.1. MARKET STUDY
 Present and Projected Demand
Health service provision is one the most priority service areas for the population. At present,
health service providers in Addis Ababa are Federal Government Agencies, Addis Ababa Health
Bureau, Non-Governmental Organizations (NGOs), factories, and the private entrepreneurs. The
number of registered and licensed health facilities by the City Administration in 2004/05 is 603.
The distribution of health facilities by their type is shown in Table
 Number of Health Facilities in Addis Ababa City by Types of Ownership (2004/2005)

Number of Health Facilities

Ownership Type
Diagnostic Health Clinic Health Total
and Center Post
imaging
Center
Addis Ababa Health Bureau 5 23 9 34 71
Ministry of Health 4 0 0 0 4
Addis Ababa University 1 0 0 0 1
Ministry of Defense 2 0 0 0 2
Police Force 1 0 0 0 1
Total Government 13 23 9 34 79
% Share Government 46.43 88.46 1.76 80.95 13.10
NGO 2 2 29 8 41
% Share NGO 7.14 7.69 5.72 19.05 6.80
Factories 0 0 102 0 102
% Share Factory 0 0 20.02 0 16.92
Private sector 13 1 376 0 390
% Share Private 46.43 3.85 74.16 0 64.68
Total 28 26 507 42 603
Source: Some Health Service Information, Addis Ababa Bureau of Health,
2004/05(Unpublished).

3.3 ORGANIZATION CHART

Medical Director
 Administration and Finance

Administration and
General service
Finance Department department

Doctor
(Maternity and General Service
Pediatrics Assistance
Clerk Customer
pecialty )

Driver
Lab technician

Organization and Human Power

6.2 Organizational Structure (Governance)

6.2.1 Board of Directors

6.2.1.1 Duties and responsibilities of the Board:

 Formulate all policies and guidelines to be used in the Diagnostic and imaging Center;
 Maintaining the primary Diagnostic and imaging Center’s compliance with all applicable
laws, its policies, procedures and plans of correction;
  Systems are in place for ensuring the quality of all services, care and treatment provided
to patients;
 Designating and defining duties and responsibilities of the CEO;
 Notifying the appropriate organ in writing within thirty (30) working days when a
vacancy in the CEO position occurs, including who will be responsible for the position
until another person is appointed;
 Notifying the appropriate organ in writing within thirty (30) working days when the CEO
vacancy is filled indicating effective date of the appointment and name of person
appointed;
 At least once a year, reviewing the medical care provided and the utilization of the
Diagnostic and imaging Center resources;
 Establishing a means for effective communication and coordination among the CEO, the
medical staff and the various Diagnostic and imaging Center departments; and
 Minutes of the Board Meeting shall be recorded, signed, and retained in the Diagnostic
and imaging Center as a
Permanent record.
 The CEO shall be the secretary and non-voting members of the Board.

6.2.2 Management committee

Ruth Kebade Ayana

Consists of heads of the medical and administrative departments.

The CEO shall be the chairperson of the Committee.

 The Committee shall be an adviser of the CEO on the day to day management of the
Diagnostic and imaging Center.
 The Committee shall meet upon regular basis. The minutes of the meeting shall be
recorded and available to the appropriate organ upon request.

6.2.3 Chief Executive Officer

Ruth Kebeda
6.2.3.1 Duties and responsibilities
The CEO shall be responsible for planning, organizing, and directing and controlling the day to
day operation of the Diagnostic and imaging Center. The CEO shall report and be directly
responsible to the Board in all matters related to the maintenance, operation, and management of
the Diagnostic and imaging Center.
The CEO shall be responsible for the operation of the Diagnostic and imaging Center twenty-
four (24) hours per day, seven (7) days per week.
 Providing protection of patients’ health, safety, and well- being;
 Maintaining staff appropriate to meet patient needs;
 Developing and implementing procedures on collecting and reporting information on
abuse, neglect and exploitation;
 Ensuring that investigations of suspected abuse, neglect or exploitation are completed and
 that steps are taken to protect patients; and
 Ensuring appropriate response to reports from the appropriate organ;

6.2.4 Chief clinical director

6.2.4.1 Duties and responsibilities

 Facilitating communication among the medical staff members and with the Diagnostic
and imaging Center;
 Implementing the Diagnostic and imaging Center and medical staff policies and
procedures;
 Recommending the appointments to the medical staff and scope of clinical privileges;
 Ensuring the provision of continuing medical education;
 Taking other necessary actions necessary to govern the medical staff and relate to the
Diagnostic and imaging Center board.

6.3 Human Power

6.3.1 Professional ( Medical)

Description Permanent Temporary Total
Local 51 51
Expatriate
Total 51 51
6.3.1.1 Professionals (medical) staff at full capacity by type
No
Professionals Number at full capacity
1 CEO 1
2 MD ( liscenced) 1
3 Medical doctors 3
4 Emergency surgical officer 1
5 Health Officers 2
6 Nurses ( Bsc) 5
7 Mid Wives 4
8 Nurses ( Diploma) 20
9 BSc anesthetist/nurse anesthetists 2
10 Ophthalmic nurse 1
11 Psychiatric Nurse 1
12 Dental professional 1
13 Radiology professional 1
14 Radiographer 1
15 Physiotherapist 1
16 Laboratory technologists 4
17 Laboratory technicians 2
18 Pharmacist 4
19 Pharmacy technician (Druggist) 2
20 Environmental Health 1
21 Health Information 1

6.3.2 Administrative (support) staff at full potential

Description Permanent Temporary Total
Local 40 40
Expatriate
Total 40 40

6.3.2.1 Administrative (support) staff at full potential by type

No Type of administration staff Number
1 Cleaners 15
2 Reception/Archive 8
3 Maintenance personnel (plumbing, electricity, 3
general maintenance services)
4 Bio-Medical Engineer 1
5 Food and dietary 10
6 Morgue attendant 1
7 Social worker 1
8 Compliant handling officer 1
Medical equipment and supplies
The MCH center will be equipped with all the medical equipment needed to
deliver the proposed service package. The table below summarizes the major
equipment and furniture that shall be made available at the MCH
Centre.
Sr. Equipment/furniture Number
No
1 Reception and waiting area
 TV with CD player 1 each
 Shelf’s of different size Built in
 Safe box 1
 Chairs for clients and attendants at waiting 30
area
2 Triage
 Round table with three chairs for consultation 1set

 BP apparatus, thermometer, weighting scale, 1 each

timer
3 Gynaecologic examination room
 Round table with three chairs for consultation 1set
 Gynaecologic examination coach 1
 BP apparatus, stethoscope, thermometer, 1 each
weighting scale, timer, Doppler foetal
stethoscope
 Swayne-neck examination light 1
 Colposcopy set with all accessories 1 set
 Speculum of different size 20
  Consumables: Aries spatula, slides with slide Packs
cover, gloves, towels, gauze, cotton swabs,
disinfectant, facility for hand washing…etc.
4 Paediatric examination room setting
 Round table with three chairs for consultation i. t
 Examination coach 1
 BP apparatus, stethoscope, thermometer, 1 each
weighting scale, timer
 Examination sets for ear, nose and throat 1 set
 Consumables: Spatula, towels, gauze, cotton Packs
swabs, disinfectant, facility for hand
washing…etc
5 Ultrasound room
 Examination coach 1
 Swivel chair/stool 1
 Ultrasound with all accessories and probe of 1 set
different size
 Consumables: drapes, jelly, … Packs.
 Desktops with printer for reporting
6 Procedure room
 Gynaecologic bed with accessories 1
 Operation lamps 1
 Swivel chair/stool 3
 Recliners 3
 Storage shelves Built-in
 Punch biopsy set 5
 Cryo-therapy set 5
 IUD insertion sets 10
  Implant insertion and removal sets 10
 Mini-laparotomy sets 5
 Vasectomy sets 5
 Circumcision sets 5
 MVE sets(MVA syringe, cannula of different 20
size, speculum, 2 sponge forceps, tenaculum,
bowl, os finder)
 D/E sets 5
 Minor surgical sets 5
 Emergency back-up: Oxygen cylinder, face package
mask, oral air way and emergency drugs as
per the national list
 Washing facility and work-tops for instrument Built-in
processing
 Steam sterilizer 1
 Consumables: drapes, gloves, disinfectant In pack
and antiseptics, sutures, gauzes, cotton swabs,
local anaesthetic drugs, needle and syringes,
PO and injectable analgesics, IV fluids with
give sets and cannula…
7 Delivery room, first stage
 Beds 3
 Doppler foetal stethoscope 1
 Tocho-cardiograph 3
 Oxygen supply system 1
 Work-tops for recording the progress Built in
 Screen 2
 BP apparatus, stethoscope, thermometer, 3 each
 timer
 Consumables: Glove, swabs, antiseptics and Packs/bottles
disinfectants.
8 Delivery room, second stage
 Delivery Beds with IV stand and receptacle 2
 Bed for neonate with heat source 2
 Doppler foetal stethoscope 3
 Oxygen supply system 1set
 Work-tops for recording Built in
 Screen 2
 BP apparatus, stethoscope, thermometer, 3 each
timer
 Delivery and Episiotomy sets 6
 Vacuum extractor 2 unit
 Outlet forceps 3
 Pick-up forceps with jars 3
 Set-up for neonatal resuscitation: hard
worktop, airway, suction, heater…
 Consumables: Gloves, swabs, drapes of Packs/bottles
different size, sutures, cannulas, needle and
syringes, antiseptics and disinfectants….
 Drugs: Magnesium sulphate, hydralazine, Depending on
diazepam, oxytocin, ergometrine, misoprostol, client load
analgesics, IV fluids/crystalloid, contraceptive with sufficient
commodities… buffer stock.
 Washing facility and work-tops for instrument Built-in
processing
 Steam sterilizer 1
9 Major Operation theatre
 Major operation bed with its accessories 1
 Anaesthesia machine with accessories like 2
echocardiography, pulse oxymetry, oxygen
concentrator and oxygen delivery system …
 Electro-cautery sets 2
 Laparoscopy sets with all the accessories 2
 Operation lamp: standing and ceiling 1 each
 Back-up light 2
 Caesarean section sets 5
 Major Laparotomy sets 5
 Hysterectomy sets 5
 Supplement like: Graves speculum, Mayoma 2
screw, abdomen retractors of different size
and shape,
 Consumables: Gloves, swabs, drapes of
different size, sutures, cannulas, needle and
syringes, antiseptics and disinfectants….
 Drugs: Magnesium sulphate, hydralazine,
diazepam, oxytocin, ergometrine, misoprostol,
analgesics, IV fluids/crystalloid, local and
general anaesthetic drugs, reversals,
tranquilizers …
 Washing facility and work-tops for instrument
processing
 Steam steriliser, big 1
10 Laboratory
 Microscope 1
  Photometry 1
 Centrifuges 1
 Hemo-analayzer 1
 Others, as per the national requirement
 Consumable: reagents, dipsticks, gloves, Based on
disinfectants, antiseptics, needle and syringes, client load
gauze
11 Inpatient unit
 Inpatient beds with IV Stands, side cupboard, 16
chairs
 Closets Built-in
 WC per room 1 per room
 BP apparatus, stethoscope, thermometer, 5 sets
weighting scale, timer, ward level
consumables and drugs, worktops, shelves
and cupboard at nurse’s station
 Doctors duty station with bookshelf, chair and sets
reading table, PC for internet facility, WC and
bed
 Staff café: chairs and tables, wash basin,
refrigerator, teakettle and coffee maker,
microwave, cups, plates, knives, forks and
spoon, cupboard.
12 Pharmacy
 Counter, cupboards, shelves… Built-in
 Drugs as permitted by the national drug list ….
 Tablet counter 2
 Weight and height scale 1
  Bench 1

13 General
 Infection prevention set-up in each room ----
destined for service(Buckets for medical
waste, general waste, tissue and sharp
disposal)
 Wash machine with dryer 2
 Incinerator and Placental pit Built-up within
compound
 Emergency kits with essential drugs and 2
oxygen delivery system
 Refrigerators(pharmacy, labour, nurse station, 6
Laboratory, EPI, staff café)
 Computer with local area network for 6
recording and reporting per-unit
From equipment’s / furniture’s/ listed in the table above, the table below
summarizes the most essential that need to be fulfilled to materialize start-up of
MCH service function.
No. Description of Qty Unit Price Total price
Equipment/Furniture (Birr) (Birr)

1 Instrument trolley 3shelves 4pcs 1,910.00 7,640.00

2 Examination bed 1pcs 2,780.00 2,780.00
3 Delivery bed 3pcs 3,080.00 9,240.00
4 Stretcher 2pcs 2,960.00 5,920.00
5 Stool chair 7pcs 1,670.00 1670
 6 Special patient bed 20pcs 5,440.00 108,800.00
7 Bed side cabinet 10pcs 2,120.00 21,200.00
8 Linen trolley 3pcs 1,940.00 5,820.00
9 Bed side cabinet with 10pcs 2,730.00 27,300.00
mayo stable
10 Guest chair 4 seat 4cs 2,910.00 11,640.00
11 Guest chair 3 seat 3pcs 2,540.00 7,620.00
12 Delivery bed big 2pcs 4,240.00 8,480.00
13 Baby crib 6pcs 1,930.00 11,580.00
14 Bed side steps/ladder 5pcs 720 3,600.00
15 Mattress for patient 20pcs 1,480.00 29,600.00
16 Mattress for baby crib 6pcs 610 3,660.00
17 Autoclave Electrical (s.s) 1pcs 28,416.30 28,416.00
60 LTR
18 Centrifuge Electrical 12 1pcs 2,175.00 2,175.00
hole
19 Delivery set 5pcs 1,350.00 6,750.00
20 Dressing set 5pcs 1,250.00 6,250.00
21 Examination light goose 4pcs 2,000.00 8,000.00
type
22 Examination table 1pcs 7,185.00 7185
23 Hospital bed (ward bed) 20pcs 7,185.00 143,706.00
24 Infant (baby) Warmer 1pcs 49,500.00 49,500.00
26 Vacuum extraction 1pcs 7,450.00 7,450.00
electrical
27 Delivery bed 2pcs 13,500.00 27,000.00
29 Human count 30 TS 1pcs 175,000.00 175,000.00
automated Hematology
system with 3-part
differential of WBC
30 Humalyzer 3000-semi 1pcs 115,000.00 115,000.00
automated clinical
chemistry analyzer
31 Humascope light LED 1pcs 12,760.00 12,760.00
34 Humaclot Junior 1pcs 40,000.00 40,000.00
35 Full digital B/W Portable 1pcs 150,000.00 150,000.00
Ultrasound system Model-
UF_400AX
36 Electrosurgical unit its 1pcs 104,675.00 104,675.00
standard accessories
38 DP 50 digital ultrasound 1pcs 220,000.00 220,000.00
with two probe & printer
39 BC 3000 plus Hematology 1pcs 165,000.00 165,000.00
analyzer
40 BA 88A semi-Auto 1pcs 56,000.00 56,000.00
chemistry analyzer
42 Delivery (obstetol) bed 2pcs 24,600.00 49,200.00
43 Operation light ceiling 1pcs 71,000.00 71,000.00
type 7 reflector
46 Operation table 1pcs 56,000.00 56,000.00
47 Wheel chair chrome 1pcs 4,311.00 4,311.00
plated
48 Instrument trolley 6pcs 5,800.00 34,800.00
49 Patient stretcher with 1pcs 6,500.00 6,500.00
 trolley

50 Vacuum extractor 1pcs 8,500.00 8,500.00

electrical st.st.cup
51 Ward screen four fold 5pcs 2,950.00 14,750.00
53 Anaesthesia machine 1pcs 375,875.00 375,875.00
Total cost 2,212,353.00

Contingency (15%) 331,852.00

Grand Total 2,544,205.00
 4. FINANCIAL REQUIREMENT
The financial resource is a prime thing for undertaking any business activity. Thus, in order
to implement this Diagnostic and imaging centre” Project, a total of 500,400,000.00
Ethiopian Birr initial investment capital is required. Out of which, 30% (150,000,000.00 Birr)
will be covered by the Public (Government) whereas, the remaining 70% (350,000,000.00 Birr) will
be covered by the promoter.

Table 10: Summary of Initial Investment Costs

S. No. Description Costs (Birr)
Fixed Investment
Land Lease Cost (10%) 27,972,945.00
Building, Construction & Civil Works 189,068,000.00
1) Tools, Equipment & Furniture 9,145,500.00
2) Vehicles 6,800,000.00
3) Transformer & Generator 2,000,000.00
Sub-total 381,780,000.00
4) Working Capital 63,620,000.00
5) Pre-operating Expenses
Feasibility Study & 3D Picture (Architectural Design) 72,500.00
Man Power Training 20,000.00
Licensing Fee & Others 3,000.00
Sub-total 95,500.00
Grand Total 500,000,000.00

4.2 GENERAL BUILDING AND CONSTRUCTION

A) REQUIRED MEDICAL EQUIPMENT AND COST

Unit of Cost (Birr)

Sr. No. Description Qty.
Measure LC TC
1 Sphygmomanometer Pcs 12 45,000 540,000
2 Clinical thermometers (assorted) Set 6 30,000 180,000
3 Diagnostic set Set 24 45,000 1,080,000
4 Scale infant Pcs 24 4,500 108,000
5 Scale adult Pcs 24 5,400 129,600
6 Examination bed Pcs 36 5,400 194,400
7 Special center bed Pcs 120 67,500 8,100,000
8 Infusion stand Pcs 30 6,750 202,500
9 Instruments sterilizer Pcs 12 22,500 270,000
10 Refrigerator Pcs 12 13,500 162,000
11 Stethoscope Pcs 12 13,500 162,000
12 Centrifuge Pcs 24 9,000 216,000
13 Lab. Bench Pcs 12 20000 240,000
14 Glass ware (assorted) Set 24 6,300 151,200
15 Timer Pcs 12 6900 82,800
16 Photometer Pcs 9 9,000 81,000
17 Hemoglobin pipette Set 12 2700 32,400
18 WBC pipette Set 12 2700 32,400
Hemocytometer with its cover
19 Pcs 6 13,500 81,000
slide
20 Test tubes (assorted) Set 12 2700 32,400
21 Measuring pipettes (assorted) Set 12 900 10,800
22 Electrical boiler Pcs 4 225,000 900,000
23 Delivery table Pcs 6 2700 16,200
24 Foetal monitor Pcs 6 135,000 810,000
25 Vacuum extractor/retoscope Pcs 6 6,750 40,500
26 Aspirator/manual Pcs 12 900 10,800
27 Breast pump Pcs 12 6,300 75,600
28 Suction unit Pcs 6 2250 13,500
29 Light portable/mobile Pcs 12 450 5,400
30 Auxiliary operating light Pcs 12 4,500 54,000
31 minor operating set Set 5 81,000 405,000
32 Autoclave Pcs 8 45,000 360,000
33 Delivery kit Set 12 1350 16,200
34 Stethoscope (baby) Pcs 12 9,000 108,000
35 Oto-opthalmoscope Pcs 12 27,000 324,000
36 Hand reflector Pcs 12 1350 16,200
37 Respiration bag adult Pcs 24 2700 64,800
38 Respiration bag babies Pcs 20 8,900 178,000
39 Oxygen cylinder 20 lts Pcs 12 12,000 144,000
40 Tourniquet Pcs 6 15000 90,000
41 Forceps assorted Pcs 12 2700 32,400
42 Enema set Set 12 13,500 162,000
43 Pediatric surgical kit Set 12 31,500 378,000
Sphygmomanometer (pediatric,
44 Pcs 6 13,950 83,700
various)
45 X-ray machine Pcs 3 540,000 1,620,000
46 Fluoroscopy Pcs 5 180,000 900,000
 47 Viewers Set 6 11,250 67,500
Cassettes intensifying screens,
48 Set 6 22,500 135,000
film
49 Hanger (different types) Set 6 5000 30,000
Grand Total 555,000 4,220,953

4.5 OFFICE EQUIPMENTS

No Description Measure Qty Unit Total

price Price

1 Chairs No 17 4000 68000

2 Tables “ 16 2500 40000

3 Computers “ 4 30000 120000

4 Printers “ 4 20000 80000

5 Computer table “ 4 1500 6000

6 Managerial chair “ 4 15,000 60000

7 Filing Cabinet “ 4 3000 12000

8 Managerial Table “ 4 6000 24000

9 Shelve “ 20 4000 80000

10 Master patient index boxes “ 10 2500 25000

11 Master patient index (MPI) Card “ 15 2500 37500

12 Patient Folder “ 1000 150 150000

13 Log book “ 1000 150 150000

14 Fire Extinguisher “ 1000 130 130000

15 Decoration “ 5500

Total 988,000

4.3 VEHICLES AND MOTORS

No Description Meas. Qty Unit cost Total cost

1 Ambulance 1 700,500 700,500

3 Toyota pick up 1 900,235 900,235

Total 1,600,735

INITIAL WORKING CAPITAL ESTIMATION OF THE PROJECT

The initial working capital is estimated to be birr 4,470,000

A. RAW MATERIAL PURCHASE AND INPUT

The medical supplies required by Diagnostic and imaging Center and corresponding costs are
indicated in Table below.

Sr. Description Qty. Cost ‘

Birr

FC LC TC

1 Adrenaline injection 45 50,000 30,000 2,280,000

2 Minophyllioc injection 30 39,250 16,900 1,194,400

3 Savlon (chlorhexidene + Cotrimide) 27 45,650 29,625 1,262,175

4 Alcohol solution 79% 20 17.313 4,938 5,284

5 Dextrose 40% injection 15 6000 2,900 92,900

6 Ergometrine maleate injection tabs 30 40750 25,950 1,248,450

7 Hydrocortisone sodium succinate 15 8,000 6,500 126,500

8 Lidocaine hydrochloride injection 15 7,688 7,063 122,383

9 Procaine hydrochloride injection 25 17,000 8,000 433,000

10 Vitamin k injection 20 25,000 14,000 514,000

11 Hyoscine hydropromide injection 45 14,550 8,050 662,800

12 Bandage different sizes 45 50,120 35,080 2,290,480

13 Cotton 45 - 26,000 30,000

14 Disposable syringes different types 26 25,550 50,000 714,300

15 Disposable needle different types 26 15,350 26,900 426,000

Grand Total 5,400,000

4.7 SALARY EXPENSE MANPOWER REQUIREMENT AND LABOUR COST

As indicated in part 4.1 (manpower) of this study, the total cost of salary and wages is estimated
to be Br.11, 501,306.00

4.8 OTHER OPERATING EXPENSES

N Description Monthly consumption Annual Remark
o Consumption

(in birr)

1 Electricity 8000 00 96000 00

2 Telephone 4000 00 48000 00

3 Water 2000 00 24000 00

4 Fuel 25000 00 300000 00

5 Detergents 2000 00 24000 00

6 Stationeries 2500 00 30000 00

7 Repair and maintenance 50000 00 600000 00 Machineries

9 Miscellaneous expenses 5000 00 60000 00

10 Resaved 1,800,00

Total 98,500 00 2,945,701

4.9 PRE- SERVICE EXPENSES

No Description Cost Remark

1 Project proposal and EIA 40,000 00

2 Licensing and others 50,000 00 Transport , and other costs

3 Advertising 764,000

Total 874,000 00

5.3.FINANCIAL ANALYSIS AND STATEMENTS

5.3.1. Underlying Assumption

The financial analysis of the envisioned Diagnostic and imaging Center is based on the data
provided in the preceding sections and the following assumptions.

A. Construction and Finance

 Construction Period ……………………………………………………….…24 Months

 Source of finance………………………………………………30% equity and 70% loan
  Bank interest rate ……………………………………………………………………10 %
 Tax holidays ……………………………………………………………………2 years
 Operating costs increase by…………………………………………………………2%
 Operating costs and raw material increased by……………………………………5%
 Utilities and operation expense …………………increase 3% per annum after 2ndyear
 Wages and Salary increase……………………Increase 3% Per annum after 2 nd year
 Sales …………………………………………..increase by 5 % per annum after 2nd year

B. Depreciation
 Building…………………………………………………………………………….5%
 Machinery and Equipment ………………………………………………………..10%
 Office Furniture……………………………………………………………………10%
 Vehicles ………………………………………………………………………..…..20%
C. Working Capital
 Accounts Receivable…………………………………………………………….30 days
 Raw material Local …………………………………………………………..…..30 days
 Work in progress…………………………………………………………………5 days
 Finished Production ……………………………………………………………..30 days
 Cash in hand ……………………………………………………………………...5 days
 Accounts payable …………………………………………………………….…..30 days

5.3.2. Source of Fund

SN Description % share Amount(in birr)
1 Owners Share 30 150,000,000
2 Bank Loan 70 350,000,000
Total 100 350,000,000

5.3.3. Loan Repayment Schedule

Year Principal Payment Interest (10%) Total Annual Payment Remaining Balance
0 0 0 0 350,000,000
 1 35,000,000 35,000,000 10,640,000 47,880,000
2 35,000,000 4,788,000 10,108,000 42,560,000
3 35,000,000 4,256,000 9,576,000 37,240,000
4 35,000,000 3,724,000 9,044,000 31,920,000
5 35,000,000 3,192,000 8,512,000 26,600,000
6 35,000,000 2,660,000 7,980,000 21,280,000
7 35,000,000 2,128,000 7,448,000 15,960,000
8 35,000,000 1,596,000 6,916,000 10,640,000
9 35,000,000 1,064,000 6,384,000 35,000,000
10 35,000,000 532,000 5,852,000 0

Table 3: Summary of Initial Investment Costs

No. Description Amount

1. Total construction costs 6,000,000
2. Medical equipment 3,500,000
3. Office furniture 2,500,000
4. Initial operation capital 1,500,000
Total 14,500,000

4.2.1. Balance Sheet (Beginning)

Asset
Current Asset Value in Br
Cash 10,0102,767

Inventory of raw material and input 11,400,000

Total Current Asset 10,010,200

Fixed Asset
Land, Building and Construction 6,435,528

Machineries and Equipment 9,220,953

 Office Equipment 988,000

Other equipment 777,178

Vehicles 4,256,575

Total Fixed Asset 12,010,200

Total Asset 350,000,000
Liability
Account Payable 350,000,000
Owner Equity
Capital 150,000,000
Total Liability and Owners Equity 350,000,000

INCOME LOSS STATEMENT

Revenue Year 1 Year 2 Year 3-10

Sales 73,350,000 81,450,000 90,500,000
Sales expenses (5%)* 410,025,000
Purchase of Raw Material 15,000,000 15,000,000 15,000,000
Gross profit 58,350,000 66,450,000 75,500,000
Expenses
Salary Expense 15,133,298 15,133,298 15,133,298
Operating Expenses 3,875,922 3,875,922 3,875,922
Pre-operating Expense 1,151,000 1,151,000 1,151,000
Total Deprecation 4,860,509 4,860,509 4,860,509
Interest Expense 7,000,000 6,300,000 5,600,000
Total Expense 32,020,729 31,320,729 30,620,729
Profit Before Tax 226,329,271 305,129,271 344,879,271
Tax(30% ) 67,898,781 91,538,781 103,463,781
Net Profit 158,430,489.70 213,590,489.70 241,415,489.70

*sales expenses not include all costs pertinent to sales that include: promotional costs, transportation of
products, commissions and other sales discounts.

5.3.7 CASH FLOW STATEMENT

Year Year 0 Year 1 Year 2 Year 3-10

Equity Capital 4,000,000

Loan principal 10,102,000

Net sale 35,350,000 51,450,000 90,500,000 110,025,000

Total cash in flow 273,350,000 351,450,000 390,500,000 410,025,000
cash payment
Purchase of raw materials 0 15,000,000 15,000,000 15,000,000

Salary expense 0 15,133,298 15,133,298 15,133,298

Investment 350,000,000 0 0 0

Operating cost 0 3,875,922 3,875,922 3,875,922

loan repayment 0 7,000,000 7,000,000 7,000,000

Lease payment 0 702,000 702,000 702,000

Tax payment 0 210,600 210,600 210,600
Total payment 41,000,000 11,788,522 11,788,522 11,788,522
Cash surplus / Deficit 0 5,793,323.33 7,990,254.63 13,952,278

Cumulative Balance 0 5,793,323.33 13,783,577.96 27,735,855.96

Return to equity 0 5,793,323.33 7,990,254.63 13,952,278

5.4 PAYBACK PERIOD OF THE PROJECT

As clearly the cash flow statement shows the promoter of the project has sufficient
amount of money that enable him pay the bank loan and invests in other service of
his interest.

When we come to the payback of this project, it will cover its initial investment cost
within few years of subsequent operation.

5.5 ENVIRONMENTAL IMPACT OF THE PROJECT

 Currently the issue of environment and envelopment get due emphasis and thus
every citizen called exert their maximum effort for fighting against any negative
impacts on the environment so as to result in a win-win solution on common agenda
that is creating environmentally friendly business environment. Most of project
environmental management activities will be carried out during the operation phase,
since this is when long term significant impacts (including environmental pollution
and human health hazard) can be expected to arise.

The objective of the environmental management program at this phase of the project
are: protection of the environment from debris and other pollutants, protection of
workers from work area health hazard, efficient use of ground water sources, waste
management and improve the environmental performance of the company.

The study team proposes an Environmental and Safety Management Unit (ESMU) in
the company’s structure to operate the environmental management program at this
stage of the project.

Coordinate and administrative all aspects of the environmental management

programs; develop further an environmental oversight capability within the
company; and facilities for the implementation of companywide Environmental
Management System (EMS).

Sufficient budget should be allocated for environmental monitoring activities.

Regular internal auditing and monitoring should be made and audit report should be
submitted to Oromia land and environmental protection Bureau on quarter basis.

5.6 FUTURE DEVELOPMENT STRATEGIES

Every service undertakings be it large or small should have to have future development plan. It is
a plain fact that Service activities are undertaken in a dynamic and turbulent environment.
Hence, to overcome or minimize the risks of uncertain future, service should devise effective
strategies that enable them to be successful in their operation. Likewise, the project center has
devised strategies to overcome the future risk of operation. The first strategy is diversification of
its activities to different other business forms. The second future development plan of the
project is expanding its branches in many other parts of the country.

5.7 PROJECT IMPLEMENTATION PLAN

Year 2025 G.C
S.N Description
1 2 3 4

1 Purchasing machineries and medical

equipment

2 Starting operation