11633880 01.Pdf

SITE MAP

Angola

The Atlantic Ocean

①ILHA H. C.

Gulf of Luanda

②SAMBIZANGA H.C.

SAMBIZANGA ⑦SIGA H.C.

⑪BAIRRO OPERARIO H.C. INGOMBOTA ③RANGEL H.C. RANGEL ⑬KINANGA H.C. ④TERRA NOVA H.C.

⑩SAMBA H.C. ⑤KATAMBOR H.C. ⑧CARIANGO H.C. ⑫PRENDA H.C.

SAMBA MAIANGA ⑨NEVES BENDINHA H.C.

⑥CASSEQUEL H.C.

KILANBA KIAXI

0 2.5km 5km ABBEREVIATIONS

Ｅ／Ｎ Exchange of Notes

ＥＵ European Union

ＪＩＣＡ Japan International Cooperation Agency

ＰＨＣ Primary Health Care

ＢＨＮ Basic Human Needs

ＧＤＰ Gross Domestic Products

ＩＯＭ International Organization for Migration

ＩＣＲＣ International Committee of the Red Cross

ＳＩＤＡ Swedish International Development Cooperation Agency

ＭＰＬＡ Movimento Popular de Libertao de Angola

ＵＮＩＴＡ Uniao Nacional pare ａ Independencia Total de Angola

ＵＮＦＰＡ United Nations Population Fund

ＵＮＨＣＲ Office of the United Nations High Commissioner For Refugees

ＵＮＩＣＥＦ United Nations International Children'ｓ Fund

ＷＨＯ World Health Organization

ＷＦＰ World Food Program

ＡＶＲ Automatic Voltage Regulator

CONTENTS

Preface Letter of Transmittal Location Map/Perspective Abbreviations

Chapter 1 Background of the project ･･････････････････････････････ 1 1-1 Details of the Request ････････････････････････････････････ 1 1-2 Outline of the Request ････････････････････････････････････ 2 1-2-1 Purpose of the Request ･･････････････････････････････ 2 1-2-2 Contents of the Request ･････････････････････････････ 3

Chapter 2 Contents of the project ････････････････････････････････ 5 2-1 Objectives of the Project･･････････････････････････････････ 5 2-2 Basic Concept of the Project ･･････････････････････････････ 5 2-3 Basic Design ･･･････････････････････････････････････････････ 6 2-3-1 Design Concept･････････････････････････････････････････ 6 2-3-2 Basic Design ･･･････････････････････････････････････････ 9

Chapter 3 Implementation Plan ･････････････････････････････････････ 66 3-1 Implementation plan ･･･････････････････････････････････････ 66 3-1-1 Implementation Concept ･･････････････････････････････ 66 3-1-2 Implementation Conditions ･･････････････････････････ 67 3-1-3 Scope of Works ････････････････････････････････････････ 67 3-1-4 Consultant Supervision ･･････････････････････････････ 68 3-1-5 Procurement Plan ･････････････････････････････････････ 72 3-1-6 Implementation Schedule ･････････････････････････････ 73 3-1-7 Obligations of recipient country ･･････････････････ 76 3-2 Project Cost Estimation ･･･････････････････････････････････ 76 3-3 Operation and Maintenance Costs ･････････････････････････ 77 3-3-1 Operation and Maintenance Plan ････････････････････ 77 3-3-2 Maintenance Costs ････････････････････････････････････ 78

Chapter 4 Project Evaluation and Recommendation ･･････････････ 80 4-1 Project Effect･･･････････････････････････････････････････････ 80 4-1-1 Verification and Substantiation of Appropriateness ････････････････････････････････････････ 80 4-1-2 Benefits ････････････････････････････････････････････････ 80 4-2 Recommendation ･････････････････････････････････････････････ 82

Appendix 1 Member List of the Survey Team Appendix 2 Survey Schedule Appendix 3 List of Party Concerned in Angola Appendix 4 Minutes of Discussion Appendix 5 Maintenance Cost

CHAPTER 1

BACKGROUND OF THE PROJECT

CHAPTER 1 BACKGROUND OF THE PROJECT

1-1 Details of the Request

The Republic of Angola (hereinafter referred to as Angola), located in the southwestern part of Africa, has a surface area of approximately 1.25 million sq km and a population of approximately 11.9 millions (estimation in 1996). After the independence of Angola from Portugal in 1975, a civil war state continued between People's Movement for Liberation of Angola (MPLA), supported by the Soviet Union and Cuba, and National League for Total Independence of Angola (UNITA), supported by the United States of America and South Africa.

In May 1991, the comprehensive peace treaty was signed by the mediation of the United Nations. The general election was held under the supervision of the United Nations in September 1992, but UNITA was dissatisfied with the result of the election and restored to arms, thus the civil war resumed.

Peace negotiations resumed from November 1993, and the cease-fire was reached with a signing of Lusaka Protocol in November 1994. In April 1997, the Government of Unity and National Reconciliation was established. However, the United Nations Security Council resolved upon sanctions to Angola due to the default of obligations under the peace agreement. Consequently, the peace process has been standstill on its progress.

Under such political situation, the health and medical services of this country were seriously damaged. Many medical facilities came to lack in medical personnel, medical eq1uipments, pharmaceuticals, etc., because of continual civil war and reduction of the governmental expenditure for health and medical services. For that reason, the health and medical conditions in Angola are now in the poor situation among the sub-Saharan Africa. It is indicated in infant mortality rate of 170/1000 births and maternal mortality rate of 1500/100000 births (against the average figures in sub-Saharan Africa of 105 and 979 respectively). Under such situation, the Ministry of Health of Angola elaborated a provisional national health plan in 1996. Improvement of medical facilities, technical improvement of medical staff and improvement of maternal and child health care were set as the important tasks in the plan. Especially, a top priority was given

- 1 - to the improvement of child health from 1999 to 2001, and the Ministry is grappling with primary health care (PHC) as a main issue in the national health problem.

Under the situation that peace has been restoring by the Lusaka Protocol, the Japan's Government has been contributing to improvement of the health and medical field through implementation of "the Medical Equipment Supply Project for Josina Machel Hospital" in 1996, "the Project for Improvement of Medical Equipment for Lucrecia Paim Maternity Hospital" in 1999. Also, "the Project Finding Study (health and medical filed)" was implemented in September 2000. Through this study, the necessity of assistance for primary health care, the aim of the project, the present condition of the project facilities, and the assistance from the other donors, were confirmed. The Ministry of Health of Angola requested Japan for a grant aid intended for procurement of basic medical equipments for thirteen (13) Health Centers in Luanda Region, which are now functioning and do not overlap with the project sites of the other donors such as EU.

1-2 Outline of the Request

1-2-1 Purpose of the Request

The Government of Angola has been especially grappling with the improvement of the maternal and child health at the PHC level as a top priority by the year of 2001, among many issues indicated in "the national health policy".

Improvement of the Health Centers (the leading medical facilities for the primary health care in the region) especially in Luanda Region, where 17% of the total population of Angola centers on, is an important issue necessary for imminent solution. A project is now promoted by the assistance of EU as steps to enhance the primary health care, such as establishment of five (5) new Health Centers, renovation of some Health Centers, and improvement and provision of the medical equipments.

This project is elaborated for thirteen (13) Health Centers, for which the Regional Health Bureau admits that prompt improvement is necessary and which do not overlap with the project sites of EU. The project aims at improving primary health care services in the field of maternal and child health in Luanda Region.

- 2 - 1-2-2 Contents of the Request

(1) Project Facilities

The project facilities are the following thirteen Health Center in Luanda province.

Original request ① Ilha Health Center Ingombota Municipal ② Sambizanga Health Center Sambizanga Municipal ③ Rangel Health Center Rangel Municipal ④ Terra Nova Health Center Rangel Municipal ⑤ Katambor Health Center Maianga Municipal ⑥ Cassequel Health Center Maianga Municipal ⑦ Siga Health Center Cazenga Municipal ⑧ Cariango Health Center Cazenga Municipal ⑨ Neves Bendinha Health Center Kilamba Kiaxi Municipal ⑩ Samba Health Center Samba Municipal

Additional request at the time of site survey ⑪ Bairro Operario Health Center Sambizanga Municipal ⑫ Prenda Health Center Maianga Municipal ⑬ Kinanga Health Center Samba Municipal

(2) Equipment in request

The equipments requested for procurement in this project are sixty (60) items, and the contents are as follows. For the portable dental unit, the spectrophotometer, the AVR and the generator, these items were finally admitted as the additional request through the negotiations with the Angola side at the time of field survey.

- 3 - 1. Out-Patient Section（22 items） Stethoscope, Sphygmomanometer, Instrument Cabinet, Instrument Trolley, Examination Table, Examination Light, Weighing Scale for Adult, Weighing scale for Infant, Fetal Doppler Unit, Diagnostic Instrument set, Examining Instrument Set, Hot Air Sterilizer, Boiling Sterilizer, Resuscitator, Wheel Chair, Dental Chair mounted Unit, Film Processor, Dental X-ray Unit, Dental Instrument Set, Hot Air Sterilizer, Instrument Cabinet, Portable Dental Unit

2. Delivery Section（17 items）

Observation Bed, Delivery Bed, Examination Table, Examination Light, Suction Unit, Foot Steps, Instrument Cabinet, Instrument Trolley, Wash Basin Stand with Basin, Cot, Delivery Instrument Set, Weighing Scale, Weighing Scale for Infant, Hot Air Sterilizer, Boiling Sterilizer, Sphygmomanometer, Stethoscope

3. Radiology Section（6 items） Diagnostic X-ray Unit, X-ray Film Processing Unit Manual, Film Dryer, Film Hanger, Film Storage Cabinet, X-ray Protection Apron

4. Laboratory Section（13 items) Binocular Microscope, Centrifuge, Micro Centrifuge, Blood Sedimentation Apparatus, Automatic Timer, Leucocyte Counter Manual, Water Bath , Incubator, Shaker, Medical Refrigerator, Hot Air Sterilizer, Laboratory Glass Wares, Spectrophotometer

5. Others（2 items）

AVR, Generator

- 4 -

CHAPTER 2

CONTENTS OF THE PROJECT

CHAPTER 2 CONTENTS OF THE PROJECT

2-1 Objectives of the Project

The Government of Angola has been grappling especially with the improvement of the maternal and child health at the PHC level as a top priority by the year of 2001, among many issues indicated in "the national health policy". Therefore, improvement of the Health Centers, which are the leading medical facilities for the primary health care to the regional inhabitant, is an important issue to be urgently solved.

This project is aimed at improving the medical services at PHC level, especially the services extended to the pregnant women, nursing mothers and infants, through improvement of the basic medical equipments of the Health Centers in Luanda Region (the metropolitan area), which has 17% of the total population of Angola.

2-2 Basic Concept of the Project

The project facilities are those ranked as the primary medical facility under the national referral system. Many of the medical equipments in those facilities have completed their life span, and this is inducing the problem of degradation of the medical function. Quantitative shortage of medical equipment due to failure or damage of the equipment is also a big problem.

In order to improve these problems and achieve the aim of this project, this project shall be implemented by providing material support through procurement of the medical equipments under the following basic concepts.

① The equipments to be procured shall be those, which benefit diagnosis and treatment to the pregnant women, nursing mothers and infants of Ruanda Region.

② The equipments to be procured shall be those, which can be operated and maintained easily.

③ The equipment plan shall reflect the medical services extended in each Health Center.

- 5 - 2-3 Basic Design

2-3-1 Design Concept

(1) Policy on work period

The work period for the project shall be within 1 physical term that is 11.7 months after the Exchange of Notes is concluded.

(2) Policy on the procurement plan aiming at improvement of medical function

① Analysis shall be made in each project facility on the scale, the medical activities, the number of patients, the disease tendency, etc. And, the equipment plan (the specification of equipment and the quantity of equipment to be procured) shall reflect the present condition of each Health Center.

② The equipments to be procured shall be basically those which are no longer discharging their essential function because of completion of their life span, and those which are quantitatively short and urgent provision is required.

③ The equipments to be procured shall not require acquisition of new personnel nor new operation technique.

④ The equipments to be procured shall not overlap with those procured by other international aid organization and by the government itself.

⑤ As for some project facilities, a clinical laboratory shall be newly established in order to secure the clinical examination level.

(3) Policy on the equipment plan

For the expensive equipment (e.g. Diagnostic X-ray Unit), the model for which utilization of the manufacturer's local agent in South Africa or in Angola is possible shall be selected.

(4) Policy on the maintenance by the implementing bodies

① The equipment plan should be formed not to require high maintenance cost nor securing large management budget.

② Reconstitution of the maintenance system, which the maintenance

- 6 - technicians assigned to the national hospitals (the technicians and staff of the Lucrecia Paim Maternity Hospital as leader) undertake the maintenance patrol to the Health Centers, shall be promoted at the time of the Detailed Design.

(5) Design policy by the category

【Design policy on demand】

① The planned equipments shall submit to the PHC services in the region with emphasis on the improvement of the maternal and child health.

② The planned equipments shall be used for conduct of labor, and diagnosis, treatment and prevention of disease.

③ The procurement shall be principally made by renewal of the existing equipments which are no longer discharging their essential functions because of completion of their life span.

④ The equipments, which are short in quantity and apparently admitted necessity of supplementation, shall be procured.

【Design policy on technical aspect】

① The planned equipments shall not require any training of a special medical technician and can be sufficiently dealt with the technical level of the existing personnel.

② In principle, the technical level of the planned equipments shall apply to the medical services of primary level that the Ministry of Health of Angola stipulates.

【Design policy on financial aspect】

① The operating cost after inducting the planned equipments shall be comparatively low so that the Regional Health Bureau and each designated facility can maintain them economically.

② The scale of the project shall be within the administrative capacity of the project facilities and within the scope where their financial and technological sustainability is secured.

- 7 - 【Design policy on procurement plan】

① Disposition of minimum spare parts and consumables necessary for the operation of the equipments to be procured, shall be planned. The quantity necessary for a period of at least one (1) year shall be appropriate, considering the market circumstances of Angola.

② As for some planned equipments on which reduction of the unit price and the shipping and containing fee can be received in comparison with the Japanese products, the procurement plan shall be elaborated also considering the possibility of procurement of the products of any third country in the market of South Africa.

【Design policy on infrastructure aspect】

① Considering the power condition of the designated facilities, disposition of small generators shall be planned.

② In order to avoid breakdown of the equipments by voltage fluctuation, disposition of automatic voltage regulators (AVR) shall be planned for some medical equipments.

【Design policy on environment】

① In order to avoid the environmental problem in the future, a model which the refrigerant of the non-fron gas was used for shall be selected as for the medical refrigerator disposed to the clinical laboratory.

【Design policy on operation and maintenance】

① The procurement of equipments shall be planned, considering the maintenance capability available in Angola, such as technicians of the Ministry of Health and a manufacturer's agent established in Angola or in the neighbor countries.

② The equipments are provided with one-year warranty after implementation of this project. Once the warranty is expired, the Ministry of Health is suggested to implement a maintenance patrol by technicians of the Ministry itself or the manufacturer's local agent.

- 8 - ③ For the main equipments, operation and maintenance trainings shall be provided to the persons in charge of each facility and the technicians of the Ministry of Health at the occasion of delivery and set-up.

④ In principle, the instruction manual shall be presented in English language or Portuguese language. However, the manual in Portuguese language must be supplied especially for the equipment that needs detailed instruction for operation.

2-3-2 Basic Plan

(1) Overall plan

1) Study in the project facilities

The 27 Health Centers are now stationed in Luanda Region in the metropolitan area of Angola. As mentioned above, the improvement of the maternal and child health at the health center level is the issue which this government is grappling with the high priority. The implementation of the aid project by EU is planned for enhancement of the primary health care. In the project, support shall be given to the construction of five (5) new Health Centers, the renovation of the existing Health Centers and the improvement of the medical equipments in Luanda. The Health Centers extend the medical services such as general ambulatory practice (internal medicine, obstetrics and gynecology, the emergency, pediatrics, dentistry, department of radiology, etc.), regular health examination to pregnant women, nursing mothers and infants, vaccination, blood examination, the simple test of excrement. Also, normal delivery is conducted in the centers which have maternity service. The improvement of primary health care of benefit to the regional inhabitant is very important and necessary in this country. The following thirteen (13) Health Centers are which do not overlap with the designated facilities of the EU project and which admitted by the government of Angola that the improvement should be urgently necessary. Therefore, those facilities are judged appropriate as the designated facilities of this project.

- 9 - ① Ilha Health Center ⑧ Cariango Health Center ② Sambizanga Health Center ⑨ Neves Bendinha Health Center ③ Rangel Health Center ⑩ Samba Health Center ④ Terra Nova Health Center ⑪ Bairro Operario Health Center ⑤ Katambor Health Center ⑫ Prenda Health Center ⑥ Cariango Health Center ⑬ Kinanga Health Center ⑦ Siga Health Center

2) Study in the requested equipment

The equipments finally requested with this project are sixty (60) items in total as mentioned in "1-2-2 (2) Equipment in request" of Chapter 1. Though the scale of each project facility is not unified, the Health Centers are important stations to offer the primary health care service and there is no great difference in the prospective role of each facility.

From the general viewpoint, the requested equipments are fundamental medical equipments to submit for the improvement of the maternal and child health in the primary level. And this request may be indispensable for the improvement of the medical service. However, the selection of equipment and its quantity should be settled for each project facility considering the medical service that each Health Center provides and the condition of the existing equipments. The equipment procurement should be planned according to the existing circumstances.

(2) Equipment procurement plan

The assessment on the selection of equipment and the fixed quantity is mentioned in the Table 2-1 "Study in the requested equipments". As for the following equipments, further study is necessary in consideration of the medical service that each Health Center provides and the condition of the existing equipments.

- 10 - 1) Individual study

Section Name of Equipment Out-Patient Dental Chair mounted Unit Portable Dental Unit Delivery Observation Bed, Examination Table, Examination Light, Foot Steps, Instrument Cabinet, Instrument Trolley, Wash Basin Stand with Basin、Weighing Scale、Weighing Scale for Infant，Hot Air Sterilizer, Boiling Sterilizer, Sphygmomanometer, Stethoscope Radiology Diagnostic X－ray Unit Laboratory Spectrophotometer Others AVR

① Out-Patient Section

Dental Chair mounted Unit：

As for the Health Centers where dental care service is provided and the dental chair mounted units are now installed, those units that are no longer discharging their essential functions shall be only renewed. The procurement shall be made to Ilha Health Center, Siga Health Center and Prenda Health Center.

Portable Dental Unit：

For the Health Centers where exodontia service is instituted with the simple instrument and the machine set and no dental chair mounted unit is installed, one (1) unit is respectively supplied. The procurement shall be made to Sambizanga Health Center, Rangel Health Center, Terra Nova Health Center and Cassequel Health Center.

② Delivery Section

Among seventeen (17) items requested for the labor section, the thirteen (13) items, except Delivery Bed, Suction Unit, Cot and Delivery Instrument Set, are submitted to the medical services in the obstetrics of outpatient. For the following

- 11 - eight (8) facilities where no labor is conducted, the procurement shall be made as undermentioned. The designated facilities are Rangel Health Center, Katambor Health Center, Siga Health Center, Cariango Health Center, Neves Bendinha Health Center, Bairro Operario Health Center, Prenda Health Center and Kinanga Health Center. In every health center, most of the equipment now available in the outpatient consultation room for obstetrics patient are deteriorated. Necessary quantities of equipment for each health center are determined in order to replace the existing equipment.

Reason of Quantity Determination:

A : The 1 unit of this item now available in the outpatient consultation room for obstetrics patient will be replaced.

B : The 2 units of this item now available in the outpatient consultation room for obstetrics patient will be replaced. C : Since procurement request is not made, this item is excluded from this plan. Considering feasibility of continued use of the existing equipment. D : The 4 units of this item 2 of each now available in the outpatient consultation room for obstetrics patient and family planning room will be replaced. E : The 1 unit of this item now available in the outpatient consultation room for obstetrics patient will be replaced. Along with the replacement of the existing Examination Table. F : The 2 units of this item now available in the outpatient consultation room for obstetrics patient will be replaced. Along with the replacement of the existing Examination Table. G : The 2 units of this item now available in the outpatient consultation room for obstetrics patient will be replaced, for use with Observation Bed and Examination Table. H : The 2 units of this item now available in both the outpatient consultation room for obstetrics patient and family planning room will be replaced. I : The 1 unit of this item now available in the outpatient consultation room will be replaced in order to provide E.P.I. and infant growth monitoring services. J : The 2 units of this item now available in the outpatient consultation room will be replaced in order to provide E.P.I. and infant growth monitoring services. K : The 1 unit of this item now available in the outpatient consultation room for obstetrics patient will be replaced, for supplementary use with Hot Air Sterilizer in urgent cases.

- 12 - L : The 2 units of this item now available in the outpatient consultation room for obstetrics patient will be replaced, for supplementary use with Hot Air Sterilizer in urgent cases.

Observation Bed：

Designated Facility Result (Name of the Health Requested Reason of Quantity (Planned Center) Quantity Determination Quantity) Rangel H.C． 2 B 2 Katambor H.C． 1 A 1 Siga H.C． 2 B 2 Cariango H.C． 1 A 1 Neves Bendinha H.C． - C - Bairro Operario H.C． - C - Prenda H.C． - C - Kinanga H.C． - C -

Examination Table：

Designated Facility Result (Name of the Health Requested Reason of Quantity (Planned Center) Quantity Determination Quantity) Rangel H.C． 2 B 2 Katambor H.C． 1 A 1 Siga H.C． 1 A 1 Cariango H.C． 4 D 4 Neves Bendinha H.C． 4 D 4 Bairro Operario H.C． 2 B 2 Prenda H.C． 2 B 2 Kinanga H.C． 2 B 2

Examination Light：

Designated Facility Result (Name of the Health Requested Reason of Quantity (Planned Center) Quantity Determination Quantity) Rangel H.C． 2 F 2 Katambor H.C． 1 E 1 Siga H.C． 2 G 2 Cariango H.C． 4 D 4 Neves Bendinha H.C． 4 D 4 Bairro Operario H.C． 2 B 2 Prenda H.C． 2 B 2 Kinanga H.C． 2 B 2

- 13 - Foot Steps：

Designated Facility Result (Name of the Health Requested Reason of Quantity (Planned Center) Quantity Determination Quantity) Rangel H.C． 2 B 2 Katambor H.C． 2 B 2 Siga H.C． 1 A 1 Cariango H.C． 4 D 4 Neves Bendinha H.C． 2 H 2 Bairro Operario H.C． 2 B 2 Prenda H.C． 2 B 2 Kinanga H.C． 2 B 2

Instrument Cabinet：

Designated Facility Result (Name of the Health Requested Reason of Quantity (Planned Center) Quantity Determination Quantity) Rangel H.C． 2 B 2 Katambor H.C． 2 B 2 Siga H.C． 1 A 1 Cariango H.C． 2 B 2 Neves Bendinha H.C． 2 B 2 Bairro Operario H.C． 2 B 2 Prenda H.C． 1 A 1 Kinanga H.C． 1 A 1

Instrument Trolley：

Designated Facility Result (Name of the Health Requested Reason of Quantity (Planned Center) Quantity Determination Quantity) Rangel H.C． 2 B 2 Katambor H.C． 1 A 1 Siga H.C． 1 A 1 Cariango H.C． 2 B 2 Neves Bendinha H.C． 2 B 2 Bairro Operario H.C． 2 B 2 Prenda H.C． 1 A 1 Kinanga H.C． 2 B 2

- 14 - Wash Basin Stand with Basin：

Designated Facility Result (Name of the Health Requested Reason of Quantity (Planned Center) Quantity Determination Quantity) Rangel H.C． 2 B 2 Katambor H.C． 2 B 2 Siga H.C． 1 A 1 Cariango H.C． 2 B 2 Neves Bendinha H.C． 2 B 2 Bairro Operario H.C． 2 B 2 Prenda H.C． 1 A 1 Kinanga H.C． 2 B 2

Weighing Scale：

Designated Facility Result (Name of the Health Requested Reason of Quantity (Planned Center) Quantity Determination Quantity) Rangel H.C． 2 B 2 Katambor H.C． 1 A 1 Siga H.C． 1 A 1 Cariango H.C． 1 A 1 Neves Bendinha H.C． 2 B 2 Bairro Operario H.C． 1 A 1 Prenda H.C． 1 A 1 Kinanga H.C． 2 B 2

Weighing Scale for Infant：

Designated Facility Result (Name of the Health Requested Reason of Quantity (Planned Center) Quantity Determination Quantity) Rangel H.C． 2 J 2 Katambor H.C． 1 I 1 Siga H.C． 1 I 1 Cariango H.C． 1 I 1 Neves Bendinha H.C． 2 J 2 Bairro Operario H.C． 1 I 1 Prenda H.C． 1 I 1 Kinanga H.C． - C -

- 15 - Hot Air Sterilizer：

Designated Facility Result (Name of the Health Requested Reason of Quantity (Planned Center) Quantity Determination Quantity) Rangel H.C． 2 B 2 Katambor H.C． 1 A 1 Siga H.C． 1 A 1 Cariango H.C． 1 A 1 Neves Bendinha H.C． 1 A 1 Bairro Operario H.C． - C - Prenda H.C． - C - Kinanga H.C． 1 A 1

Boiling Sterilizer：

Designated Facility Result (Name of the Health Requested Reason of Quantity (Planned Center) Quantity Determination Quantity) Rangel H.C． 2 L 2 Katambor H.C． 1 K 1 Siga H.C． 1 K 1 Cariango H.C． 2 L 2 Neves Bendinha H.C． 2 L 2 Bairro Operario H.C． - C - Prenda H.C． - C - Kinanga H.C． 1 K 1

Sphygmomanometer:

Designated Facility Result (Name of the Health Requested Reason of Quantity (Planned Center) Quantity Determination Quantity) Rangel H.C． 2 B 2 Katambor H.C． 2 B 2 Siga H.C． 1 A 1 Cariango H.C． 1 A 1 Neves Bendinha H.C． 2 B 2 Bairro Operario H.C． 1 A 1 Prenda H.C． 1 A 1 Kinanga H.C． 2 B 2

- 16 - Stethoscope：

Designated Facility Result (Name of the Health Requested Reason of Quantity (Planned Center) Quantity Determination Quantity) Rangel H.C． 2 B 2 Katambor H.C． 2 B 2 Siga H.C． 1 A 1 Cariango H.C． 1 A 1 Neves Bendinha H.C． 2 B 2 Bairro Operario H.C． 1 A 1 Prenda H.C． 1 A 1 Kinanga H.C． 2 B 2

Also, twelve (12) delivery instrument sets are requested for procurement from Neves Bendinha Health Center. However, this equipment shall not be procured in this project because labor is not conducted at this facility.

③ Radiology Section

Diagnostic X-ray Unit：

As for the four (4) facilities (Ilha, Terra Nova, Cassequel and Neves Bendinha) which have radiology department at present and in which old Diagnostic X-ray Unit is used, the renewal of this equipment is planned in this project.

Siga Health Center used to have the radiology department and possess this equipment. And, this facility strongly intends to resume this service. As a result of the site survey, it is admitted that the demand to the patient being high and the former X-ray room is still available. Also, this facility mentions that increase in the personnel of X-ray technician is possible. Accordingly, the adequacy of the procurement is judged is high. This project aims at supporting resumption of this service.

Samba Health Center is to move to the new site, and establishment of the radiology department is planned. Therefore, the procurement of the Diagnostic X-ray Unit is planned in this project.

- 17 - ④ Laboratory Section

Spectrophotometer：

Terra Nova Health Center has most clinical experts with twenty-five (25) persons among the project facilities. It does not currently have a spectrophotometer, however, there are comparatively many hepatitic patients in this area, and the demand is high for the examination in the biochemical field, such as the examination of the hapatic function. While this is equipment newly procured, this Center agreed to select some of the laboratory technicians and make them receive trainings in the higher rank institution. There is no problem on the personnel. When this situation is judged synthetically, it is concluded that the necessity and the validity of the procurement of one (1) spectrophotometer in this project are high.

Though Neves Bendinha Health Center has about ten (10) clinical experts, the technical level is high when it is compared with other Health Centers. This Center has temporarily withdrawn from the examination in biochemical field due to the disabled spectrophotometer. However, this facility has a strong intention to resume the examination service in the early stage. As for this facility as well, it is concluded that the renewal of one (1) spectrophotometer is appropriate, considering the demand is high for the examination in the biochemical field, such as examination of the hapatic function.

Foundation and/or extension of the laboratory rooms:

The establishment of the clinical laboratory is planned for two (2) Health Centers of Siga and Bairro Operario in this project by the following reason.

As for Siga Health Center that the clinical laboratory is very small and has a functional problem, the establishment of the clinical laboratory is planned so that a problem in hygiene can improve and the occupation space for clinical experts can be secured.

- 18 - An individual plan was devised in Bairro Health Center, which does not have a clinical examination section, to open the section in early stage. However, there is no prospect of raising the fund which is necessary for the implementation of this plan, and the current situation is that the establishment plan of the clinical laboratory has to be put off. Considering the activities of other Health Centers, even though this facility extends the primary health care service of the locally adherent type, the demand for the basic clinical examination service is very high. Therefore, it is beneficial and effective to the area inhabitant to prepare the environment which enables this facility to start a clinical examination service under the support of this project.

⑤ Others

AVR：

As for the necessity and the validity for the procurement of AVR, the undesirable circumstance of electric power in the area concerned was confirmed through the field survey. The quantity requested from each facility (final list of the requested equipments attached to the Minutes) was equivalent to the quantity of the following equipments worked by electricity. In the subsequent domestic analysis, it was judged appropriate to reduce the supply quantity of AVR by restricting the equipment which is coupled to AVR according to the following reason.

Deletion Reason:

A; the equipment that the structure is simple and the maintenance is easy at the time of trouble

B; the equipment that the endurance is recognized against the fluctuation of the voltage

- 19 - 【Study for AVR】

Equipment required AVR Requested Deletion Planned Quantity for Health Center Quantity ①②③④⑤⑥⑦⑧⑨⑩⑪⑫⑬ Out-Patient Examination Light 52 A ――――――――――――― Hot Air Sterilizer 18 2112121122111 Boiling Sterilizer 42 A B ――――――――――――― Dental Chair mounted Unit 8 4000002000020 Dental X-ray Unit 1B――――――――――――― Hot Air Sterilizer 6 1101011000010 Portable Dental Unit 4 0111010000000 Delivery Examination Light 34 A ――――――――――――― Suction Unit 10 2103020002000 Hot Air Sterilizer 16 2222111112001 Boiling Sterilizer 20 A B ――――――――――――― Radiology Diagnostic X-ray Unit 6B――――――――――――― Film Dryer 6 1001011011000 Laboratory Binocular Microscope 26 B ――――――――――――― Centrifuge 14 1112111111111 Micro Centrifuge 11 1111110111110 Water Bath 10 A ――――――――――――― Incubator 10 B ――――――――――――― Medical Refrigerator 12 1111111111110 Hot Air Sterilizer 12 1111111111110 Spectrophotometer 2 0001000010000 Total 320 16 10 8 16 6 12 9 6 9 11 5 8 3

According to the examination result of the above table, the supply quantity to each Health Center shall be planned as follows. Result of Quantity

①Ilha Health Center （ 16 ） ②Sambizanga Health Center （ 10 ） ③Rangel Health Center （ 8 ） ④Terra Nova Health Center （ 16 ） ⑤Katambor Health Center （ 6 ） ⑥Cassequel Health Center （ 12 ） ⑦Siga Health Center （ 9 ） ⑧Cariango Health Center （ 6 ） ⑨Neves Bendinha Health Center （ 9 ） ⑩Samba Health Center （ 11 ） ⑪Bairro Operario Health Center （ 5 ） ⑫Prenda Health Center （ 8 ） ⑬Kinanga Health Center （ 3 ）

- 20 - 2) Selection of equipment

Criteria for equipment to be procured are as follows and the result of examination for the each requested equipment is shown in the table 2-1.

【Basic Criteria for giving High Priority and Low Priority】

1. High Priority

(1) Equipment that is to be replaced for existing old/decrepit equipment.

(2) Equipment that is to be a supplement for the equipment lacking distinctly in its quantity.

(3) Equipment that is required for basic hospital treatment/ diagnosis.

(4) Equipment that is easy to operate and maintain.

(5) Equipment that may give much benefit/effect to hospital.

(6) Equipment that is highly cost-effective.

(7) Equipment that is proven for its medical usefulness（necessity）.

2. Low Priority

(1) Equipment that requires high operation and maintenance cost.

(2) Equipment that has limited benefit/effect to hospital.

(3) Equipment that is lowly cost-effective.

(4) Equipment that is not for treatment/diagnosis use, but for academic research purposes.

(5) Equipment that can be substituted with a simple one.

(6) Equipment that may cause environmental pollution by its medical waste, etc.

(7) Equipment that is not proven for its medical usefulness (necessity).

(8) Equipment that is for personal usage by hospital staff (not for medical usage).

- 21 - (9) Equipment that has more than minimum required quantity (inefficient, overlapped equipment).

【Additional Criteria for considering recipient condition】

1. High Priority

(1) Equipment that can be operated by hospital's current technical capabilities.

(2) Equipment that can be operated/maintained by hospital staff including technicians of a local agent etc., consigned for its operation/maintenance.

(3) Equipment that matches with hospital's social position/ function (referral system, local needs).

(4) Equipment that can be expected its usefulness also in collaboration with other donor's assistance.

2. Low Priority

(1) Equipment that is difficult to locally procure its spare parts and consumables.

(2) Equipment that cannot be operated by hospital's current technical capability.

(3) Equipment that cannot be operated/maintained by hospital staff.

(4) Equipment that does not match with hospital's social position /function (referral system, local needs).

(5) Equipment that requires large scale of infrastructure work (water, electricity supply, drainage, etc.) for its installation.

(6) Equipment that can be substituted by efficient usage of existing equipment．

Selection of equipment was made by above-mentioned procedure and the result was shown as follows.

Comprehensive evaluation: ○ ････Acceptable

× ････Not acceptable

- 22 - Table 2-1 Result of Examination for Requested Equipment

１．Ilha H.C.

Basic Criteria Additional Criteria Result Requested Criteria for giving Criteria for giving Criteria for giv- Criteria for giving Re- Supple DepartmentItem Name of Equipment New Quantity High Priolity Low Priolity ing High Priolity Low Priolity newal -ment No. Evalu- Quantity 1234567123456789 1234123456 ation １．Out-Patient 1-1 Stethoscope 10 ○ ○ ○ ○ ○ ⑥ ④ ○ 10 1-2 Sphygmomanometer 10 ○ ○ ○ ○ ○ ⑥ ④ ○ 10 1-3 Instrument Cabinet 9 ○ ○ ○ ○ ○ ⑤ ④ ○ 9 1-4 Instrument Trolley 9 ○ ○ ○ ○ ○ ⑤ ④ ○ 9 1-5 Examination Table 6 ○ ○ ○ ○ ○ ○ 6 1-6 Examination Light 6 ○ ○ ○ ○ ○ ○ 6 1-7 Weighing Scale for Adult 3 ○ ○ ○ ○ ○ ○ 3 1-8 Weighing scale for Infant 3 ○ ○ ○ ○ ○ ○ 3 1-9 Fetal Doppler Unit 2 ○ ○ ○ ○ ○ ○ ○ ○ 2 1-10 Diagnostic Instrument set 6 ○ ○ ○ ○ ○ ④ ② ○ 6 1-11 Examining Instrument Set 6 ○ ○ ○ ○ ○ ④ ② ○ 6 1-12 Hot Air Sterilizer 2 ○ ○ ○ ○ ○ ○ ○ 2 1-13 Boiling Sterilizer 4 ○ ○ ○ ○ ○ ○ 4 1-14 Resuscitator 2 ○ ○ ○ ○ ○ ○ 2 - 23 1-15 Wheel Chair 4 ○ ○ ○ ○ ○ ○ 4 1-16 Dental Chair mounted Unit 2 ○ ○ ○ ○ ○ ○ ○ 2 1-17 Film Processor 1 ○ ○ ○ ○ ○ ○ 1 1-18 Dental X-ray Unit 1 ○ ○ ○ ○ ○ ○ 1 1-19 Dental Instrument Set 2 ○ ○ ○ ○ ○ ○ 2 1-20 Hot Air Sterilizer 1 ○ ○ ○ ○ ○ ○ ○ 1 1-21 Instrument Cabinet 2 ○ ○ ○ ○ ○ ○ 2 1-22 Portable Dental Unit 0 -- ２．Delivery 2-1 Observation Bed 3 ○ ○ ○ ○ ○ ○ 3 2-2 Delivery Bed 2 ○ ○ ○ ○ ○ ○ ○ 2 2-3 Examination Table 2 ○ ○ ○ ○ ○ ○ 2 2-4 Examination Light 2 ○ ○ ○ ○ ○ ○ 2 2-5 Suction Unit 2 ○ ○ ○ ○ ○ ○ 2 2-6 Foot Steps 3 ○ ○ ○ ○ ○ ○ 3 2-7 Instrument Cabinet 3 ○ ○ ○ ○ ○ ○ 3 2-8 Instrument Trolley 3 ○ ○ ○ ○ ○ ○ 3 2-9 Wash Basin Stand with Basin 3 ○ ○ ○ ○ ○ ○ 3 2-10 Cot 1 ○ ○ ○ ○ ○ ○ 1 2-11 Delivery Instrument Set 18 ○ ○ ○ ○ ○ ○ ④ ⑭ ○ 18 2-12 Weighing Scale 3 ○ ○ ○ ○ ○ ○ 3 2-13 Weighing Scale for Infant 3 ○ ○ ○ ○ ○ ○ 3 2-14 Hot Air Sterilizer 2 ○ ○ ○ ○ ○ ○ ○ 2 2-15 Boiling Sterilizer 2 ○ ○ ○ ○ ○ ○ 2 2-16 Sphygmomanometer 3 ○ ○ ○ ○ ○ ○ 3 2-17 Stethoscope 3 ○ ○ ○ ○ ○ ○ 3 Table 2-1 Result of Examination for Requested Equipment

１．Ilha H.C.

- 24 4-8 Incubator 1 ○ ○ ○ ○ ○ ○ 1 4-9 Shaker 1 ○ ○ ○ ○ ○ ○ 1 4-10 Medical Refrigerator 1 ○ ○ ○ ○ ○ ○ ○ 1 4-11 Hot Air Sterilizer 1 ○ ○ ○ ○ ○ ○ 1 4-12 Laboratory Glass Wares 1 ○ ○ ○ ○ ○ ○ 1 4-13 Spectrophotometer 0 -- ５．Others 5-1 AVR 33 ○ ○ ○ ○ ○ ○ 16 5-2 Generator 3 ○ ○ ○ ○ ○ ○ ○ 3 Table 2-1 Result of Examination for Requested Equipment

２．Sambizanga H.C.

Basic Criteria Additional Criteria Result Requested Criteria for giving Criteria for giving Criteria for giv- Criteria for giving Re- Supple DepartmentItem Name of Equipment New Quantity High Priolity Low Priolity ing High Priolity Low Priolity newal -ment No. Evalu- Quantity 12345671 234567891234123456 ation １．Out-Patient 1-1 Stethoscope 6 ○ ○ ○ ○ ○ ③ ③ ○ 6 1-2 Sphygmomanometer 6 ○ ○ ○ ○ ○ ③ ③ ○ 6 1-3 Instrument Cabinet 4 ○ ○ ○ ○ ○ ③ ① ○ 4 1-4 Instrument Trolley 4 ○ ○ ○ ○ ○ ③ ① ○ 4 1-5 Examination Table 4 ○ ○ ○ ○ ○ ③ ① ○ 4 1-6 Examination Light 4 ○ ○ ○ ○ ○ ③ ① ○ 4 1-7 Weighing Scale for Adult 2 ○ ○ ○ ○ ○ ○ 2 1-8 Weighing scale for Infant 2 ○ ○ ○ ○ ○ ○ 2 1-9 Fetal Doppler Unit 2 ○ ○ ○ ○ ○ ○ ○ ○ 2 1-10 Diagnostic Instrument set 3 ○ ○ ○ ○ ○ ○ 3 1-11 Examining Instrument Set 3 ○ ○ ○ ○ ○ ○ 3 1-12 Hot Air Sterilizer 1 ○ ○ ○ ○ ○ ○ ○ 1 1-13 Boiling Sterilizer 4 ○ ○ ○ ○ ○ ○ 4 1-14 Resuscitator 2 ○ ○ ○ ○ ○ ○ 2 - 25 1-15 Wheel Chair 2 ○ ○ ○ ○ ○ ○ 2 1-16 Dental Chair mounted Unit 0 -- 1-17 Film Processor 0 -- 1-18 Dental X-ray Unit 0 -- 1-19 Dental Instrument Set 1 ○ ○ ○ ○ ○ ○ 1 1-20 Hot Air Sterilizer 1 ○ ○ ○ ○ ○ ○ ○ 1 1-21 Instrument Cabinet 1 ○ ○ ○ ○ ○ ○ 1 1-22 Portable Dental Unit 1 ○ ○ ○ ○ ○ ○ ○ 1 ２．Delivery 2-1 Observation Bed 2 ○ ○ ○ ○ ○ ○ 2 2-2 Delivery Bed 1 ○ ○ ○ ○ ○ ○ ○ 1 2-3 Examination Table 2 ○ ○ ○ ○ ○ ○ 2 2-4 Examination Light 2 ○ ○ ○ ○ ○ ○ 2 2-5 Suction Unit 1 ○ ○ ○ ○ ○ ○ 1 2-6 Foot Steps 2 ○ ○ ○ ○ ○ ○ 2 2-7 Instrument Cabinet 2 ○ ○ ○ ○ ○ ○ 2 2-8 Instrument Trolley 2 ○ ○ ○ ○ ○ ○ 2 2-9 Wash Basin Stand with Basin 2 ○ ○ ○ ○ ○ ○ 2 2-10 Cot 1 ○ ○ ○ ○ ○ ○ 1 2-11 Delivery Instrument Set 18 ○ ○ ○ ○ ○ ○ ④ ⑭ ○ 18 2-12 Weighing Scale 2 ○ ○ ○ ○ ○ ○ 2 2-13 Weighing Scale for Infant 2 ○ ○ ○ ○ ○ ○ 2 2-14 Hot Air Sterilizer 2 ○ ○ ○ ○ ○ ○ ○ 2 2-15 Boiling Sterilizer 2 ○ ○ ○ ○ ○ ○ 2 2-16 Sphygmomanometer 2 ○ ○ ○ ○ ○ ○ 2 2-17 Stethoscope 2 ○ ○ ○ ○ ○ ○ 2 Table 2-1 Result of Examination for Requested Equipment

２．Sambizanga H.C.

- 26 4-8 Incubator 1 ○ ○ ○ ○ ○ ○ 1 4-9 Shaker 1 ○ ○ ○ ○ ○ ○ 1 4-10 Medical Refrigerator 1 ○ ○ ○ ○ ○ ○ ○ 1 4-11 Hot Air Sterilizer 1 ○ ○ ○ ○ ○ ○ 1 4-12 Laboratory Glass Wares 1 ○ ○ ○ ○ ○ ○ 1 4-13 Spectrophotometer 0 -- ５．Others 5-1 AVR 25 ○ ○ ○ ○ ○ ○ 10 5-2 Generator 2 ○ ○ ○ ○ ○ ○ ○ 2 Table 2-1 Result of Examination for Requested Equipment

３．Rangel H.C.

Basic Criteria Additional Criteria Result Requested Criteria for giving Criteria for giving Criteria for giv- Criteria for giving Re- Supple DepartmentItem Name of Equipment New Quantity High Priolity Low Priolity ing High Priolity Low Priolity newal -ment No. Evalu- Quantity 12345671 234567891234123456 ation １．Out-Patient 1-1 Stethoscope 10 ○ ○ ○ ○ ○ ⑥ ④ ○ 10 1-2 Sphygmomanometer 10 ○ ○ ○ ○ ○ ⑥ ④ ○ 10 1-3 Instrument Cabinet 6 ○ ○ ○ ○ ○ ④ ② ○ 6 1-4 Instrument Trolley 6 ○ ○ ○ ○ ○ ④ ② ○ 6 1-5 Examination Table 4 ○ ○ ○ ○ ○ ○ 4 1-6 Examination Light 6 ○ ○ ○ ○ ○ ④ ② ○ 6 1-7 Weighing Scale for Adult 2 ○ ○ ○ ○ ○ ○ 2 1-8 Weighing scale for Infant 2 ○ ○ ○ ○ ○ ○ 2 1-9 Fetal Doppler Unit 1 ○ ○ ○ ○ ○ ○ ○ ○ 1 1-10 Diagnostic Instrument set 3 ○ ○ ○ ○ ○ ○ 3 1-11 Examining Instrument Set 3 ○ ○ ○ ○ ○ ○ 3 1-12 Hot Air Sterilizer 1 ○ ○ ○ ○ ○ ○ ○ 1 1-13 Boiling Sterilizer 4 ○ ○ ○ ○ ○ ○ 4 1-14 Resuscitator 3 ○ ○ ○ ○ ○ ○ 3 - 27 1-15 Wheel Chair 0 -- 1-16 Dental Chair mounted Unit 0 -- 1-17 Film Processor 0 -- 1-18 Dental X-ray Unit 0 -- 1-19 Dental Instrument Set 1 ○ ○ ○ ○ ○ ○ ○ 1 1-20 Hot Air Sterilizer 0 -- 1-21 Instrument Cabinet 0 -- 1-22 Portable Dental Unit 1 ○ ○ ○ ○ ○ ○ ○ 1 ２．Delivery 2-1 Observation Bed 2 ○ ○ ○ ○ ○ ○ 2 2-2 Delivery Bed 0 -- 2-3 Examination Table 2 ○ ○ ○ ○ ○ ○ 2 2-4 Examination Light 2 ○ ○ ○ ○ ○ ○ 2 2-5 Suction Unit 0 -- 2-6 Foot Steps 2 ○ ○ ○ ○ ○ ○ 2 2-7 Instrument Cabinet 2 ○ ○ ○ ○ ○ ○ 2 2-8 Instrument Trolley 2 ○ ○ ○ ○ ○ ○ 2 2-9 Wash Basin Stand with Basin 2 ○ ○ ○ ○ ○ ○ 2 2-10 Cot 0 -- 2-11 Delivery Instrument Set 0 -- 2-12 Weighing Scale 2 ○ ○ ○ ○ ○ ○ 2 2-13 Weighing Scale for Infant 2 ○ ○ ○ ○ ○ ○ 2 2-14 Hot Air Sterilizer 2 ○ ○ ○ ○ ○ ○ ○ 2 2-15 Boiling Sterilizer 2 ○ ○ ○ ○ ○ ○ 2 2-16 Sphygmomanometer 2 ○ ○ ○ ○ ○ ○ 2 2-17 Stethoscope 2 ○ ○ ○ ○ ○ ○ 2 Table 2-1 Result of Examination for Requested Equipment

３．Rangel H.C.

- 28 4-8 Incubator 1 ○ ○ ○ ○ ○ ○ 1 4-9 Shaker 1 ○ ○ ○ ○ ○ ○ 1 4-10 Medical Refrigerator 1 ○ ○ ○ ○ ○ ○ ○ 1 4-11 Hot Air Sterilizer 1 ○ ○ ○ ○ ○ ○ 1 4-12 Laboratory Glass Wares 1 ○ ○ ○ ○ ○ ○ 1 4-13 Spectrophotometer 0 -- ５．Others 5-1 AVR 25 ○ ○ ○ ○ ○ ○ 8 5-2 Generator 2 ○ ○ ○ ○ ○ ○ ○ 2 Table 2-1 Result of Examination for Requested Equipment

４．Terra Nova H.C.

Basic Criteria Additional Criteria Result Requested Criteria for giving Criteria for giving Criteria for giv- Criteria for giving Re- Supple DepartmentItem Name of Equipment New Quantity High Priolity Low Priolity ing High Priolity Low Priolity newal -ment No. Evalu- Quantity 12345671 23456789 1234123456 ation １．Out-Patient 1-1 Stethoscope 15 ○ ○ ○ ○ ○ ⑧ ⑦ ○ 15 1-2 Sphygmomanometer 15 ○ ○ ○ ○ ○ ⑧ ⑦ ○ 15 1-3 Instrument Cabinet 9 ○ ○ ○ ○ ○ ⑤ ④ ○ 9 1-4 Instrument Trolley 9 ○ ○ ○ ○ ○ ⑤ ④ ○ 9 1-5 Examination Table 6 ○ ○ ○ ○ ○ ○ 6 1-6 Examination Light 6 ○ ○ ○ ○ ○ ○ 6 1-7 Weighing Scale for Adult 3 ○ ○ ○ ○ ○ ○ 3 1-8 Weighing scale for Infant 3 ○ ○ ○ ○ ○ ○ 3 1-9 Fetal Doppler Unit 2 ○ ○ ○ ○ ○ ○ ○ ○ 2 1-10 Diagnostic Instrument set 6 ○ ○ ○ ○ ○ ○ 6 1-11 Examining Instrument Set 6 ○ ○ ○ ○ ○ ○ 6 1-12 Hot Air Sterilizer 2 ○ ○ ○ ○ ○ ○ ○ 2 1-13 Boiling Sterilizer 6 ○ ○ ○ ○ ○ ○ 6 1-14 Resuscitator 2 ○ ○ ○ ○ ○ ○ 2 - 29 1-15 Wheel Chair 1 ○ ○ ○ ○ ○ ○ 1 1-16 Dental Chair mounted Unit 0 -- 1-17 Film Processor 0 -- 1-18 Dental X-ray Unit 0 -- 1-19 Dental Instrument Set 1 ○ ○ ○ ○ ○ ○ 1 1-20 Hot Air Sterilizer 1 ○ ○ ○ ○ ○ ○ ○ 1 1-21 Instrument Cabinet 1 ○ ○ ○ ○ ○ ○ 1 1-22 Portable Dental Unit 1 ○ ○ ○ ○ ○ ○ ○ 1 ２．Delivery 2-1 Observation Bed 3 ○ ○ ○ ○ ○ ○ 3 2-2 Delivery Bed 0 -- 2-3 Examination Table 3 ○ ○ ○ ○ ○ ○ 3 2-4 Examination Light 2 ○ ○ ○ ○ ○ ○ 2 2-5 Suction Unit 3 ○ ○ ○ ○ ○ ○ 3 2-6 Foot Steps 5 ○ ○ ○ ○ ○ ○ 5 2-7 Instrument Cabinet 3 ○ ○ ○ ○ ○ ○ 3 2-8 Instrument Trolley 3 ○ ○ ○ ○ ○ ○ 3 2-9 Wash Basin Stand with Basin 3 ○ ○ ○ ○ ○ ○ 3 2-10 Cot 1 ○ ○ ○ ○ ○ ○ 1 2-11 Delivery Instrument Set 18 ○ ○ ○ ○ ○ ○ ④ ⑭ ○ 18 2-12 Weighing Scale 3 ○ ○ ○ ○ ○ ○ 3 2-13 Weighing Scale for Infant 3 ○ ○ ○ ○ ○ ○ 3 2-14 Hot Air Sterilizer 2 ○ ○ ○ ○ ○ ○ ○ 2 2-15 Boiling Sterilizer 4 ○ ○ ○ ○ ○ ○ 4 2-16 Sphygmomanometer 3 ○ ○ ○ ○ ○ ○ 3 2-17 Stethoscope 3 ○ ○ ○ ○ ○ ○ 3 Table 2-1 Result of Examination for Requested Equipment

４．Terra Nova H.C.

５．Katambor H.C.

Basic Criteria Additional Criteria Result Requested Criteria for giving Criteria for giving Criteria for giv- Criteria for giving Re- Supple Department Item Name of Equipment New Quantity High Priolity Low Priolity ing High Priolity Low Priolity newal -ment No. Evalu- Quantity 12345671 23456789 1234123456 ation １．Out-Patient 1-1 Stethoscope 6 ○ ○ ○ ○ ○ ③ ③ ○ 6 1-2 Sphygmomanometer 6 ○ ○ ○ ○ ○ ③ ③ ○ 6 1-3 Instrument Cabinet 4 ○ ○ ○ ○ ○ ○ 4 1-4 Instrument Trolley 4 ○ ○ ○ ○ ○ ○ 4 1-5 Examination Table 2 ○ ○ ○ ○ ○ ○ 2 1-6 Examination Light 2 ○ ○ ○ ○ ○ ○ 2 1-7 Weighing Scale for Adult 2 ○ ○ ○ ○ ○ ○ 2 1-8 Weighing scale for Infant 2 ○ ○ ○ ○ ○ ○ 2 1-9 Fetal Doppler Unit 1 ○ ○ ○ ○ ○ ○ ○ ○ 1 1-10 Diagnostic Instrument set 3 ○ ○ ○ ○ ○ ○ 3 1-11 Examining Instrument Set 3 ○ ○ ○ ○ ○ ○ 3 1-12 Hot Air Sterilizer 1 ○ ○ ○ ○ ○ ○ ○ 1 1-13 Boiling Sterilizer 3 ○ ○ ○ ○ ○ ○ 3 1-14 Resuscitator 0 -- - 31 1-15 Wheel Chair 0 -- 1-16 Dental Chair mounted Unit 0 -- 1-17 Film Processor 0 -- 1-18 Dental X-ray Unit 0 -- 1-19 Dental Instrument Set 0 -- 1-20 Hot Air Sterilizer 0 -- 1-21 Instrument Cabinet 0 -- 1-22 Portable Dental Unit 0 -- ２．Delivery 2-1 Observation Bed 1 ○ ○ ○ ○ ○ ○ 1 2-2 Delivery Bed 0 -- 2-3 Examination Table 1 ○ ○ ○ ○ ○ ○ 1 2-4 Examination Light 1 ○ ○ ○ ○ ○ ○ 1 2-5 Suction Unit 0 -- 2-6 Foot Steps 2 ○ ○ ○ ○ ○ ○ 2 2-7 Instrument Cabinet 2 ○ ○ ○ ○ ○ ○ 2 2-8 Instrument Trolley 1 ○ ○ ○ ○ ○ ○ 1 2-9 Wash Basin Stand with Basin 2 ○ ○ ○ ○ ○ ○ 2 2-10 Cot 0 -- 2-11 Delivery Instrument Set 0 -- 2-12 Weighing Scale 1 ○ ○ ○ ○ ○ ○ 1 2-13 Weighing Scale for Infant 1 ○ ○ ○ ○ ○ ○ 1 2-14 Hot Air Sterilizer 1 ○ ○ ○ ○ ○ ○ ○ 1 2-15 Boiling Sterilizer 1 ○ ○ ○ ○ ○ ○ 1 2-16 Sphygmomanometer 2 ○ ○ ○ ○ ○ ○ 2 2-17 Stethoscope 2 ○ ○ ○ ○ ○ ○ 2 Table 2-1 Result of Examination for Requested Equipment

５．Katambor H.C.

- 32 4-8 Incubator 1 ○ ○ ○ ○ ○ ○ 1 4-9 Shaker 1 ○ ○ ○ ○ ○ ○ 1 4-10 Medical Refrigerator 1 ○ ○ ○ ○ ○ ○ ○ 1 4-11 Hot Air Sterilizer 1 ○ ○ ○ ○ ○ ○ 1 4-12 Laboratory Glass Wares 1 ○ ○ ○ ○ ○ ○ 1 4-13 Spectrophotometer 0 -- ５．Others 5-1 AVR 16 ○ ○ ○ ○ ○ ○ 6 5-2 Generator 2 ○ ○ ○ ○ ○ ○ ○ 2 Table 2-1 Result of Examination for Requested Equipment

６．Cassequel H.C.

Basic Criteria Additional Criteria Result Requested Criteria for giving Criteria for giving Criteria for giv- Criteria for giving Re- Supple DepartmentItem Name of Equipment New Quantity High Priolity Low Priolity ing High Priolity Low Priolity newal -ment No. Evalu- Quantity 12345671 23456789 1234123456 ation １．Out-Patient 1-1 Stethoscope 10 ○ ○ ○ ○ ○ ⑥ ④ ○ 10 1-2 Sphygmomanometer 10 ○ ○ ○ ○ ○ ⑥ ④ ○ 10 1-3 Instrument Cabinet 0 -- 1-4 Instrument Trolley 4 ○ ○ ○ ○ ○ ○ 4 1-5 Examination Table 3 ○ ○ ○ ○ ○ ○ 3 1-6 Examination Light 5 ○ ○ ○ ○ ○ ○ 5 1-7 Weighing Scale for Adult 2 ○ ○ ○ ○ ○ ○ 2 1-8 Weighing scale for Infant 2 ○ ○ ○ ○ ○ ○ 2 1-9 Fetal Doppler Unit 2 ○ ○ ○ ○ ○ ○ ○ ○ 2 1-10 Diagnostic Instrument set 3 ○ ○ ○ ○ ○ ○ 3 1-11 Examining Instrument Set 3 ○ ○ ○ ○ ○ ○ 3 1-12 Hot Air Sterilizer 2 ○ ○ ○ ○ ○ ○ ○ 2 1-13 Boiling Sterilizer 4 ○ ○ ○ ○ ○ ○ 4 1-14 Resuscitator 0 -- - 33 1-15 Wheel Chair 2 ○ ○ ○ ○ ○ ○ 2 1-16 Dental Chair mounted Unit 0 -- 1-17 Film Processor 0 -- 1-18 Dental X-ray Unit 0 -- 1-19 Dental Instrument Set 1 ○ ○ ○ ○ ○ ○ 1 1-20 Hot Air Sterilizer 1 ○ ○ ○ ○ ○ ○ ○ 1 1-21 Instrument Cabinet 1 ○ ○ ○ ○ ○ ○ 1 1-22 Portable Dental Unit 1 ○ ○ ○ ○ ○ ○ ○ 1 ２．Delivery 2-1 Observation Bed 0 -- 2-2 Delivery Bed 0 -- 2-3 Examination Table 0 -- 2-4 Examination Light 2 ○ ○ ○ ○ ○ ○ 2 2-5 Suction Unit 2 ○ ○ ○ ○ ○ ○ 2 2-6 Foot Steps 2 ○ ○ ○ ○ ○ ○ 2 2-7 Instrument Cabinet 0 -- 2-8 Instrument Trolley 2 ○ ○ ○ ○ ○ ○ 2 2-9 Wash Basin Stand with Basin 2 ○ ○ ○ ○ ○ ○ 2 2-10 Cot 1 ○ ○ ○ ○ ○ ○ 1 2-11 Delivery Instrument Set 12 ○ ○ ○ ○ ○ ○ ④ ⑧ ○ 12 2-12 Weighing Scale 2 ○ ○ ○ ○ ○ ○ 2 2-13 Weighing Scale for Infant 2 ○ ○ ○ ○ ○ ○ 2 2-14 Hot Air Sterilizer 1 ○ ○ ○ ○ ○ ○ ○ 1 2-15 Boiling Sterilizer 1 ○ ○ ○ ○ ○ ○ 1 2-16 Sphygmomanometer 1 ○ ○ ○ ○ ○ ○ 1 2-17 Stethoscope 1 ○ ○ ○ ○ ○ ○ 1 Table 2-1 Result of Examination for Requested Equipment

６．Cassequel H.C.

- 34 4-8 Incubator 1 ○ ○ ○ ○ ○ ○ 1 4-9 Shaker 1 ○ ○ ○ ○ ○ ○ 1 4-10 Medical Refrigerator 1 ○ ○ ○ ○ ○ ○ ○ 1 4-11 Hot Air Sterilizer 1 ○ ○ ○ ○ ○ ○ 1 4-12 Laboratory Glass Wares 1 ○ ○ ○ ○ ○ ○ 1 4-13 Spectrophotometer 0 -- ５．Others 5-1 AVR 28 ○ ○ ○ ○ ○ ○ 12 5-2 Generator 3 ○ ○ ○ ○ ○ ○ ○ 3 Table 2-1 Result of Examination for Requested Equipment

７．Siga H.C.

Basic Criteria Additional Criteria Result Requested Criteria for giving Criteria for giving Criteria for giv- Criteria for giving Re- Supple DepartmentItem Name of Equipment New Quantity High Priolity Low Priolity ing High Priolity Low Priolity newal -ment No. Evalu- Quantity 12345671 23456789 1234123456 ation １．Out-Patient 1-1 Stethoscope 5 ○ ○ ○ ○ ○ ③ ② ○ 5 1-2 Sphygmomanometer 5 ○ ○ ○ ○ ○ ③ ② ○ 5 1-3 Instrument Cabinet 3 ○ ○ ○ ○ ○ ○ 3 1-4 Instrument Trolley 3 ○ ○ ○ ○ ○ ○ 3 1-5 Examination Table 2 ○ ○ ○ ○ ○ ○ 2 1-6 Examination Light 4 ○ ○ ○ ○ ○ ○ 4 1-7 Weighing Scale for Adult 1 ○ ○ ○ ○ ○ ○ 1 1-8 Weighing scale for Infant 1 ○ ○ ○ ○ ○ ○ 1 1-9 Fetal Doppler Unit 1 ○ ○ ○ ○ ○ ○ ○ ○ 1 1-10 Diagnostic Instrument set 2 ○ ○ ○ ○ ○ ○ 2 1-11 Examining Instrument Set 2 ○ ○ ○ ○ ○ ○ 2 1-12 Hot Air Sterilizer 1 ○ ○ ○ ○ ○ ○ ○ 1 1-13 Boiling Sterilizer 2 ○ ○ ○ ○ ○ ○ 2 1-14 Resuscitator 2 ○ ○ ○ ○ ○ ○ 2 - 35 1-15 Wheel Chair 0 -- 1-16 Dental Chair mounted Unit 1 ○ ○ ○ ○ ○ ○ ○ 1 1-17 Film Processor 0 -- 1-18 Dental X-ray Unit 0 -- 1-19 Dental Instrument Set 1 ○ ○ ○ ○ ○ ○ 1 1-20 Hot Air Sterilizer 1 ○ ○ ○ ○ ○ ○ ○ 1 1-21 Instrument Cabinet 1 ○ ○ ○ ○ ○ ○ 1 1-22 Portable Dental Unit 0 -- ２．Delivery 2-1 Observation Bed 2 ○ ○ ○ ○ ○ ○ 2 2-2 Delivery Bed 0 -- 2-3 Examination Table 1 ○ ○ ○ ○ ○ ○ 1 2-4 Examination Light 2 ○ ○ ○ ○ ○ ○ 2 2-5 Suction Unit 0 -- 2-6 Foot Steps 1 ○ ○ ○ ○ ○ ○ 1 2-7 Instrument Cabinet 1 ○ ○ ○ ○ ○ ○ 1 2-8 Instrument Trolley 1 ○ ○ ○ ○ ○ ○ 1 2-9 Wash Basin Stand with Basin 1 ○ ○ ○ ○ ○ ○ 1 2-10 Cot 0 -- 2-11 Delivery Instrument Set 0 -- 2-12 Weighing Scale 1 ○ ○ ○ ○ ○ ○ 1 2-13 Weighing Scale for Infant 1 ○ ○ ○ ○ ○ ○ 1 2-14 Hot Air Sterilizer 1 ○ ○ ○ ○ ○ ○ ○ 1 2-15 Boiling Sterilizer 1 ○ ○ ○ ○ ○ ○ 1 2-16 Sphygmomanometer 1 ○ ○ ○ ○ ○ ○ 1 2-17 Stethoscope 1 ○ ○ ○ ○ ○ ○ 1 Table 2-1 Result of Examination for Requested Equipment

７．Siga H.C.

- 36 4-8 Incubator 0 -- 4-9 Shaker 1 ○ ○ ○ ○ ○ ○ 1 4-10 Medical Refrigerator 1 ○ ○ ○ ○ ○ ○ ○ 1 4-11 Hot Air Sterilizer 1 ○ ○ ○ ○ ○ ○ 1 4-12 Laboratory Glass Wares 1 ○ ○ ○ ○ ○ ○ 1 4-13 Spectrophotometer 0 -- ５．Others 5-1 AVR 19 ○ ○ ○ ○ ○ ○ 9 5-2 Generator 2 ○ ○ ○ ○ ○ ○ ○ 2 Table 2-1 Result of Examination for Requested Equipment

８．Cariango H.C.

Basic Criteria Additional Criteria Result Requested Criteria for giving Criteria for giving Criteria for giv- Criteria for giving Re- Supple DepartmentItem Name of Equipment New Quantity High Priolity Low Priolity ing High Priolity Low Priolity newal -ment No. Evalu- Quantity 12345671 23456789 1234123456 ation １．Out-Patient 1-1 Stethoscope 5 ○ ○ ○ ○ ○ ③ ② ○ 5 1-2 Sphygmomanometer 5 ○ ○ ○ ○ ○ ③ ② ○ 5 1-3 Instrument Cabinet 3 ○ ○ ○ ○ ○ ○ 3 1-4 Instrument Trolley 3 ○ ○ ○ ○ ○ ○ 3 1-5 Examination Table 3 ○ ○ ○ ○ ○ ○ 3 1-6 Examination Light 3 ○ ○ ○ ○ ○ ○ 3 1-7 Weighing Scale for Adult 1 ○ ○ ○ ○ ○ ○ 1 1-8 Weighing scale for Infant 1 ○ ○ ○ ○ ○ ○ 1 1-9 Fetal Doppler Unit 1 ○ ○ ○ ○ ○ ○ ○ ○ 1 1-10 Diagnostic Instrument set 2 ○ ○ ○ ○ ○ ○ 2 1-11 Examining Instrument Set 2 ○ ○ ○ ○ ○ ○ 2 1-12 Hot Air Sterilizer 1 ○ ○ ○ ○ ○ ○ ○ 1 1-13 Boiling Sterilizer 2 ○ ○ ○ ○ ○ ○ 2 1-14 Resuscitator 2 ○ ○ ○ ○ ○ ○ 2 - 37 1-15 Wheel Chair 0 -- 1-16 Dental Chair mounted Unit 0 -- 1-17 Film Processor 0 -- 1-18 Dental X-ray Unit 0 -- 1-19 Dental Instrument Set 0 -- 1-20 Hot Air Sterilizer 0 -- 1-21 Instrument Cabinet 0 -- 1-22 Portable Dental Unit 0 -- ２．Delivery 2-1 Observation Bed 1 ○ ○ ○ ○ ○ ○ 1 2-2 Delivery Bed 0 -- 2-3 Examination Table 4 ○ ○ ○ ○ ○ ○ 4 2-4 Examination Light 4 ○ ○ ○ ○ ○ ○ 4 2-5 Suction Unit 0 -- 2-6 Foot Steps 4 ○ ○ ○ ○ ○ ○ 4 2-7 Instrument Cabinet 2 ○ ○ ○ ○ ○ ○ 2 2-8 Instrument Trolley 2 ○ ○ ○ ○ ○ ○ 2 2-9 Wash Basin Stand with Basin 2 ○ ○ ○ ○ ○ ○ 2 2-10 Cot 0 -- 2-11 Delivery Instrument Set 0 -- 2-12 Weighing Scale 1 ○ ○ ○ ○ ○ ○ 1 2-13 Weighing Scale for Infant 1 ○ ○ ○ ○ ○ ○ 1 2-14 Hot Air Sterilizer 1 ○ ○ ○ ○ ○ ○ ○ 1 2-15 Boiling Sterilizer 2 ○ ○ ○ ○ ○ ○ 2 2-16 Sphygmomanometer 1 ○ ○ ○ ○ ○ ○ 1 2-17 Stethoscope 1 ○ ○ ○ ○ ○ ○ 1 Table 2-1 Result of Examination for Requested Equipment

８．Cariango H.C.

- 38 4-8 Incubator 1 ○ ○ ○ ○ ○ ○ 1 4-9 Shaker 1 ○ ○ ○ ○ ○ ○ 1 4-10 Medical Refrigerator 1 ○ ○ ○ ○ ○ ○ ○ 1 4-11 Hot Air Sterilizer 1 ○ ○ ○ ○ ○ ○ 1 4-12 Laboratory Glass Wares 1 ○ ○ ○ ○ ○ ○ 1 4-13 Spectrophotometer 0 -- ５．Others 5-1 AVR 20 ○ ○ ○ ○ ○ ○ 6 5-2 Generator 2 ○ ○ ○ ○ ○ ○ ○ 2 Table 2-1 Result of Examination for Requested Equipment

９．Neves Bendinha H.C.

Basic Criteria Additional Criteria Result Requested Criteria for giving Criteria for giving Criteria for giv- Criteria for giving Re- Supple DepartmentItem Name of Equipment New Quantity High Priolity Low Priolity ing High Priolity Low Priolity newal -ment No. Evalu- Quantity 12345671 23456789 1234123456 ation １．Out-Patient 1-1 Stethoscope 6 ○ ○ ○ ○ ○ ③ ③ ○ 6 1-2 Sphygmomanometer 6 ○ ○ ○ ○ ○ ③ ③ ○ 6 1-3 Instrument Cabinet 3 ○ ○ ○ ○ ○ ○ 3 1-4 Instrument Trolley 3 ○ ○ ○ ○ ○ ○ 3 1-5 Examination Table 4 ○ ○ ○ ○ ○ ○ 4 1-6 Examination Light 4 ○ ○ ○ ○ ○ ○ 4 1-7 Weighing Scale for Adult 1 ○ ○ ○ ○ ○ ○ 1 1-8 Weighing scale for Infant 1 ○ ○ ○ ○ ○ ○ 1 1-9 Fetal Doppler Unit 1 ○ ○ ○ ○ ○ ○ ○ ○ 1 1-10 Diagnostic Instrument set 2 ○ ○ ○ ○ ○ ○ 2 1-11 Examining Instrument Set 2 ○ ○ ○ ○ ○ ○ 2 1-12 Hot Air Sterilizer 2 ○ ○ ○ ○ ○ ○ ○ 2 1-13 Boiling Sterilizer 2 ○ ○ ○ ○ ○ ○ 2 1-14 Resuscitator 1 ○ ○ ○ ○ ○ ○ 1 - 39 1-15 Wheel Chair 4 ○ ○ ○ ○ ○ ○ 4 1-16 Dental Chair mounted Unit 0 -- 1-17 Film Processor 0 -- 1-18 Dental X-ray Unit 0 -- 1-19 Dental Instrument Set 0 -- 1-20 Hot Air Sterilizer 0 -- 1-21 Instrument Cabinet 0 -- 1-22 Portable Dental Unit 0 -- ２．Delivery 2-1 Observation Bed 0 -- 2-2 Delivery Bed 0 -- 2-3 Examination Table 4 ○ ○ ○ ○ ○ ○ 4 2-4 Examination Light 4 ○ ○ ○ ○ ○ ○ 4 2-5 Suction Unit 0 -- 2-6 Foot Steps 2 ○ ○ ○ ○ ○ ○ 2 2-7 Instrument Cabinet 2 ○ ○ ○ ○ ○ ○ 2 2-8 Instrument Trolley 2 ○ ○ ○ ○ ○ ○ 2 2-9 Wash Basin Stand with Basin 2 ○ ○ ○ ○ ○ ○ 2 2-10 Cot 0 -- 2-11 Delivery Instrument Set 12 ○ × 0 2-12 Weighing Scale 2 ○ ○ ○ ○ ○ ○ 2 2-13 Weighing Scale for Infant 2 ○ ○ ○ ○ ○ ○ 2 2-14 Hot Air Sterilizer 1 ○ ○ ○ ○ ○ ○ ○ 1 2-15 Boiling Sterilizer 2 ○ ○ ○ ○ ○ ○ 2 2-16 Sphygmomanometer 2 ○ ○ ○ ○ ○ ○ 2 2-17 Stethoscope 2 ○ ○ ○ ○ ○ ○ 2 Table 2-1 Result of Examination for Requested Equipment

９．Neves Bendinha H.C.

- 40 4-8 Incubator 1 ○ ○ ○ ○ ○ ○ 1 4-9 Shaker 1 ○ ○ ○ ○ ○ ○ 1 4-10 Medical Refrigerator 1 ○ ○ ○ ○ ○ ○ ○ 1 4-11 Hot Air Sterilizer 1 ○ ○ ○ ○ ○ ○ 1 4-12 Laboratory Glass Wares 1 ○ ○ ○ ○ ○ ○ 1 4-13 Spectrophotometer 1 ○ ○ ○ ○ ○ ○ ○ 1 ５．Others 5-1 AVR 24 ○ ○ ○ ○ ○ ○ 9 5-2 Generator 2 ○ ○ ○ ○ ○ ○ ○ 2 Table 2-1 Result of Examination for Requested Equipment

１０．Samba H.C.

Basic Criteria Additional Criteria Result Requested Criteria for giving Criteria for giving Criteria for giv- Criteria for giving Re- Supple DepartmentItem Name of Equipment New Quantity High Priolity Low Priolity ing High Priolity Low Priolity newal -ment No. Evalu- Quantity 12345671 23456789 1234123456 ation １．Out-Patient 1-1 Stethoscope 10 ○ ○ ○ ○ ○ ④ ⑥ ○ 10 1-2 Sphygmomanometer 10 ○ ○ ○ ○ ○ ④ ⑥ ○ 10 1-3 Instrument Cabinet 6 ○ ○ ○ ○ ○ ④ ② ○ 6 1-4 Instrument Trolley 6 ○ ○ ○ ○ ○ ④ ② ○ 6 1-5 Examination Table 4 ○ ○ ○ ○ ○ ○ 4 1-6 Examination Light 4 ○ ○ ○ ○ ○ ○ 4 1-7 Weighing Scale for Adult 2 ○ ○ ○ ○ ○ ○ 2 1-8 Weighing scale for Infant 2 ○ ○ ○ ○ ○ ○ 2 1-9 Fetal Doppler Unit 2 ○ ○ ○ ○ ○ ○ ○ ○ 2 1-10 Diagnostic Instrument set 3 ○ ○ ○ ○ ○ ○ 3 1-11 Examining Instrument Set 3 ○ ○ ○ ○ ○ ○ 3 1-12 Hot Air Sterilizer 2 ○ ○ ○ ○ ○ ○ ○ 2 1-13 Boiling Sterilizer 4 ○ ○ ○ ○ ○ ○ 4 1-14 Resuscitator 3 ○ ○ ○ ○ ○ ○ 3 - 41 1-15 Wheel Chair 4 ○ ○ ○ ○ ○ ○ 4 1-16 Dental Chair mounted Unit 0 -- 1-17 Film Processor 0 -- 1-18 Dental X-ray Unit 0 -- 1-19 Dental Instrument Set 0 -- 1-20 Hot Air Sterilizer 0 -- 1-21 Instrument Cabinet 0 -- 1-22 Portable Dental Unit 0 -- ２．Delivery 2-1 Observation Bed 5 ○ ○ ○ ○ ○ ○ 5 2-2 Delivery Bed 2 ○ ○ ○ ○ ○ ○ ① ① ○ 2 2-3 Examination Table 5 ○ ○ ○ ○ ○ ② ③ ○ 5 2-4 Examination Light 7 ○ ○ ○ ○ ○ ③ ④ ○ 7 2-5 Suction Unit 2 ○ ○ ○ ○ ○ ○ 2 2-6 Foot Steps 6 ○ ○ ○ ○ ○ ○ 6 2-7 Instrument Cabinet 2 ○ ○ ○ ○ ○ ○ 2 2-8 Instrument Trolley 2 ○ ○ ○ ○ ○ ○ 2 2-9 Wash Basin Stand with Basin 4 ○ ○ ○ ○ ○ ○ 4 2-10 Cot 1 ○ ○ ○ ○ ○ ○ 1 2-11 Delivery Instrument Set 18 ○ ○ ○ ○ ○ ○ ○ 18 2-12 Weighing Scale 2 ○ ○ ○ ○ ○ ○ 2 2-13 Weighing Scale for Infant 2 ○ ○ ○ ○ ○ ○ 2 2-14 Hot Air Sterilizer 2 ○ ○ ○ ○ ○ ○ ○ 2 2-15 Boiling Sterilizer 2 ○ ○ ○ ○ ○ ○ 2 2-16 Sphygmomanometer 2 ○ ○ ○ ○ ○ ○ 2 2-17 Stethoscope 2 ○ ○ ○ ○ ○ ○ 2 Table 2-1 Result of Examination for Requested Equipment

１０．Samba H.C.

- 42 4-8 Incubator 1 ○ ○ ○ ○ ○ ○ 1 4-9 Shaker 1 ○ ○ ○ ○ ○ ○ 1 4-10 Medical Refrigerator 1 ○ ○ ○ ○ ○ ○ ○ 1 4-11 Hot Air Sterilizer 1 ○ ○ ○ ○ ○ ○ 1 4-12 Laboratory Glass Wares 2 ○ ○ ○ ○ ○ ○ 2 4-13 Spectrophotometer 0 -- ５．Others 5-1 AVR 32 ○ ○ ○ ○ ○ ○ 11 5-2 Generator 3 ○ ○ ○ ○ ○ ○ ○ 3 Table 2-1 Result of Examination for Requested Equipment

１１．Bairro Operario H.C.

Basic Criteria Additional Criteria Result Requested Criteria for giving Criteria for giving Criteria for giv- Criteria for giving Re- Supple DepartmentItem Name of Equipment New Quantity High Priolity Low Priolity ing High Priolity Low Priolity newal -ment No. Evalu- Quantity 12345671 23456789 1234123456 ation １．Out-Patient 1-1 Stethoscope 5 ○ ○ ○ ○ ○ ③ ② ○ 5 1-2 Sphygmomanometer 5 ○ ○ ○ ○ ○ ③ ② ○ 5 1-3 Instrument Cabinet 3 ○ ○ ○ ○ ○ ○ 3 1-4 Instrument Trolley 3 ○ ○ ○ ○ ○ ○ 3 1-5 Examination Table 4 ○ ○ ○ ○ ○ ○ 4 1-6 Examination Light 4 ○ ○ ○ ○ ○ ○ 4 1-7 Weighing Scale for Adult 2 ○ ○ ○ ○ ○ ○ 2 1-8 Weighing scale for Infant 2 ○ ○ ○ ○ ○ ○ 2 1-9 Fetal Doppler Unit 1 ○ ○ ○ ○ ○ ○ ○ ○ 1 1-10 Diagnostic Instrument set 3 ○ ○ ○ ○ ○ ○ 3 1-11 Examining Instrument Set 3 ○ ○ ○ ○ ○ ○ 3 1-12 Hot Air Sterilizer 1 ○ ○ ○ ○ ○ ○ ○ 1 1-13 Boiling Sterilizer 2 ○ ○ ○ ○ ○ ○ 2 1-14 Resuscitator 1 ○ ○ ○ ○ ○ ○ 1 - 43 1-15 Wheel Chair 1 ○ ○ ○ ○ ○ ○ 1 1-16 Dental Chair mounted Unit 0 -- 1-17 Film Processor 0 -- 1-18 Dental X-ray Unit 0 -- 1-19 Dental Instrument Set 0 -- 1-20 Hot Air Sterilizer 0 -- 1-21 Instrument Cabinet 0 -- 1-22 Portable Dental Unit 0 -- ２．Delivery 2-1 Observation Bed 0 -- 2-2 Delivery Bed 0 -- 2-3 Examination Table 2 ○ ○ ○ ○ ○ ○ 2 2-4 Examination Light 2 ○ ○ ○ ○ ○ ○ 2 2-5 Suction Unit 0 -- 2-6 Foot Steps 2 ○ ○ ○ ○ ○ ○ 2 2-7 Instrument Cabinet 2 ○ ○ ○ ○ ○ ○ 2 2-8 Instrument Trolley 2 ○ ○ ○ ○ ○ ○ 2 2-9 Wash Basin Stand with Basin 2 ○ ○ ○ ○ ○ ○ 2 2-10 Cot 0 -- 2-11 Delivery Instrument Set 0 -- 2-12 Weighing Scale 1 ○ ○ ○ ○ ○ ○ 1 2-13 Weighing Scale for Infant 1 ○ ○ ○ ○ ○ ○ 1 2-14 Hot Air Sterilizer 0 -- 2-15 Boiling Sterilizer 0 -- 2-16 Sphygmomanometer 1 ○ ○ ○ ○ ○ ○ 1 2-17 Stethoscope 1 ○ ○ ○ ○ ○ ○ 1 Table 2-1 Result of Examination for Requested Equipment

１１．Bairro Operario H.C.

- 44 4-8 Incubator 0 -- 4-9 Shaker 1 ○ ○ ○ ○ ○ ○ 1 4-10 Medical Refrigerator 1 ○ ○ ○ ○ ○ ○ ○ 1 4-11 Hot Air Sterilizer 1 ○ ○ ○ ○ ○ ○ 1 4-12 Laboratory Glass Wares 1 ○ ○ ○ ○ ○ ○ 1 4-13 Spectrophotometer 0 -- ５．Others 5-1 AVR 14 ○ ○ ○ ○ ○ ○ 5 5-2 Generator 2 ○ ○ ○ ○ ○ ○ ○ 2 Table 2-1 Result of Examination for Requested Equipment

１２．Prenda H.C.

Basic Criteria Additional Criteria Result Requested Criteria for giving Criteria for giving Criteria for giv- Criteria for giving Re- Supple DepartmentItem Name of Equipment New Quantity High Priolity Low Priolity ing High Priolity Low Priolity newal -ment No. Evalu- Quantity 12345671 23456789 1234123456 ation １．Out-Patient 1-1 Stethoscope 4 ○ ○ ○ ○ ○ ③ ① ○ 4 1-2 Sphygmomanometer 4 ○ ○ ○ ○ ○ ③ ① ○ 4 1-3 Instrument Cabinet 3 ○ ○ ○ ○ ○ ○ 3 1-4 Instrument Trolley 3 ○ ○ ○ ○ ○ ○ 3 1-5 Examination Table 2 ○ ○ ○ ○ ○ ○ 2 1-6 Examination Light 2 ○ ○ ○ ○ ○ ○ 2 1-7 Weighing Scale for Adult 1 ○ ○ ○ ○ ○ ○ 1 1-8 Weighing scale for Infant 1 ○ ○ ○ ○ ○ ○ 1 1-9 Fetal Doppler Unit 2 ○ ○ ○ ○ ○ ○ ○ ○ 2 1-10 Diagnostic Instrument set 3 ○ ○ ○ ○ ○ ○ 3 1-11 Examining Instrument Set 3 ○ ○ ○ ○ ○ ○ 3 1-12 Hot Air Sterilizer 1 ○ ○ ○ ○ ○ ○ ○ 1 1-13 Boiling Sterilizer 2 ○ ○ ○ ○ ○ ○ 2 1-14 Resuscitator 1 ○ ○ ○ ○ ○ ○ 1 - 45 1-15 Wheel Chair 0 -- 1-16 Dental Chair mounted Unit 1 ○ ○ ○ ○ ○ ○ ○ 1 1-17 Film Processor 0 -- 1-18 Dental X-ray Unit 0 -- 1-19 Dental Instrument Set 1 ○ ○ ○ ○ ○ ○ 1 1-20 Hot Air Sterilizer 1 ○ ○ ○ ○ ○ ○ 1 1-21 Instrument Cabinet 1 ○ ○ ○ ○ ○ ○ 1 1-22 Portable Dental Unit 0 -- ２．Delivery 2-1 Observation Bed 0 -- 2-2 Delivery Bed 0 -- 2-3 Examination Table 2 ○ ○ ○ ○ ○ ○ 2 2-4 Examination Light 2 ○ ○ ○ ○ ○ ○ 2 2-5 Suction Unit 0 -- 2-6 Foot Steps 2 ○ ○ ○ ○ ○ ○ 2 2-7 Instrument Cabinet 1 ○ ○ ○ ○ ○ ○ 1 2-8 Instrument Trolley 1 ○ ○ ○ ○ ○ ○ 1 2-9 Wash Basin Stand with Basin 1 ○ ○ ○ ○ ○ ○ 1 2-10 Cot 0 -- 2-11 Delivery Instrument Set 2 ○ × 0 2-12 Weighing Scale 1 ○ ○ ○ ○ ○ ○ 1 2-13 Weighing Scale for Infant 1 ○ ○ ○ ○ ○ ○ 1 2-14 Hot Air Sterilizer 0 -- 2-15 Boiling Sterilizer 0 -- 2-16 Sphygmomanometer 1 ○ ○ ○ ○ ○ ○ 1 2-17 Stethoscope 1 ○ ○ ○ ○ ○ ○ 1 Table 2-1 Result of Examination for Requested Equipment

１２．Prenda H.C.

- 46 4-8 Incubator 1 ○ ○ ○ ○ ○ ○ 1 4-9 Shaker 1 ○ ○ ○ ○ ○ ○ 1 4-10 Medical Refrigerator 1 ○ ○ ○ ○ ○ ○ ○ 1 4-11 Hot Air Sterilizer 1 ○ ○ ○ ○ ○ ○ 1 4-12 Laboratory Glass Wares 1 ○ ○ ○ ○ ○ ○ 1 4-13 Spectrophotometer 0 -- ５．Others 5-1 AVR 19 ○ ○ ○ ○ ○ ○ 8 5-2 Generator 2 ○ ○ ○ ○ ○ ○ ○ 2 Table 2-1 Result of Examination for Requested Equipment

１３．Kinanga H.C.

Basic Criteria Additional Criteria Result Requested Criteria for giving Criteria for giving Criteria for giv- Criteria for giving Re- Supple DepartmentItem Name of Equipment New Quantity High Priolity Low Priolity ing High Priolity Low Priolity newal -ment No. Evalu- Quantity 12345671 23456789 1234123456 ation １．Out-Patient 1-1 Stethoscope 6 ○ ○ ○ ○ ○ ③ ③ ○ 6 1-2 Sphygmomanometer 6 ○ ○ ○ ○ ○ ③ ③ ○ 6 1-3 Instrument Cabinet 4 ○ ○ ○ ○ ○ ○ 4 1-4 Instrument Trolley 4 ○ ○ ○ ○ ○ ○ 4 1-5 Examination Table 2 ○ ○ ○ ○ ○ ○ 2 1-6 Examination Light 2 ○ ○ ○ ○ ○ ○ 2 1-7 Weighing Scale for Adult 2 ○ ○ ○ ○ ○ ○ 2 1-8 Weighing scale for Infant 2 ○ ○ ○ ○ ○ ○ 2 1-9 Fetal Doppler Unit 1 ○ ○ ○ ○ ○ ○ ○ ○ 1 1-10 Diagnostic Instrument set 3 ○ ○ ○ ○ ○ ○ 3 1-11 Examining Instrument Set 3 ○ ○ ○ ○ ○ ○ 3 1-12 Hot Air Sterilizer 1 ○ ○ ○ ○ ○ ○ ○ 1 1-13 Boiling Sterilizer 3 ○ ○ ○ ○ ○ ○ 3 1-14 Resuscitator 0 -- - 47 1-15 Wheel Chair 0 -- 1-16 Dental Chair mounted Unit 0 -- 1-17 Film Processor 0 -- 1-18 Dental X-ray Unit 0 -- 1-19 Dental Instrument Set 0 -- 1-20 Hot Air Sterilizer 0 -- 1-21 Instrument Cabinet 0 -- 1-22 Portable Dental Unit 0 -- ２．Delivery 2-1 Observation Bed 0 -- 2-2 Delivery Bed 0 -- 2-3 Examination Table 2 ○ ○ ○ ○ ○ ○ 2 2-4 Examination Light 2 ○ ○ ○ ○ ○ ○ 2 2-5 Suction Unit 0 -- 2-6 Foot Steps 2 ○ ○ ○ ○ ○ ○ 2 2-7 Instrument Cabinet 1 ○ ○ ○ ○ ○ ○ 1 2-8 Instrument Trolley 2 ○ ○ ○ ○ ○ ○ 2 2-9 Wash Basin Stand with Basin 2 ○ ○ ○ ○ ○ ○ 2 2-10 Cot 0 -- 2-11 Delivery Instrument Set 0 -- 2-12 Weighing Scale 2 ○ ○ ○ ○ ○ ○ 2 2-13 Weighing Scale for Infant 0 -- 2-14 Hot Air Sterilizer 1 ○ ○ ○ ○ ○ ○ ○ 1 2-15 Boiling Sterilizer 1 ○ ○ ○ ○ ○ ○ 1 2-16 Sphygmomanometer 2 ○ ○ ○ ○ ○ ○ 2 2-17 Stethoscope 2 ○ ○ ○ ○ ○ ○ 2 Table 2-1 Result of Examination for Requested Equipment

１３．Kinanga H.C.

According to the result of examination and selection in "2-3-1 Design Concept" and "2-3-2 Basic Design" of Chapter 2, the equipments shall be procured to each project facility. The detail of those equipments is as the Table 2-2 "Equipment Plan". As for three (3) Health Centers of Bairro Operario, Prenda and Kinanga which were additionally included in this project, the quantity of the requested equipments is not shown in the equipment list attached to the Minutes of Discussion. By the mutual consent between Angola and Japan, the procurement plan for these sites is made according to the result of the domestic analysis by the study team.

Requested quantities and Final quantities Equipment List Project Facilities in the Minutes Final quantities of Discussions after analysis ① Ilha Health Center 58 items 58 items （212 pcs.）（195 pcs.） ② Sambizanga Health Center 50 items 50 items （140 pcs.）（125 pcs.） ③ Rangel Health Center 43 items 43 items （131 pcs.）（114 pcs.） ④ Terra Nova Health Center 56 items 56 items （226 pcs.）（205 pcs.） ⑤ Katambor Health Center 40 items 40 items （90 pcs.）（80 pcs.） ⑥ Cassequel Health Center 50 items 50 items （143 pcs.）（127 pcs.） ⑦ Siga Health Center 48 items 48 items （93 pcs.）（83 pcs.） ⑧ Cariango Health Center 41 items 41 items （94 pcs.）（80 pcs.） 48 items 47 items ⑨ Neves Bendinha Health Center （131 pcs.）（104 pcs.） ⑩ Samba Health Center 52 items 52 items （194 pcs.）（173 pcs.） ⑪ Bairro Operario Health 37 items Center －（75 pcs.） ⑫ Prenda Health Center 42 items －（75 pcs.） ⑬ Kinanga Health Center 31 items －（69 pcs.） 595 items Total －（1,505 pcs.）

- 49 - Table 2-2 Distribution Plan of Equipment

EQUIPMENT ①②③④⑤⑥⑦⑧⑨⑩⑪ ⑫ ⑬ TOTAL 1. Out-patient 1-1 Stethoscope 10 6 10 15 6 10 5 5 6 10 5 4 6 98 1-2 Sphygmomanometer 10 6 10 15 6 10 5 5 6 10 5 4 6 98 1-3 Instrument Cabinet 9469403336334 57 1-4 Instrument Trolley 9469443336334 61 1-5 Examination Table 6446232344422 46 1-6 Examination Light 6466254344422 52 1-7 Weighing Scale for Adult 3223221112212 24 1-8 Weighing Scale for Infant 3223221112212 24 1-9 Fetal Doppler Unit 2212121112121 19 1-10 Diagnostic Instrument Set 6336332223333 42 1-11 Examining Instrument Set 6336332223333 42 1-12 Hot Air Sterilizer 2112121122111 18 1-13 Boiling Sterilizer 4446342224223 42 1-14 Resuscitator 2232002213110 19 1-15 Wheel Chair 4201020044100 18 1-16 Dental Chair mounted Unit 2000001000010 4 1-17 Film Processor 1000000000000 1 1-18 Dental X-ray Unit 1000000000000 1 1-19 Dental Instrument Set 2111011000010 8 1-20 Hot Air Sterilizer 1101011000010 6 1-21 Instrument Cabinet 2101011000010 7 1-22 Portable Dental Unit 0111010000000 4 2. Delivery 2-1 Observation Bed 3223102105000 19 2-2 Delivery Bed 2100000002000 5 2-3 Examination Table 2223101445222 30 2-4 Examination Light 2222122447222 34 2-5 Suction Unit 2103020002000 10 2-6 Foot Steps 3225221426222 35 2-7 Instrument Cabinet 3223201222211 23 2-8 Instrument Trolley 3223121222212 25 2-9 Wash Basin Stand with Basin 3223221224212 28 2-10 Cot 1101010001000 5 2-11 Delivery Instrument Set 18 18 0 18 0 12 0 0 0 18 0 0 0 84 2-12 Weighing Scale 3223121122112 23 2-13 Weighing Scale for Baby 3223121122110 21 2-14 Hot Air Sterilizer 2222111112001 16 2-15 Boiling Sterilizer 2224111222001 20 2-16 Sphygmomanometer 3223211122112 23 2-17 Stethoscope 3223211122112 23 3. Radiology 3-1 Diagnostic X-ray Unit 1001011011000 6 3-2 X-ray Film Processing Unit, Manual 1001011001000 5 3-3 Film Dryer 1001011011000 6 3-4 Film Hanger 4004044044000 24 3-5 Film Storage Cabinet 1001011011000 6 3-6 X-ray Protection Apron 2002022022000 12 4. Laboratory 4-1 Binocular Microscope 3223221123221 26 4-2 Centrifuge 1112111111111 14 4-3 Micro Centrifuge 1111110111110 11 4-4 Blood Sedimentation Apparatus 2112111121121 17 4-5 Automatic Timer 2122221112120 19 4-6 Leucocyte Counter, Manual 2122221113222 23 4-7 Water Bath 1111110111010 10 4-8 Incubator 1111110111010 10 4-9 Shaker 1111111111110 12 4-10 Medical Refrigerator 1111111111110 12 4-11 Hot Air Sterilizer 1111111111110 12 4-12 Laboratory Glass Wares 1111111112111 14 4-13 Spectrophotometer 0001000010000 2 5. Others 5-1 AVR 16 10 8 16 6 12 9 6 9 11 5 8 3 119 5-2 Generator 3223232223222 30 195 125 114 205 80 127 83 80 104 173 75 75 69 1,505

- 50 - (4) Specifications of the main equipment for the project.

Main equipments to be procured in this project are three (3) items. Their detailed specification, level and purpose of use are as shown in the Table 2-3 "Specification of Main Equipments".

Table 2-3 Specifications of Main Equipment

DESCRIPTION SPECIFICATIONS APPLICATIONS Q’TY

Movement: Chair seat Though exodontia is Hydraulic mainly performed as the Height of seat:Min.450～660mm dental care at present, Backrest angle: Upright 65deg. high-quality

Dental Chair mounted Operating light: provided treatment toward the 1 4 Unit with Hand-piece, Air turbine, dental caries becomes Micro-motor possible in the early stages by the procurement of this equipment.

Composition: Treatment Unit, Though exodontia is Vacuum pack, mainly performed as the Small compressor dental care at present, Water tank: 200cc or more high-quality treatment with Hand-piece toward the dental caries becomes 2 Portable Dental Unit possible in the early 4

stages by the procurement of this equipment. Also, it is handy and easily available for the first aid of the emergency. X-ray tube：Single tube In the PHC level, the Power supply：Single phase, 200 plain examination unit ～240V being in the most Voltage／Ampair：150kv、320mA frequent use shall be Focus time：0.01～10 sec． procured. In the Tube support： Health Centers, it is

Diagnostic X-ray Vertical travel 400～2,000mm mainly submitted for 3 6 Unit Longitudinal travel 2,500mm the organicus

Lateral travel 250mm photography of the with Bucky table, Bucky stand pectoral region and the abdomen, and the diagnosis of bone and articulation.

- 51 - (5) Facility outline and installation plan

For each project facility, the institutional outline, the configuration drawing and the layout plan for the equipment installation are shown as follows.

- 52 - ① Ilha H. C.

Age of the building ：1990 Water supply ： City water Structure of the building：Brick +Concrete Drainage system ： City sewage system Voltage ：1Φ220Ｖ 3Φ380V Solid waste ： Trash processing Power failure ：Few disposal system by community

mnl l n e h k k f g i mbm cd b a j k

a Urgent Bank b Consulting Room(Internal medicine) c Consulting Room(Pediatrics ) d Vaccine e Consulting Room(Obstetrics) f Delivery Room g Labor Room Access Road h Family planning i X-Ray Room j Darkroom k Laboratory l Pharmacy m Administrator n Dental Site Plan

② ② ①

①

③

④ ① ② ⑤

③

X-RAY ROOM ① Floating Bucky Table ② X-ray Tube Support Unit DENTAL ③ Vertical Bucky Stand ① Dental unit ④ X-ray Control Console ② Compressor ⑤ X-ray Control Cabinet ③ Dental X-ray unit

0 1 Installation Plan 3m

- 53 - ② Sambizanga H.C.

Age of the building ：1982 Water supply ： Water Tank Structure of the building：Brick +Concrete Drainage system ： City sewage system Voltage ：1Φ220Ｖ 3Φ380V Solid waste ： Trash processing Power failure ：Often disposal system by community

Access Road

o a b h m m f k m g m l a Urgent Bank c e b Consulting Room (Internal medicine) c Consulting Room d n 2F PLAN (Pediatrics ) d Vaccine e Consulting Room (Obstetrics) 1F PLAN f Delivery Room g Labor Room h Family planning k Laboratory l Pharmacy m Administrator n Dental Site Plan o Tuberculosis

- 54 - ③ Rangel H.C.

m d c m

a Urgent Bank b b Consulting Room (Internal medicine) c Consulting Room e l k a (Pediatrics ) d Vaccine e Consulting Room (Obstetrics) h Family planning Access Road k Laboratory l Pharmacy m Administrator

Site Plan

- 55 - ④ Terra Nova H.C.

Age of the building ：1963 Water supply ： City water Structure of the building：Brick +Concrete Drainage system ： City sewage system Voltage ：1Φ220Ｖ 3Φ380V Solid waste ： Trash processing Power failure ：Few disposal system by community

k kkk b d a Urgent Bank b Consulting Room (Internal medicine) Access Road c Consulting Room m (Pediatrics ) d Vaccine e Consulting Room (Obstetrics) n f Delivery Room h a g Labor Room p h Family planning i X-Ray Room i j Darkroom j k Laboratory m l c q efo l Pharmacy m Administrator g g n Dental o Tuberculosis p Treatment Room Site Plan q ORS

④

X-RAY ROOM ⑥ ① Floating Bucky Table ② X-ray Tube Support Unit Vertical Bucky Stand ⑤ ② ③ ① ④ X-ray Control Console ⑤ X-ray Control Cabinet ⑥ X-ray Protective Floor Screen (2mm Pb) ③

0 1 3m Installation Plan

- 56 - ⑤ Katambor H.C.

Age of the building ：1983 Water supply ： Water Tank Structure of the building：Brick +Concrete Drainage system ： City sewage system Voltage ：1Φ220Ｖ 3Φ380V Solid waste ： Trash processing Power failure ：Often disposal system by community

c e m d h m a k

2F PLAN b a Treatment Room l b Consulting Room c Consulting Room (Pediatrics ) d Vaccine e Consulting Room Access Road (Obstetrics) h Family planning k Laboratory 1F PLAN l Pharmacy m Administrator

Site Plan

- 57 - ⑥ Cassequel H.C.

Age of the building ：1995 Water supply ： Water Tank Structure of the building：Brick +Concrete Drainage system ： City sewage system Voltage ：1Φ220Ｖ 3Φ380V Solid waste ： Trash processing Power failure ：Few disposal system by community

g g a Urgent Bank b Consulting Room f (Internal medicine) h c Consulting Room e (Pediatrics ) Access Road d Vaccine e Consulting Room (Obstetrics) cmb c q p m m l f Delivery Room g Labor Room h Family planning j i X-Ray Room i kkk d m a j Darkroom k Laboratory l Pharmacy m Administrator p Treatment Room q ORS

Site Plan

⑤ ④

① ⑥ ②

X-RAY ROOM ① Floating Bucky Table ② X-ray Tube Support Unit ③ Vertical Bucky Stand ④ X-ray Control Console ⑤ X-ray Control Cabinet ③ ⑥ X-ray Protective Floor Screen (2mm Pb)

0 1 3m Installation Plan

- 58 - ⑦ Siga H.C.

Age of the building ：1966 Water supply ： City Water Structure of the building：Brick +Concrete Drainage system： City sewage system Voltage ：1Φ220Ｖ 3Φ380V Solid waste ： Trash processing Power failure ：Few disposal system by community

n e b a m c j i Laboratory

Access Road a Urgent Bank b Consulting Room c Treatment Room e Consulting Room (Obstetrics) i X-Ray Room j Darkroom m Administrator n Dental Site Plan

⑤ ③ ②

①

②

⑥ ④ ①

X-RAY ROOM DENTAL ① Floating Bucky Table ① Dental unit ② X-ray Tube Support Unit ② Compressor ③ Vertical Bucky Stand ④ X-ray Control Console ⑤ X-ray Control Cabinet ⑥ X-ray Protective Floor Screen (2mm Pb) 0 1 3m Installation Plan

- 59 - ⑧ Cariango H.C.

Age of the building ：1975 Water supply ： Water Tank Structure of the building：Brick +Concrete Drainage system： City sewage system Voltage ：1Φ220Ｖ 3Φ380V Solid waste ： Trash processing Power failure ：Very often disposal system by community

Access Road

n h b k l a Urgent Bank b Consulting Room (Internal medicine) c Consulting Room (Pediatrics ) m d d Vaccine o e Consulting Room (Obstetrics) e a c n h Family planning k Laboratory l Pharmacy m Administrator n Treatment Room o Tuberculosis Site Plan

- 60 - ⑨ Neves Bendinha H.C.

Age of the building ：1990 Water supply ： City water Structure of the building：Brick +Concrete Drainage system： City sewage system Voltage ：1Φ220Ｖ 3Φ380V Solid waste ： Trash processing Power failure ：Few disposal system by community

k k i d e j k

h a Urgent Bank b Consulting Room c a (Internal medicine) b c Consulting Room (Pediatrics ) d Vaccine p c c e Consulting Room m (Obstetrics) h Family planning Access Road i X-Ray Room j Darkroom k Laboratory m Administrator Site Plan p Treatment Room

④

⑤ X-RAY ROOM Floating Bucky Table ① ① ② ② X-ray Tube Support Unit ③ Vertical Bucky Stand ④ X-ray Control Console ⑤ X-ray Control Cabinet ③

0 1 3m Installation Plan

- 61 - ⑩ Samba H.C.

Age of the building ：2001 Water supply ： City water Structure of the building：Brick +Concrete Drainage system ： City sewage system Voltage ：1Φ220Ｖ 3Φ380V Solid waste ： Trash processing Power failure ：- disposal system by community

f g n d k i g j l m m e e c c b b e m m m

Access Road b Consulting Room(Internal medicine) i X-Ray Room c Consulting Room(Pediatrics ) j Darkroom d Vaccine k Laboratory e Consulting Room(Obstetrics) l Pharmacy f Delivery Room m Administrator g Labor Room n ORS Site Plan

②

①

⑤ ③ ⑥ ④

X-RAY ROOM ① Floating Bucky Table ② X-ray Tube Support Unit ③ Vertical Bucky Stand ④ X-ray Control Console ⑤ X-ray Control Cabinet ⑥ X-ray Protective Floor Screen (2mm Pb)

0 1 3m Installation Plan

- 62 - ⑪ Bairro Operario H.C.

Age of the building ：1986 Water supply ： City water Structure of the building：Brick +Concrete Drainage system ： City sewage system Voltage ：1Φ220Ｖ 3Φ380V Solid waste ： Trash processing Power failure ：Few disposal system by community

Access Road

m m l b Laboratory d a Urgent Bank c e b Consulting Room (Internal medicine) a c Consulting Room (Pediatrics ) d Vaccine e Consulting Room (Obstetrics) l Pharmacy m Administrator

Site Plan

- 63 - ⑫ Prenda H.C.

Age of the building ：1993 Water supply ： Water Tank Structure of the building：Brick +Concrete Drainage system ： City sewage system Voltage ：1Φ220Ｖ 3Φ380V Solid waste ： Trash processing Power failure ：Often disposal system by community

Access Road

n b a d c a Urgent Bank m e l c b Consulting Room k h (Internal medicine) c Consulting Room (Pediatrics ) d Vaccine e Consulting Room (Obstetrics) h Family planning k Laboratory l Pharmacy m Treatment Room n Dental Site Plan

② ①

DENTAL ① Dental unit ② Compressor

0 1 3m Installation Plan

- 64 - ⑬ Kinanga H.C.

Age of the building ：1979 Water supply ： Water Tank Structure of the building：Brick +Concrete Drainage system ： City sewage system Voltage ：1Φ220Ｖ 3Φ380V Solid waste ： Trash processing Power failure ：Very often disposal system by community

l d k a

c e h a Treatment Room b m b Consulting Room (Internal medicine) c Consulting Room (Pediatrics ) Access Road d Vaccine e Consulting Room (Obstetrics) h Family planning k Laboratory l Pharmacy m Administrator

Site Plan

- 65 -

CHAPTER 3

IMPLEMENTATION PLAN

CHAPTER 3 IMPLEMENTATION PLAN

3-1 Implementation Plan

3-1-1 Implementation Concept

This project will be implemented officially in accordance with the grant aid framework of the Government of Japan after approval of both Japanese and Angolan Governments and the conclusion of the Exchange of Notes (E/N). Prior to the implementation, a Japanese consulting company will be selected by the Angolan side, and the company will commence their work for the approval of tender documents for equipment procurement. After completion of tender documents, a Japanese trading company which will be chosen by tender for the project will implement actual work of equipment procurement and installation. The consultant agreement and the supply contract will come into effect after approval of the Government of Japan.

For the implementation of the project conducted within the framework of the Japan’s grant aid, the following items should be considered:

(1) The work schedule should be confirmed by both Japanese and Angolan staff in charge. Both sides should clarify the scope of work and the starting and completion dates of each task to avoid confusion in mutual work plans.

(2) In order to shorten the work period as much as possible, the trading company must investigate the project facilities by two months before delivery of the equipment. The company also must check delivery routes, power supply, water supply and drainage, and prepare a bringing-in schedule.

(3) It is considered to take about 1.7 months for installation and hand-over.

(4) The dismantling work of the existing equipment is carried out by the Angolan side for installation of X-ray unit and dental equipments. In order to avoid the delay of the work on the Angolan side, discussion should be held with the Angolan side on the appropriate time to dismantle the equipment at the time of site survey by engineers of the supplier and the schedule coordination should be made not to interfere the practice of medical services.

(5) An instruction and training seminar will be held for Angolan technicians, at which the trading company will teach operation and regular maintenance methods for the main equipment.

- 66 - (6) As for equipment procured in Japan, Japanese engineers, specializing in X-ray machine, Dental equipment and Laboratory equipment, will give instruction in its installation and operation.

3-1-2 Implementation Conditions

Taking into account that the project facilities are the Health Centers in practice, the delivery and installation procedures, such as installation schedule, delivery routes and depository of the equipment, should be duly considered through the consultation with each project facility so that the daily medical activities may not be disturbed. Especially in case of renewal, sufficient consultation should be made to avoid long unavailability of the equipment caused by the removal, and prompt installation will be required for the stable medical activities.

3-1-3 Scope of Works

(1) The scope of responsibility of the Japanese side under the grant aid for this project covers procurement and subsequent installation of the medical equipment for thirteen Health Centers in Luanda Province.

The scope is limited to as described below:

1. The equipment that is shown in the aforementioned list of distribution plan of equipment.

2. Marine-transport and land-transport expenses, and inland-transport expenses to the project facilities.

3. Foundation of the laboratory rooms (Siga Health Center and Vairro Operario Health Center)

4. Expenses for installation of the equipment (expenses for dispatch of engineers, local workers, tools and measuring meters).

5. Expenses required for carrying out test-run and guidance for operation, inspection and maintenance, relating to all the procured equipment.

(2) The scope of responsibility of Angolan side

1. During the implementation period of this project, a place should be provided for a temporary office in each project facility.

- 67 - 2. The infrastructures (electricity, water supply, drainage and other incidental facilities) necessary for the project should be provided or improved before installation of the equipment, and the existing equipment should be removed from places where the new equipment will be installed.

3. The equipment purchased under this project, should be unloaded without delay and necessary conveniences for customs clearance and internal transportation of the products should be provided.

4. Payments of customs duties and other fiscal levies should be exempted for the Japanese nationals who reside in Angola to implement this project.

5. For the Japanese nationals who are connected with supply of the equipment and services required for the implementation of the project, necessary conveniences for their stay in Angola should be provided and sufficient considerations should be taken for their security as well.

6. In accordance with the Banking Arrangements, the Angolan side should pay the commission for the Banking Arrangements and the issuance of the “authorization to pay” to the authorized foreign exchange bank in Japan.

7. The equipment purchased under the grant aid should be maintained properly and used effectively. For this purpose, necessary budget and personnel should be assured.

3-1-4 Consultant Supervision

(1) Implementation system

This project is implemented by the following five parties:

1) Responsible agency (authorities who assume control of the project)

The responsible agency for this project is the Ministry of Health.

2) Project implementing body

The implementing bodies are thirteen Health Centers which are the project facilities. The Ministry of Health superintends general operations for the project, and the directors and the general managers of each project facility are in charge of actual work of the project.

- 68 -

3) Consultant

Since the project is implemented under the Japanese grant aid program, it is stipulated by its rule that a Japanese consultant gives instructions, advises and coordinates from a fair standpoint at each stage of the project, according to the agreement with the responsible agency of Angola. Besides, the consultant performs necessary work for smooth implementation of the project.

The specific tasks are as follows:

＊ Dentailed Design Study

Confirmation of tender documents for procurement (documents of tender conditions, equipment specifications and budget reports).

＊ Promotion of tender and supply contract

Decision on the supply contract system, preparation of supply contract draft, examination on the contents of the report for equipment installation work, and selection of suppliers (public announcement of tender, tender and tender evaluation, contract negotiation and contract witnessing).

＊ Inspection and approval of work execution drawings

Inspection and approval of equipment specification reports, work execution drawings, and work execution plans submitted by the suppliers.

＊ Report on work progress

Report on progress of work execution to the implementing bodies and the related organizations.

＊ Cooperation in payment approval procedures

Audit on bills relating to the remuneration to be paid after shipment, and cooperation in these procedures.

＊ Consulting work

Witnessing of various works from the beginning through the completion.

- 69 - 4) Supplier

A Japanese supplier (trading company) who will be selected by tender implements procurement of the equipment. The supplier, based upon the contract with the Angolan side, is responsible for manufacturing, supply, bringing-in and installation of the equipment, and gives instructions on equipment operation and maintenance to the Angolan side before hand-over.

5) JICA

Japan International Cooperation Agency (JICA) leads the consultant and the supplier so that the project can be implemented properly in accordance with the Japan’s grant aid system. Moreover, JICA discusses with the responsible agency and the implementing bodies for promoting implementation of the project, if it is necessary.

Figure 3-1 Implementation Flow Chart

Government of Japan JICA Responsible Agency

Ministry of Health, Angola Consultant Agreement

Consultant Administration

Project Health Centers Providing Consulting Service Ilha Health Center Sambizanga Health Center Rangel Health Center Terra Nova Health Center Equipement procurement management Product inspection Katambor Health Center Cassequel Health Center Siga Health Center Supply Contract Cariango Health Center Neves Bendinha Health Center Samba Health Center Bairro Operario Health Center Supplier Prenda Health Center Delivery of equipment Kinanga Health Center Guidance on operation & maintenance

- 70 - (2) Implementation design and supervision

The consultant, based on the agreement with the Angolan side, performs implementation design and supervision for the project. The implementation design is made, in accordance with the basic design study, to determine detailed specifications of the equipment and to prepare the tender documents comprised of such the specifications, tender guidance, draft of supply contract.

The supervision is made to assure that the work of the supplier is implemented in accordance with the contract, and to give instructions, advice and coordination from a fair standpoint to promote the project.

The supervision consists of the following:

1) Stage of implementation design

Confirmation of tender documents, and preparation for tender and contract documents.

2) Stage of tender

Prior screening of applicants for tender, implementation of tender, evaluation of the contents of tender, and conclusion of contract.

3) Stage of work execution

Supervision of work execution (inspection/approval of equipment specifications, supervision of shipment/marine-transport/inland- transport, instruction/supervision of installation, and supervision of work to be covered by the partner country), report on the work execution progress, and issuance of certificates. (Upon confirming that the equipment installation is completed in conformity with the contract conditions, the consultant witnesses hand-over of the equipment and completes its duty after obtaining acknowledgement for receipt of the equipment from the Angolan side.)

Besides the above-mentioned work, the consultant reports on the progress, payment procedures, completion of delivery &c., to whom concerned in the Government of Japan.

- 71 - (3) Personnel plan

Those who will be engaged in the consulting operation for the implementation design and the supervision of the work execution are as follows:

1) Project manager : 1 person The project manager will supervise the whole consulting operation.

2) Medical equipment planner : 1 person This person will analyze the planned equipment.

3) Facility planner : 1 person This person will check and supervise the foundation of the laboratory rooms.

4) Cost estimator : 1 person This person will estimate the project cost at the Detailed Design Stage. .

3-1-5 Procurement Plan

(1)Procurement of the equipment

As for the equipment applied to the following condition, procurement of the products manufactured in any third country shall be planned.

1) Reduction of the unit price and the shipping and containing fee can be received.

2) The competing principle in the tender can be expected.

Table 3-1 Equipment to be procured from a third country

Equipment Origin Market Country Instrument Cabinet South Africa South Africa Examination Table South Africa South Africa Examination Table (Gyne.) South Africa South Africa Foot Steps South Africa South Africa

(2) Transportation of the medical equipment

The equipments procured in Japan shall be transported from any sending port in Japan to the port of Luanda in Angola. The equipments procured

- 72 - in South Africa shall be transported from the port of Durban in South Africa to the port of Luanda, and then forwarded to each project site together with the equipments procured in Japan by motor lorry. In order to protect the equipments from damage and robbery, these equipments shall be packed into the container in each site and transported.

3-1-6 Implementation Schedule

(1) Implementing process

When Cabinet meetings of the Government of Japan approves this project and the Exchange of Notes (E/N) for the implementation of the project is concluded between both relevant countries, the project will be carried out in the following procedures:

1. Conclusion of the E/N between both governments.

2. Conclusion of agreement between the responsible agency and an authorized foreign exchange bank in Japan on payment of the grant aid fund from the Japanese side for implementation of this project (Banking Arrangements).

3. Conclusion of the consultant agreement between the responsible agency and the Japanese consultant.

4. Issuance, by the responsible agency, of authorization to pay (A/P) according to the consultant agreement.

5. Verification of the above agreement and assent of payment by the Government of Japan.

6. Implementation design and preparation of tender documents by the consultant.

7. Approval of the tender documents by the responsible agency and preparation of tender by the consultant.

8. Tender and evaluation of tender documents.

9. Conclusion of supply contract (sales contract) relating to equipment. Procurement between the responsible agency and a Japanese trading company.

10. Verification of the above contract by the Government of Japan.

11. Issuance, by the responsible agency, of authorization to pay (A/P) according to the supply contract.

- 73 - 12. Approval to manufacture of equipment and work execution drawings. (The consultant examines and approves the equipment specifications submitted by the suppliers, gives necessary instructions, and coordinates for smooth implementation of the project by making close contacts with the responsible agency.)

13. Witnessing for equipment inspection. (The consultant witnesses factory inspection before shipment, if necessary, and approves the inspection as the proxy of the responsible agency and the project implementing bodies.)

14. Supervision of work execution. (In accordance with the agreement, the consultant, as the proxy of the responsible agency and the project implementing bodies, scrutinizes and approves the equipment specifications, inspects and approves the equipment, supervises shipment and inland-transport, supervises the installation, and supervises works covered by the partner county.)

15. Superintending of work progress. (The consultant supervises work progress so that the equipment procurement contract can be completed within the period stated in the E/N, and gives necessary directions to the supplier.)

16. Final inspection and test-runs. (The consultant conducts final inspection and test-run to the procured equipment after all works are completed, confirms that the performance is as described in the specifications, and submits a certificate of completion to the responsible agency.)

17. Completion and hand-over.

- 74 - (2) Period of implementation

After the conclusion of the E/N, the period required for each task on the Japanese side is roughly mentioned in the following table:

Table 3-2 Period of implementation and content of work

Content of Work Phase I Conclusion of the consultant agreement, 1. About 1.3 months discussion about detailed design 2. Detailed design, preparation of tender documents 1.8 3. Approval of tender documents 0.8 4. Tendering, conclusion of contract and approval 1.3 5. Manufacture of equipment 3.0 6. Transportation 1.5 7. Installation (including an initial test, adjustment, operation guidance, training, 2.0 maintenance instruction and confirmationof hand- over, etc.) TOTAL 11.7 months

The work progress chart is as follows:

Figure 3-2 Work Execution

1234567891011 (Survey in Angola) Detail Design (Preparation in Japan)

(Confirmation of tender documents)

(Tender & Conclusion of Supply Contract) PHASE I 〈Total 5.2 months〉

(Manufacturing & Procurement) Execution & Procurement

(Inspection at factory in Japan)

(Transportation)

(Installation & Test)

(Final inspection & Hand-over) 〈Total 6.5 months〉

- 75 - 3-1-7 Obligations of Recipient Country

For implementation of this project, Angola is required to undertake the following necessary measures:

(a) To execute all tasks stated in (2) of Chapter 3-1-3.

(b) To maintain and use properly and effectively the equipment procured under the grant aid program, and to report its condition to the Government of Japan on a regular basis.

3-2 Project Cost Estimation (Borne by Recipient Country)

Among the equipments to be procured, those of which installation work is necessary, such as X-ray unit and dental unit, are included. The Health Centers where the procurement of these equipments are planned in this project, are now using old equipments or used to extend the medical services making use of these equipments. The environment to install the equipments is organized. Therefore, there is no economical burden by repair and renovation of the facility before the installation of the equipment.

However, the dismantling work of the existing equipment should be carried out by the Angolan side before installation work. This work is feasible in cooperation with the equipment maintenance technicians of the Ministry of Health.

The task required to each project facility is shown in the following.

The Task Required Designated Facilities

Ilha Health Center (2 sets) Removal of existed Dental Unit Siga Health Center Prenda Health Center Ilha Health Center Removal of existed X-ray Unit Terra Nova Health Center Cassequel Health Center Neves Bendinha Health Center

- 76 - 3-3 Operation and Maintenance Costs

3-3-1 Operation and Maintenance Plan

The organization of the Ministry of Health used to comprise the Maintenance Control Bureau, and the technicians who take charge of maintenance of medical equipments belonged to the Bureau. While the decentralization proceeds, these technicians each are assigned to five (5) institutions among eight (8) national hospitals located in Luanda. These technicians take the lead in the maintenance of the medical equipments of the national hospitals. However, this function is not fulfilled as much as prospective due to the deficiency of maintenance tools and the delay in acquisition of the maintenance technique to the new equipments.

A complete set of maintenance tools was supplied to the maintenance department of this hospital in "the Project for Improvement of Medical Equipment for Lucrecia Paim Maternity Hospital" implemented in 1999 by the Japan's grant aid, in order to improve such situation. When the medical equipments were delivered to this hospital, trainings were held on the equipment maintenance by the technicians dispatched from Japan or South Africa. Accordingly, the maintenance department of this hospital was reinforced in both a material aspect (maintenance tools) and a personnel aspect (technique of staff).

No exclusive maintenance technician is assigned to the Health Centers (PHC level) designated in this project. At the time of machine troubles, these facilities make a request for the repair to the Regional Health Bureau and the Ministry of Health. However, the repair work is often delayed due to the defect of the liaison system among each person in charge. As for the maintenance of the medical equipments to be procured in this project, the great improvement can be expected by administering the following measures to the existing system and making it reflect on the equipment plan.

① Reconstitution of the existing system

The reconstitution of the system, which the maintenance technicians assigned to five (5) national hospitals (the technicians and staff of the Lucrecia Paim Maternity Hospital as leader) take the lead in the maintenance patrol to the Health Centers, shall be promoted at the time of the Detailed Design.

- 77 - ② Measures to the equipment plan

For the expensive equipments to be procured in this project, such as Diagnostic X-ray Unit, it should be the equipment plan enabling utilization of the manufacturer's local agent in South Africa or in Angola.

3-3-2 Maintenance Costs

For the consumables for the medical care, such as medicines and injection needles, the Health Centers do not purchase such consumables on the budget of themselves, but usually manage with the kit regularly provided in kind by the Regional Health Bureau.

The total cost, required for the operation and maintenance of the medical equipments newly procured to every thirteen (13) Health Centers in this project, was estimated at US$14000 per annum at the minimum. The cost for this increase is equivalent to about 3% of US$489000 of the expenditure of the operation costs and the general administrative costs for fiscal 1999 of the Regional Health Bureau in Luanda. And it is concluded that the Angolan side has enough capacity of bearing this cost.

The improvement of the primary health care in this country, especially the improvement of the maternal and child health care service, is not only an outstanding problem of the Regional Health Bureau. Because this is also the field of which improvement is necessary in the national level, the Ministry of Health appreciates the necessity of securing a budget for the operation and maintenance. As written in the Minutes, the purchase of the consumables for the medical equipments newly procured in this project shall be implemented by the Ministry of Health and the Regional Health Bureau. Therefore, no interference can be expected for the management in each health center level.

- 78 - Annual Maintenance Expenses

Expenses for Spare Exchange Designated Facilities Parts and in US dollar Consumables Annual(JPY) ($1.- = ¥110.26) ① Ilha Health Center 318,180.- 2,885.- ② Sambizanga Health Center 14,320.- 129.- ③ Rangel Health Center 8,320.- 75.- ④ Terra Nova Health Center 240,580.- 2,191.- ⑤ Katambor Health Center 8,320.- 75.- ⑥ Cassequel Health Center 235,700.- 2,137.- ⑦ Siga Health Center 247,860.- 2,247.- ⑧ Cariango Health Center 5,920.- 53.- ⑨ Neves Bendinha Health Center 227,220.- 2,060.- ⑩ Samba Health Center 238,100.- 2,159.- ⑪ Bairro Operario Health 8,320.- 75.- Center ⑫ Prenda Health Center 34,880.- 316.- ⑬ Kinanga Health Center 5,920.- 53.- Total 1,593,640.- 14,453.-

- 79 -

CHAPTER 4

PROJECT EVALUATION AND RECOMMENDATION

CHAPTER 4 PROJECT EVALUATION AND RECOMMENDATION

4-1 Project Effect

4-1-1 Verification and Substantiation of Appropriateness

The improvement of the maternal and child health is shown as the important policy in "the national health plan" that the Government of Angola temporarily elaborated in 1996. And the improvement of the PHC level in the maternal and child health service is especially mentioned as an important task.

The designated facilities in this project are thirteen (13) Health Centers located in Luanda Region(the metropolitan area) where about 17% of the population of this country is concentrated. Each facility requires urgent improvement of the medical equipments and has the priority in the equipment procurement.

In this project, procurement shall be made mainly for the medical equipments of the designated facilities by renewal of the existing equipments and supplementation of the equipments in shortage. Moreover, those equipments can be sufficiently maintained by the current personnel. Accordingly, it is believed that there is no technical problem in using and maintaining the equipments to be procured.

As the explanation of the present maintenance situation and the proposal about the countermeasure in "3-3 Operation and Maintenance Costs" of Chapter 3, the operation and maintenance system can be greatly improved by reconstructing the existing system and administering a countermeasure with the equipment plan of this project, even for the Health Centers of PHC level where no exclusive maintenance technician is disposed.

To recapitulate, the cooperation policies of this project are to support the national plan and to contribute to the improvement of the primary health care especially in the field of the maternal and child health in this country. Also, the positive attitude of the Angolan side to meet their engagements was confirmed. Therefore, it is judged highly appropriate to implement this

4-1-2 Benefits

If this project is implemented, the area receiving benefit ranges seven (7) counties of Luanda Region, with a beneficiary population of approximately 1.66 million inhabitants. This corresponds to about 14% of the total population of this country, and 80% of the inhabitants of Luanda Region can receive the benefit.

- 80 - This implies the greatness of the influence that this project has the effect upon the improvement of the primary health care service in this Region, particularly on the improvement of the maternal and child health.

(1) Direct Effect

・ The improvement of diagnosis and regular health examination service

The improvement of the following diagnosis and the medical check-up service in the outpatient section can be expected by renewal and supplementation of various equipments in trouble or in malfunction due to aging.

・ It becomes possible to accurately judge the physical condition of expectant mother, fetus and infant by procurement of Diagnostic Instrument Set, Fetal Doppler Unit, Stethoscope, Weighing Scale, etc.

・ It becomes possible to make diagnosis of diseases of the respiratory system easily with high-quality images by procurement of Diagnostic X-ray Unit.

・ The precision of malaria inspection, sanguineous inspection, examination of urine and the examination of the hapatic function, shall improve by procurement of Binocular Microscope, Centrifuge, Leucocyte Counter and Spectrophotometer toward the clinical laboratory.

・ The improvement of medical treatment

Increase in the number of patients can be expected by improving the quality of the current service, such as the treatment after the medical check-up in the obstetrics and the gynecology, the treatment of dental caries in the dental section where treatment is now mainly extended by exodontia, and the first aid of the emergency patient.

・ The qualitative and quantitative improvement of maternity service

It facilitates the midwives to conduct labor by renewal and supplementation of the equipment of the maternity section in five (5) Health Centers. Accordingly, it contributes to relieve the pregnant women of physical burden at the delivery. By providing such high-quality services, the number of delivery at home decreases and it becomes possible to perform safe delivery care.

- 81 - (2) Indirect Effect

・ Improving awareness of inhabitants, especially pregnant women and nursing mothers

By the functional improvement after the procurement of medical equipments, it contributes to growing reliance of the inhabitants, especially of pregnant women and nursing mothers, on the PHC service, and to improving their awareness toward the healthcare.

・ The normalization of referral system

Due to the deficiency of the medical facilities and the service, many patients have to directly receive treatment in the secondary or the tertiary medical facilities, though they have diseases at the PHC level such as malaria, diarrhea and infectious disease. It causes the congestion of the outpatients in each hospital. This project enables those patients, who have availed themselves of the medical services in hospitals, to receive the primary health care in each Health Center. Accordingly, the referral system shall function normally, and the secondary and the tertiary medical facilities can fulfill their original function.

This enables the inhabitants to receive medical services at the neighbor facility, so that it contributes to lessening of the mental and economical burden of patients.

4-2 Recommendation

As described above, the great effect can be expected and the maternal and child health care service of the PHC level can be improved by the implementation of this project. Accordingly, it is concluded that this project is worth implementing. Further improvement in the following points is necessary for smooth implementation of this project and the continuous and effective utilization of the equipments to be procured.

・ Improvement of management of the project facilities

After the equipment procurement by this project, the Ministry of Health and the Regional Health Bureau are requested to make the kit of consumables substantial, which is submitted for these equipments. The enhancement of the support system, which enables the continuous utilization of the equipments to be procured, is necessary.

- 82 - ・ Improvement of maintenance system of the equipments

At present, no exclusive maintenance technician of the medical equipments is disposed in the Health Centers which are the primary health care facilities. In order to secure the maintenance system of the equipment to be procured in this project, the maintenance patrol service system to each Health Center should be organized with applying the technicians and staff of the Ministry of Health, who are assigned to the national hospitals.

・ Campaign for enlightenment of local inhabitants

Each Health Center is requested to activate a daily enlightenment movement in order to help local inhabitants in acquiring better understanding and knowledge on the health and hygiene. The establishment of the primary health care service system, which enables the early diagnosis and treatment, is desirable.

- 83 -