GAMC-MUNICIPAL PLANNING SECRETARY

PROJECT DEPARTMENT HEAD

PRE-INVESTMENT TECHNICAL DESIGN STUDY

“ CONST. HOSPITAL DEL NORTE ( OP) D.2”

1. DIAGNOSIS OF THE CURRENT SITUATION.

1.1 Determination of the area of influence of the project
The site of the “Construction Hospital del Norte ( OP) D.2” project is located in the
Northeast Zone of the city of Cochabamba, Cercado Province, Districts No. 2 Sub
District No. 22, Otb. Vidrio Lux at a distance of 5 kilometers from the center of the city
of Cochabamba; The access to the location area is via Av. Beijing North Ring Road
entering from Av. Ring Road I; The cardinal limits of the location surface being the
following: North: street nn. And mza Nº 040 and 625, Sud: public area and Av. Beijing
North Beltway, East: forestation area and Pintumayu torrente and West: Urpila Street.
The property itself is located on the foothills of the Tunari Mountain Range and is
mainly made up of the following geomorphological landscapes: Mountain ranges, Pie
de Monte and Flood Valley. According to this characterization, D-2 has a marked
rugged topography due to the presence of mountain ranges with predominant slopes
between 10-15% in the North-South direction, spatially it presents a unitary
characteristic throughout its extension, open and with wide views towards the valleys,
the city and the Tunari Mountain Range that defines and limits the space in the
northern sector. It is crossed in the direction of the slope by a series of torrents and
natural drainages, which segment the territory in the North-South direction.
The Hospital del Norte D.2 Construction project covers an approximate area of 4,000
m², almost all of which corresponds to the urbanized area, the rest are formations of
torrents and foothills with low vegetation; the furthest part (Taquiña Agrarian Union),
from the geographical center of the city of Cochabamba.
The predominant land use is residential with an area that occupies 76% of the
district territory, that is, it is an essentially residential district. The building typologies
clearly express the social formation of the municipality, there are urban enclaves
(Urbanización el Bosque, el Escudaño among others) that show high levels of
urbanization, a product of investments made by the owners, which coexist with areas
of low-income precarious settlements that They lack the minimum basic services. The
majority of the district is characterized by middle and lower middle class housing, in
many cases with social housing buildings. On the structuring roads and axes, the
beginning of a trend of construction of condominium and commercial buildings and
services is evident. The environmental conditions of this typology, due to being
inserted in spatial structures with inadequate supports and inappropriate regulations,
present a risk of habitability conditions. . It is noted that the demand and processes

_______________________________________________________________
“CONST. HOSPITAL DEL NORTE (OP) D.2”
GAMC-MUNICIPAL PLANNING SECRETARY
PROJECT DEPARTMENT HEAD

of land speculation affect the stability of residence of low-income strata through a

process of substitution by higher-income residents.

1.2 Physical characteristics of the area of influence

1.2.1 Climate
The climate in the area included by the Cercado Province, in the flat or central sector,
corresponds to a temperate zone, presenting average annual temperatures around
18 º C. It is estimated that the average temperature decreases by approximately 10 º
C for every 1250 m of elevation difference. According to the Köppen classification,
the Cwa classifications have been determined for the central region as a temperate
climate with a dry season in winter and BSk for the mountainous regions as a dry
semi-arid climate with a dry winter and average annual temperature less than 18 º C.
The region has a minimum temperature of –3.0 ºC, a maximum temperature of 33 ºC
and an average temperature of 18 ºC.

1.2.2 Rainfall
The region is divided into two clearly defined seasons, the rainy season with
precipitation in the months of November to March and the dry season, without
precipitation during the months of April to October; The months of November,
December, January and February are wet, while the months of May to August
experience extreme droughts. The region has rainfall that fluctuates between 400 to
650 mm per year, although higher rainfall is recorded in the Tunari National Park,
around 900 mm per year. The cloud formations coming from the Northeast of the
department are prevented from passing by the presence of the mountain massif in the
northern area of the Cercado Province, corresponding to the region called rain
shadow, that is, on the opposite side of the humid sectors corresponding to the forest.
Inter-Andean humid. According to Ismael Montes de Oca for the Cercado Province,
the rainiest year was 1984 with 705.6 mm and the least rainy year was 1980 with
267.7 mm. The relative humidity ranges between 44 to 65%.

1.2.3 The winds

The winds in the study area are predominantly northwesterly, with the highest
intensity winds having occurred in 1990 with more than 70 knots to the north; The
wind speed indicates a value of 0.5 km/h in July, up to a value of 3.1 km/h in
October, with a predominant direction from Southeast to Northwest. Performing an
analysis, with emphasis on the time, it is observed that the behavior of the wind is
different depending on whether it is day or night, during the day the wind does not

_______________________________________________________________
“CONST. HOSPITAL DEL NORTE (OP) D.2”
GAMC-MUNICIPAL PLANNING SECRETARY
PROJECT DEPARTMENT HEAD

have a well-defined direction, however, taking an average it can be stated that It

comes from the South, at night the wind direction is quite marked, it comes from the
East.

1.2.4 Floors
The origin of the soils in the Valley of the Cercado Province comes from the
deposits of fluviolacustrine sediments, from the Quaternary, which reached a good
development. In general, the soils are of the orders Inceptisols and Vertisols. The
slope in the flat sector or valley of the Cercado Province presents low slopes (from 0
to 15%).
The existing soil in the study area can be classified as having medium to slow
permeability, due to the clay texture characteristics it presents. Water erosion in the
area is of the laminar type, in furrows, and abrasive wind erosion. Erosion processes
most frequently seem to occur due to human intervention, especially due to the
construction of civil works, opening of avenues and streets and industrial facilities in
the execution stage.

1.2.4 Water resources

The Cercado Province in its approximately 309 km2, is crossed by two rivers in the
east - west direction, twelve defined streams in the northern sector, three lagoons in
the valley sector, three lagoons in the northern sector within the limits provided by
the plans of the Honorable Municipal Mayor's Office (2003), three lagoons in the
northern sector within the limits in conflict with the Chapare province and three
ravines of relative magnitude in the southern sector, a tunnel on San Pedro Hill, a
waste treatment lagoon sewage or oxidation lagoon and an undetermined number
of canals for irrigation and water collection from the torrents and rainwater that cross
the territory in general in an east-west direction.
 Rivers. The rivers that cross the Cercado Province from east to west are the
Rocha River and the Tamborada River, both of relative importance because
they are intermittent or seasonal rivers. The Rocha River is one of the
geographical symbols of the city of Cochabamba, it is located in the central
sector of the study area, it runs through the study area from east to west with a
southerly inclination and originates in the upper parts of the Municipality of
Sacaba. The Tamborada River is located in the southern sector of the study
area, it is fed by the surpluses of the Angostura dam and flows into the Rocha
River at the height of District 9, close to the oxidation lagoons for wastewater
treatment. of the urban area.
 Torrenteras. In Cochabamba, in the area corresponding to the valley of the

_______________________________________________________________
“CONST. HOSPITAL DEL NORTE (OP) D.2”
GAMC-MUNICIPAL PLANNING SECRETARY
PROJECT DEPARTMENT HEAD

Cercado province, a large number of torrentera among those that enter and
pass through D-2 are the Aranjuez, the Cantarrana, Pajcha and Pintumayo
torrentera coming from the Tunari mountain range, has a surface of 219.9
hectares. and a perimeter of 6930 meters.
In general, the torrenteras have become solid waste dumps, because the
garbage collection service is not enough to cover the demand of the
population. The organic decomposition of waste has a decisive impact on the
quality of groundwater.
 Quebrada In the northern sector there are 7 ravines defined and named
from east to west as Quebrada Tupuraya, Quebrada Soto Mayu, Quebrada
Andrada (To the west of the Lomas de Aranjuez Urbanization), Quebrada
Cantarrana, Quebrada Pajcha, Quebrada Pintu Mayu and Quebrada
Logostani. The waters of all the streams flow into the Rocha River, through
channeling systems that convey the waters of these streams through the
urban area of the Cercado Province.
 Deep water. Groundwater is found in the District due to the presence of
mountain range basins, the existence of water from wells is considered suitable
for consumption.

1.2.5 Vegetation and Flora

The study area is part of the central Cochabamba Valley basin and belongs to the
biogeographic provinces of the Peruvian Puna (the upper part of the northern
mountains) and the Boliviano-Tucumana biogeographic province (the part of the
valleys).
Due to the conditions of humidity, temperature and altitudinal levels, in the area that
includes the Cercado province there are different types of vegetation.
The area that belongs to the Tunari Biogeographic District with an altitudinal level that
exceeds 3200 meters above sea level, is mainly characterized by dense grasslands,
low scrub and aquatic vegetation. The latter generally develops in the area of the
wetlands and banks of high-altitude lagoons. On the slopes of Tunari Park there are
large forest plantations of mainly Eucalyptus and Pine.
Currently, the climax forests of the series are reduced to residual and more or less
degraded enclaves, still being deciduous microforests with a canopy of 6-8 m in
more conserved areas, characterized by the composition of Soto ( Schinopsis
Haenkeana ) and Kacha-kacha. ( Aspidosperma quebracho-blanco ), with some
trees such as the Gargatea ( Carica quercifolia ) and some Arks or Jacarandas (
Jacaranda mimosifolia ) especially in the upper altitudinal section of the series.
Phytosociologically these forests have been classified as the Carico quercifoliae-
Schinopsietum haenkeanae association.

_______________________________________________________________
“CONST. HOSPITAL DEL NORTE (OP) D.2”
GAMC-MUNICIPAL PLANNING SECRETARY
PROJECT DEPARTMENT HEAD

1.2.6 Seismicity
The seismicity that occurs in Bolivia is related to the subduction process that the
Nazca plate is experiencing in the west of the South American continental plate. The
earthquakes are largely found in the central region of the territory, departments of
Cochabamba, Chuquisaca and Santa Cruz (Vega, 1989); Compressive stresses in
the direction N 56º E, present in the central region of Bolivia, seem to be the cause of
the superficial focus seismic activity (Vega and Buforn, 1992).
The seismic activity in Cochabamba is essentially superficial (depth less than 25 km).
The sources of seismic activity are located to the west, north and northeast of the city
of Cochabamba; to the west between Sipe Sipe, Tapacarí and Quillacollo, to the
north in the Tunari mountain range and to the northeast between the provinces of
Chapare and Carrasco: The most intense seismic activity in Cochabamba occurs
between the towns of Totora and Aiquile, the largest earthquakes always occur. have
occurred in the northeast and southeast of the department.
There are very few earthquakes that occurred in Cochabamba for which there is
sufficient intensity data; isosistic maps are available for those of the last century.
Using these maps, it can be determined that the entire city has a primary seismic risk
of around 45%, especially the area located in the central Valley where the marshes
previously existed, and indirect risk due to secondary or combined effects of an
earthquake and other factors. (slides, geologically poorly formed hills, soil
liquefaction, erosion processes, etc.), approximately 35%. The northern area, and the
settlements close to the Tunari mountain range, are the ones with the least seismic
risk (20%).
In the city, the risk is lower due to the indirect effect of the intensity of the seismic
waves, the problem arises from the secondary effect that the composition of the soil
has in the urban area since the urban area was in the past the bed of extensive
Pantanals, their geological composition and water table can cause serious damage to
larger structures.

1.3 Socioeconomic conditions of the beneficiaries of the project's area of

influence.
The area of influence of Hospital del Norte covers Districts 2 and 13 of the
Municipality. The main socio-economic indicators of the area are shown below:

1.3.1 Target population

_______________________________________________________________
“CONST. HOSPITAL DEL NORTE (OP) D.2”
GAMC-MUNICIPAL PLANNING SECRETARY
PROJECT DEPARTMENT HEAD

The area of influence of the Northern Hospital Construction project covers the territory
of Districts 2 and 13 of the Northern Zone of the city of Cochabamba; The inhabitants
of the two Districts reach 79,362 inhabitants. as shown in the following table:

TABLE Nº 1.3.1.1: POPULATION OF THE AREA OF INFLUENCE OF THE PROJECT

Districts Man Women Partial
No. 2 31956 34330 66287
No. 13 6546 7031 13577
TOTAL 38502 41362 79864
Source: prepared with INE_SIGED data from 2012

1.3.2 Population by age groups and sex

The data on the composition of the population by age groups and sex are shown in
the following table:

TABLE Nº 1.3.2.1: POPULATION BY AGE AND SEX GROUPS

Age Population
Masculine Feminine %
groups Dist. 2 and 13
0-3 3020 2893 5913 7,40
4-5 1542 1425 2967 3,72
6 - 19 10818 10901 21719 27,19
20 - 39 13375 14208 27583 34,54
40 - 59 6556 7793 14349 17,97
60 and
more 3191,00 4142 7333 9,18
Total 79864 100
Source: prepared with INE_SIGED data from 2012

The population by age groups shows a young population, since 38.31% are under 20
years old, followed by the adult population group, which is between 20 and 39 years
old (34.54%) and finally adults over 65 years that make up 9.18% of the total.

1.3.3 Growth rate

The population of the project's area of influence is 79,864 inhabitants. (CNPV-2012)
the population growth rate is different from each other; Consequently, significant
growth is observed in District 13 with a higher growth rate for the area of influence of
the D-2 and 13 project; growths exposed in the following table:

_______________________________________________________________
“CONST. HOSPITAL DEL NORTE (OP) D.2”
GAMC-MUNICIPAL PLANNING SECRETARY
PROJECT DEPARTMENT HEAD
TABLE Nº 1.3.3.1: POPULATION PROJECTION OF THE PROJECT AREA OF INFLUENCE
POPULATIO INTERCENSAL
AREA OF PROJECTED POPULATION
N YEAR GROWTH
INFLUENCE
2012 2015 2020 2025 2030 RATE
District No.
66287 70582 75952 81321 86690 1,62%
2
District No.
7,60%
13 13577 17704 22864 28023 33182
TOTAL 79864
Source: prepared with INE_SIGED data from 2012

The data presented in the preceding table allows us to understand that the area of
influence of the project in the coming 15 years, depending on the population growth
rates, will increase by a fifth more in relation to the current one.

1.3.4 Migrations
TABLE 1.3.4.1: MIGRATIONS
Migration Percentage
Migrants 1,2%
National 0,9%
Of the outside 0,3%
Source: prepared with INE_SIGED data from 2012

A relatively small percentage of the population settled in the area is of migrant origin,
1.2% being national or from abroad.

1.3.5 Economic Activity to

Information based on data from the 2001 Census regarding employment and
occupation will allow us to approximate a characterization of the socioeconomic
situation of the population. In the municipality, 44.6% of the Population is of Working
Age (PET), however 39.7% of that population is Economically Active (PEA) and the
Unemployment Rate is 3.6%; In District 2 the information is quite similar, the PET is
44.8% of the total, of which 39.0% is the Economically Active Population, with an
Economic Dependency Index between 4 to 5 people, however the Unemployment
Rate is 4.6% which It is higher than the municipal average and the highest among all
Districts.
Observing the EAP in District 2, there is a differentiated participation by sex in the
labor market, where male insertion is greater (53.57%) than female insertion
(46.43%) and also differentiated by occupational category. The majority of the
population is inserted in the occupational category of Workers or Employees
(57.34%) where a greater proportion corresponds to men (54.53%), followed by Self-

_______________________________________________________________
“CONST. HOSPITAL DEL NORTE (OP) D.2”
GAMC-MUNICIPAL PLANNING SECRETARY
PROJECT DEPARTMENT HEAD

Employed Workers (34.35%) where participation by sex is almost equal. In the

category of Patron, Partner or Employer, the gender differences are greater, with
65.29% of men and only 34.71% of women within that category. Another important
occupational category is that of Family Worker, in which female participation is higher
(54.10%).
Regarding the sectors of the economy and occupational groups, workers in the
Northern zone are in the salaried sector, considered by the formal economy, followed
by the tertiary sector, services and retail trade, as shown in the following table:
Information based on Census data regarding employment and occupation will allow us
to approximate a characterization of the socioeconomic situation of the population. In
the municipality, 44.6% of the Population is of Working Age (PET), however 39.7% of
that population is Economically Active (PEA) and the Unemployment Rate is 3%.

TABLE Nº 1.3.5.1: POPULATION OCCUPATIONAL CATEGORY

OCCUPATIONAL CATEGORY MAN WOMEN TOTAL %
WORKER AND EMPLOYEE 9899 7260 17159 48,04
HOUSEHOLD WORKER 16 765 781 2,19
OWN ACCOUNT AND MERCHANT 7297 5867 13164 36,86
EMPLOYER OR PARTNER 719 490 1281 3,59
UNPAID FAMILY WORKER
453 895
442 2,51
PRODUCTION COOPERATIVE
87 171
SERVICES 84 0,48
UNSPECIFIED 1050 1214 2264 6,34
Total 19593 16122 35715 100
Source: prepared with INE_SIGED data from 2012

Analyzing labor insertion by sector of the economy and branch of activity, it is

observed that there is a concentration in employees with 57%, followed by self-
employment (services) and retail trade with 35%, then in smaller percentages,
Transportation, Storage and Communications, Services to Homes and Domestic,
Education, Hotels and Restaurants and others.

1.3.6 Employment
TABLE 1.3.6.1: EMPLOYMENT ACCORDING TO ECONOMIC ACTIVITY
Employment by economic
activity Number Percentage
Others 16.582 46,4%
Commerce transport
warehouses 10.674 29,9%
Manufacture 3.815 10,7%

_______________________________________________________________
“CONST. HOSPITAL DEL NORTE (OP) D.2”
GAMC-MUNICIPAL PLANNING SECRETARY
PROJECT DEPARTMENT HEAD

Construction 3.671 10,3%

Agriculture 740 2,1%
Electricity gas water waste 149 0,4%
Mining 84 0,2%
Total 35.715 100
Source: prepared with INE_SIGED data from 2012

46% of the population is dedicated to a variety of service and informal activities, then
almost 30% is dedicated to commerce, transportation and storage. Consequently, the
predominant activity is that of services.

1.3.7 Health
The Cercado public health system organized as the “Metropolitan Health Network”
has 17 Health Areas or Centers, organized in turn into two Sub-Networks – delimited
by the Rocha River – “Northern Metropolitan Network” which has 8 Centers and “Sud
Metropolitan Network” that includes 9 Centers. All of these Health Centers
correspond to a 1st Level of Care, which corresponds mainly to prevention actions.
The mobility of the population must be taken into account, that is, they do not
necessarily go to the District Centers, particularly due to the Level of Care (1st.
Level), likewise, care in the District Health Centers may not always correspond to the
population only residing in the District.

TABLE Nº 1.3.7.1: HEALTH CENTERS ACCORDING TO % OF POPULATION ATTENDANCE

HEALTH CENTERS Man Women TOTAL %

Health Fund: CNS, COSMIL
or others 9643 11059 20702 11
private health insurance 5812 6220 12032 6
Public health establishment
20776 23109 43885 23
Private health facility
10182 11064 21246 11
Traditional Medicine 4101 4319 8420 4
Hunting Solutions 17995 20582 38577 20
Pharmacy or Self-medication 20954 22202 43156 23
Source: prepared with INE_SIGED data from 2012

The data in the preceding table allow us to understand the following: the population to
be treated goes more to public health establishments and Pharmacies or self-
medication, followed by Homemade solutions.

_______________________________________________________________
“CONST. HOSPITAL DEL NORTE (OP) D.2”
GAMC-MUNICIPAL PLANNING SECRETARY
PROJECT DEPARTMENT HEAD

Therefore, the Hospital del Norte constitutes, for various reasons, a hospital that has
an area of municipal influence, that is, the entire municipality.

1.3.8 living place

TABLE 1.3.8.1. HOUSING TYPE

Households Number Percentage

Individuals 22.597 99,6%
Collectives 97 0,4%
Total 22.694 100
Source: prepared with INE_SIGED data from 2012

The majority of homes in these two districts are private and only 0.4, that is, less than
1%, are collective.

1.3.9 Basic services:

 Electric power
TABLE 1.3.9.1: TYPE OF ACCESS TO ELECTRICAL ENERGY
Access Number Percentage
Grid energy 20.559 97,3%
Does not have 490 2,3%
Other source 91 0,4%
Total 21.140 100
Source: prepared with INE_SIGED data from 2012

The coverage of the electrical energy network covers 97% of the population and only
2.3% does not have energy.

 Gas access
TABLE 1.3.9.2: TYPE OF ACCESS TO ENERGY FOR COOKING
Type of use Number Percentage
Gas in bottle 18613 88,0%
Piped gas 1874 8,9%
Firewood 276 1,3%
Others (E. Electric, solar) 377 1,8%
Total 21140 100%
Source: prepared with INE_SIGED data from 2012

88% of homes have access to gas by bottle and 97% including gas through the
network. Still 1.3% use firewood for cooking in the analyzed districts
_______________________________________________________________
“CONST. HOSPITAL DEL NORTE (OP) D.2”
GAMC-MUNICIPAL PLANNING SECRETARY
PROJECT DEPARTMENT HEAD

 Drinking water
TABLE 1.3.9.3: TYPE OF ACCESS TO DRINKING WATER
Access Number Percentage
network pipe 16841 79,7%
delivery car 2051 9,7%
Well 899 4,3%
public pool 835 3,9%
Rain, river, slope 438 2,1%
Other (lake, water carrier) 76 0,4%
Total 21140 100
Source: prepared with INE_SIGED data from 2012

80% of the population has access to drinking water, the rest obtains water from
delivery cars, wells, public pools, among others.

 Sewerage
TABLE 1.3.9.4: TYPE OF ACCESS TO SEWER SERVICE
Guy Number Percentage
Sewerage 16086 79,8%
septic tank 1687 8,4%
Cesspool 2369 11,8%
On the street 7 0,0%
ravine, river 0 0,0%
Lake, Curiche 1 0,0%
Total 20150 100
Source: prepared with INE_SIGED data from 2012

Sewage coverage reaches 80% of the population, almost 12% use a blind well and
8% use a septic tank.

 Garbage disposal
TABLE 1.3.9.5: TYPE OF ACCESS TO GARBAGE DISPOSAL
Deletion type Number Percentage
container trash can 3055 14,5%
garbage truck 17057 80,7%
Wasteland 54 0,3%
River 120 0,6%
They burn 701 3,3%
They bury 69 0,3%

_______________________________________________________________
“CONST. HOSPITAL DEL NORTE (OP) D.2”
GAMC-MUNICIPAL PLANNING SECRETARY
PROJECT DEPARTMENT HEAD

Others 84 0,4%
Total 21140 100
Source: prepared with INE_SIGED data from 2012

Although just over 85% of the population has coverage to eliminate garbage either by
garbage cart or container, the remaining 15% of the population uses highly polluting
systems such as depositing garbage in vacant land, rivers, or other systems.

1.4 Environmental Situation and Disaster Risk

The location of the project site area is topographically favorable; However, the
possible risks are analyzed and recommended in the Environmental Sheet.
The project in its technical component has designed infrastructure and equipment for
the treatment of wastewater, organic and inorganic contaminating material, which can
be in the form of suspended and/or dissolved particles; treatment to be carried out in
order to achieve a water quality required by the discharge regulations or by the type
of reuse for which it will be destined.

2 GOALS:
2.1 General
Build an urban health infrastructure facility Designed on a 4,000 m² plot of land, a
constructed area of 11,600.00 m² on 6 staggered levels, direct access from the street
to the first 3 levels, which facilitates the entry and exit of patients within the framework
of the Standards issued by institutions and in accordance with Art. 2 of the Health
Code. 2nd hospital Level that will have all the specialties required for this level of
care.

2.2 Specific
Construction with the following environments:
Emergency care environments, Outpatient consultation, Diagnostic support
imaging, Pharmacy, Laboratory, Surgical Pavilion, Maternity Area, Morgue,
Hospitalization with 122 Beds, support areas and general services, direct
access from the street to the first 3 levels, which facilitates the entry and exit of
patients.
What is described in the preceding point is detailed in the different Components of the
technical area, attached hereto.

_______________________________________________________________
“CONST. HOSPITAL DEL NORTE (OP) D.2”
GAMC-MUNICIPAL PLANNING SECRETARY
PROJECT DEPARTMENT HEAD

3 MARKET STUDY
3.1 Analysis of demand

TABLE Nº 3.1.1: POPULATION PROJECTION OF THE AREA OF INFLUENCE OF THE PROJECT

POPULATI INTERCENSAL
AREA OF PROJECTED POPULATION
ON YEAR GROWTH
INFLUENCE
2012 2015 2020 2025 2030 RATE
District No. 2 66287 70582 75952 81321 86690 1,62%
District No.
7,60%
13 13577 17704 22864 28023 33182
TOTAL 79.864 88.286 98.816 109.344 119.872

Source: prepared with INE_SIGED data from 2012

TABLE 3.1.2. INDEX OF NUMBER OF BEDS PER 1000 INHABITANTS

COUNTRY INDEX
Argentina 4,7
Uruguay 3
Brazil 2,8
Chili 2,1
Ecuador 1,6
Peru 1,5
Bolivia 1,1
Source.- http://datos.bancomundial.org/indicador/SH.MED.BEDS.ZS

According to data from the World Health Organization (WHO), the rate of beds per
inhabitant according to the International Standard is 2.5 to 4 beds per 1000
inhabitants.
This index varies according to the amount of population in the coverage areas
according to the following table:

TABLE 3.1.3: BEDS PER 1000 INHABITANTS ACCORDING TO POPULATION

Populations less than 25,000 inhabitants 2.5 - 3 beds per 1000 inhabitants.

Populations 25,000 -100,000 inhabitants 3 - 4 beds per 1000 inhabitants.

Older populations 100,000 inhabitants 4 -4.75 beds per 1000 inhabitants.

Source.-http://maiquiflores.over-blog.es/article-estandares-para-la-planificacion-y-evaluacion-de-hospitales-venezuela-2010-
54362145.html

_______________________________________________________________
“CONST. HOSPITAL DEL NORTE (OP) D.2”
GAMC-MUNICIPAL PLANNING SECRETARY
PROJECT DEPARTMENT HEAD

The Hospital del Norte should consequently, according to international standards, have
between 3 to 4 beds per inhabitant, however it has 1.23 beds per 1000 inhabitants,
slightly higher than the national average for Bolivia which is 1.1 beds according to
information from the WHO.

TABLE 3.1.4: COVERAGE IN REGARDS TO BEDS AT THE HOSPITAL DEL NORTE

DETAIL BEDS
North Hospital 1.23
Hospital del Norte according to WHO International Standard 3- 4
Source.-own elaboration

3.2 Offer analysis

The Hospital del Norte offers all the medical specialties of a tertiary hospital and has
122 beds, although evaluating a project only by the number of beds is somewhat
incomplete, since much of the quality of care will depend on the human resource. and
the supplies that this hospital has, from the municipal perspective, which according to
the Law has powers to build hospitals and health centers, in order to provide an
infrastructure of this kind, special attention must be paid to ensuring that it is not
oversized according to to the population it must cover, and having a coverage of 1.2
beds per 1000 inhabitants constitutes good coverage for the conditions of the country,
where on average there is a coverage of 1.1 beds per 1000 inhabitants.
Regarding the operation or functioning of the project, this competence corresponds to
the central level of government and the construction of this hospital has all the
required documentation that it must have with respect to the coordination carried out
with the Departmental Health Service.

4 PROJECT SIZE
The Hospital del Norte D.2 will have all the specialties required for this level of care, it
will have Emergencies, Outpatient Consultation, Imaging Diagnostic Support,
Pharmacy, Laboratory, Surgical Pavilion, Maternity Area, Morgue, Hospitalization with
122 Beds, general support and services. Designed on a 4,000 m² plot of land, a
constructed area of 11,600.00 m² on 6 staggered levels, direct access from the street
to the first 3 levels, which facilitates the entry and exit of patients.
The general budget is Bs.: 66,954,943.85. (Sixty-Six Million Nine Hundred Fifty-Four
Thousand Nine Hundred Forty-Three 85/100 Bolivianos)

5 PROJECT LOCALIZATION

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“CONST. HOSPITAL DEL NORTE (OP) D.2”
GAMC-MUNICIPAL PLANNING SECRETARY
PROJECT DEPARTMENT HEAD

5.1 Location and Study Area:

The site of the “Construction Hospital del Norte D.2” project is located in the
Northeast Zone of the city of Cochabamba, Cercado Province, Districts No. 2 Sub
District No. 22, Otb. Vidrio Lux neighborhood at a distance of 5 kilometers from the
center of the city of Cochabamba; The access to the location area is via Av. Beijing
North Ring Road entering from Av. Ring Road I; plus following reference:

to) Political location

 Department: Cochabamba
 Province: Cercado
 Municipality: Cercado
 Districts: No. 2 and 13 (Condebamba Zone and foot of mountain range)
 OTB: Lux Glass Neighborhood

b) Access roads to the project area

 Av. Beijing North Ring Road
 Av. Beltway II (East to West)
 Urpila Street (North to South)

c) Cardinal limits of the location surface

 Boundaries:
 North: street nn. And block No. 040 and 625
 South: public area and Av. Beijing North Ring Road
 East: forestation area and Pintumayu stream
 West: Urpila Street

d) Geo Reference Map

For a greater appreciation, the following map allows us to observe the location
of the project, in D 2 it can be seen that it includes the access roads to the
OTB Barrio Vidrio Lux.

IMAGE Nº 1: LOCATION HOSPITAL DEL NORTE D.2

_______________________________________________________________
“CONST. HOSPITAL DEL NORTE (OP) D.2”
GAMC-MUNICIPAL PLANNING SECRETARY
PROJECT DEPARTMENT HEAD

Av. Beijing North Ring Road I

Source: Google Aerial Image 2015

The location of the Hospital del Norte D.2 is based on the existence of available land
registered in Municipal Assets dependent on the GAMC; The Topography of the
terrain of moderate slope, with basic services; It has home electricity, treated
communication routes that border the surroundings of the property, the coliseum has
its main entrance as shown in the aerial photo (see image No. 1).
The location of the property in said area is justified by the high population growth and
deficit in health infrastructure; The new construction avoids the transfer to other
health centers far from the area.

6 PROJECT ENGINEERING
Yo) Basic Engineering Study ( See Technical Component, Engineering)
 Soil Study

i) Detailed Engineering Component Designs: (engineering folder)

 Metric calculations
 Analysis of unitary prices
 Engineering Budget

iii) Execution Schedule (engineering folder)

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“CONST. HOSPITAL DEL NORTE (OP) D.2”
GAMC-MUNICIPAL PLANNING SECRETARY
PROJECT DEPARTMENT HEAD

iv) Plans (engineering folder)

v) Technical Specifications (engineering folder)

7 EQUIPMENT (not applicable)

8 TRAINING AND TECHNICAL ASSISTANCE (not applicable)

9 ENVIRONMENTAL IMPACT EVALUATION (Law 1333 and regulations)

(See annex No. 2)

10 ANALYSIS AND DESIGN OF PREVENTION AND RISK MANAGEMENT

MEASURES
The location of the project site area is topographically favorable, since it is a hillside,
consequently solid terrain.
No disaster risks have been identified that could affect the project since it is located in
an elevated location and is also far from torrents or watercourses that could affect the
project in some way.
Although no disaster risks have been identified that could affect the project since it is
located in an elevated location and also far from torrents or water courses that could
affect the project in some way; However, the following is recommended:

 The treatment of wastewater, organic and inorganic polluting material, which

may be in the form of suspended and/or dissolved particles, has merited a
specialized study in order to achieve a water quality required by the discharge
regulations or by the type. of reuse to which it will be destined. The technical
details are found in the engineering part of the Project.
 Internally, the risk of a fire is latent. Therefore, the placement of fire
extinguishers in the building must be planned and to ensure their efficiency,
commitments must be signed to periodically recharge them at the cost of those
responsible for maintenance, as indicated by the manufacturer of said
equipment.

11 DETERMINATION OF INVESTMENT COSTS (project components,

environmental, compensation, supervision and supervision of the
project)
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“CONST. HOSPITAL DEL NORTE (OP) D.2”
GAMC-MUNICIPAL PLANNING SECRETARY
PROJECT DEPARTMENT HEAD

The data pertinent to the project are indicated in table No. 17.1, point 17 of this study
“Construction Hospital del Norte D.2”.

12 OPERATION PLAN, MAINTENANCE AND ASSOCIATED COSTS

For the operation and/or functioning stage of the Hospital del Norte construction
project D.2. The Secretary of Health dependent on the GAMC is in charge of
providing and managing health furniture and equipment before the corresponding
authorities.
Likewise, the Secretary of Health must coordinate and manage the Medical and
Paramedical Items before the Ministry of Health for the operation of the new Hospital
del Norte D.2. The maintenance of the environments and infrastructure facilities in
operation is the responsibility of the GAMC through its operational arm, Department
of Health, dependent on the corresponding Sub-Mayor's Office.

12.1 MAINTENANCE COSTS

This section considers the incidence of labor costs, tool materials to guarantee proper
functioning in terms of sustained care.
Given that this is a work of infrastructure for daily use, deterioration is expected in
the interiors on the exposed faces of the cyclopean concrete and reinforced concrete
walls and slabs due to the traffic of patients, doctors and the general population;
Therefore, the use of unskilled labor for tasks is contemplated.
The Secretary of Health, in coordination with the Secretary of Infrastructure (OO.PP)
dependent on the GAMC , in charge of maintaining all public infrastructure, has
calculated the corresponding cost for the maintenance of the Hospital del Norte D.2,
which are summarized in the following table:

TABLE Nº 12.1 SUMMARY OF MAINTENANCE COSTS HOSPITAL DEL NORTE D.2 (BS./YEAR)
HUMAN MATERIAL- PARTIAL
COMPONENTS RESOURCE TOOL 40% in Bs.
S 60%
755296,8
Architectural 453178,12 302118,74 6
117076,6
Electric 70246,01 46830,68 9
Hydrosanitary 30710,00 20472,61 51182,61
923556,1
TOTAL
6
Source: Data from the Technical Component of the Project; 2015

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“CONST. HOSPITAL DEL NORTE (OP) D.2”
GAMC-MUNICIPAL PLANNING SECRETARY
PROJECT DEPARTMENT HEAD

With the indicated amount, maintenance work is carried out periodically using
technically required equipment and machinery 1 times a year. The breakdown of
costs by item and by components is attached in annexes.

13 ORGANIZATION FOR THE IMPLEMENTATION OF THE PROJECT

The Departmental Health Service SEDES and the Secretary of Health dependent on
the GAMC, in accordance with their powers, are the institutions in charge of putting
the new health infrastructure into service, as well as supervising its correct
functioning, under an Operating Regulation.
During the study stage, in order to guarantee the conditions under which the health
infrastructure was implemented, commitments have been generated so that problems
are not faced in the future, highlighting that the construction of the infrastructure was
carried out under commitments and conditions. that the person responsible for
administration must comply with, they are part of this study (The information indicated
in the ITCP annex is attached)

14 ECONOMIC EVALUATION
14.1 Technical criteria for evaluation
Given that the health infrastructure does not generate income that can provide
financial profitability to the GAMC, the following indicators provided for in the Basic
Pre-investment Regulation RM 115/15 will be used to evaluate the project:
Although the Hospital del Norte has a coverage or radius of action that covers District
2 and District 13, in reality as a Hospital that has all the services it has the same level
of the only tertiary hospital in the municipality located in the center of the city,
therefore its coverage as such covers an estimated 900,826 inhabitants for the year
2016, the indicator cost efficiency of investment per beneficiary will consequently be
calculated taking into account the population of the city of Cochabamba.

TABLE 14.1.1: COST-EFFICIENCY PARAMETERS FOR HEALTH PROJECTS

INVESTMENT COST PER BENEFICIARY (In US dollars)

Source: Ministry of Development Planning - VIPFE “Update of Cost - Efficiency Parameters for the Bolivian Economy”. 2007

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“CONST. HOSPITAL DEL NORTE (OP) D.2”
GAMC-MUNICIPAL PLANNING SECRETARY
PROJECT DEPARTMENT HEAD

Indicator Cost Investment cost efficiency per beneficiary

The Cost Efficiency Indicator of the project amounts to $us 10.66 of investment cost
per beneficiary, which is slightly above the maximum average indicated by the
Governing Body. Since it is a variation in cents, this project is technically considered
efficient and therefore viable.

15 DETERMINATION OF OPERATIONAL SUSTAINABILITY (not applicable)

16 PROJECT SENSITIVITY ANALYSIS (not applicable)

17 FINANCING STRUCTURE BY COMPONENT

TABLE Nº 17.1: ECONOMIC RESOURCES IN Bs.
FINANCING (Bs.) GRAND
DESCRIPTION
GAMC OTHERS TOTAL

INFRASTRUCTURE 66.954.943,85 0,00 66.954.943,85

ENVIRONMENTAL
MITIGATION MEASURES 0.00 0,00 0,00

TECHNICAL SUPERVISION 0.00 0,00 0,00

INSPECTION 0,00 0,00 0,00
TOTAL 66.954.943,85 0,00 66.954.943,85
SOURCE: Prepared with data from the Technical component of the Project

Total Budget Data broken down according to Components in the general budget of
the project

18 PROJECT EXECUTION SCHEDULE (physical-financial)

(Engineering folder)

19 TECHNICAL SPECIFICATIONS SHEET (engineering)

(Engineering folder)

20 CONCLUSIONS AND RECOMMENDATIONS

The Technical Study of the Project has been concluded in accordance with the
regulations and technical criteria indicated in RM 115/2015 “Basic Pre-investment
Regulation” in what corresponds to the Engineering and socioeconomic components
that must be studied in accordance with regulations.
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“CONST. HOSPITAL DEL NORTE (OP) D.2”
GAMC-MUNICIPAL PLANNING SECRETARY
PROJECT DEPARTMENT HEAD

In the socioeconomic part, all aspects that identify the size and area of influence of
the project have been considered according to the market study, as well as the
evaluation according to the Project's cost-efficiency indicators.
From the completed study, the following conclusions are reached:
 There will be a modern 2nd grade Hospital. Level in the North Zone of the city,
in the Otb. Police District of District 2, according to the needs of the population
of different age groups of Districts 2 and 13; the built infrastructure of
11,600.00m² on 6 levels; with Laboratory, Surgical Pavilion, Maternity Area,
Morgue, Hospitalization with 122 Beds.

There are the following Recommendations:

 Permanent control of the use of the Hospital as it has been projected and
constant orientation of patients and users of the new health center.
 Carry out continuous maintenance of the infrastructure and installation in
general.

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“CONST. HOSPITAL DEL NORTE (OP) D.2”