COMPLIANCE MONITORING REPORT (CMR)

INFRASTRUCTURE SECTOR

Sub-Sector: Buildings

Type of Scheme: Independent

PART - A: PROJECT PROFILE

1.	Scheme / Unit Information
	a.	ADP / UID No.	953 (2025-26) / HLDTH-PP-22-0387
	b.	Name of the Project / QRC	Construction of 10 bedded Hospital "Atta Muhammad Shahani (Alias Firaq Ali)" at Village Mir Khan Shahani, UC Gadeji, Taluka Sobho Dero, Khairpur (Revised on 05.01.21) (C: 41.700+R: 29.435) (SDG #3)
	c.	Visit Location of the Project	UC/Town	Gambat	District	Khairpur
	d.	GPS Location Coordinates	Lat (N):	27°17'41.7"N	Long (E):	68°27'50.2"E
	e.	Administrative Department	Health Department
	f.	Executing Agency	Health wing, Works & Services Department, Govt. of Sindh
	g.	Consultant / Design Engineer	N.A.
	h.	Contractor (s)	M/S Simming Builders Govt. contractors
	i.	Date of A.A. Issued	27-01-2016 30-09-2016 (Date of PDWP Approval)		Completion Month/Year as per PC-I	June 2025
	j.	Revision of PC-I Status	Revised		Date of Revision (if any)	(Revised on 05.01.2021)
	k.	Project Objectives (as per PC-I)	To provide the qualitative / better Health Facilities to poor population of the surrounding area of the vicinity.

2.	Monitoring Visit History
	a.	Last Visit Date (if any)	19-12-2017 25-11-2020 14-12-2023		Last Visit's Assessment Status	Satisfactory Satisfactory Unsatisfactory
	b.	Planned Visit Date	08/12/2025		Current Visit Date	06/12/2025
	c.	Reason for Delay (if any)	N.A.
	d.	A.D/E.A Officer(s) on Site	Name	Mr. Muneer Kandhro	Designation	Sub Engineer
	d.	A.D/E.A Officer(s) on Site	Name	Mr. Muhammad Bilal	Designation	Official from DHO office Khp
	e.	MEC Team During the Visit	Name	Engr. Muhammad Hanif Abro	Designation	MEO Buildings
	f.	Any local Community member interviewed/engaged for visit	Name	No	Occupation	N/A

3.	Financial Progress (FP). (Amounts in PKR, million)
	a.	Funding Agency Share (%)	GoS Share	100%	GoP Share	0%	FPA Share	0%
	b.	Approved Cost of the Project (M)	Capital	37.611	Revenue	8.217	Total	46.00
	c.	Revised Cost of the Project (if any)	Capital	41.700	Revenue	29.435	Total	71.135
	d.	Unit Cost of the Project (if applicable)	Capital	-	Revenue	-	Total	-
	e.	Financial Progress (Up to 5 Years) of Scheme	Up to 2021-22	2022-23	2023-24	2024 -25	2025 -26	TOTAL
		i. Allocation	C: 42.358 R: 17.982 T=60.34	C: 0.677 R:11.453	C:0.17 R:11.96	C:0.00 R:12.00	C:0.00 R:12.13
		ii. Releases (as per F.D. Data)	C: 42.054 R: 17.982 T=60.036	C: 0 R:0.02	C:0.00 R:10.99	0.00	0.00	71.046
		iii. Expenditure (as per F.D/E.A Data)	C: 41.023 R: 17.982 T=59.005	0.00	0.00	0.00	0.00	59.005
	f.	Overall Financial Progress in %	83%		FP variance vs PP		0%

Financial/Physical Progress Graph. (Amounts in PKR, million)

[Bar Chart: Financial Progress (Max. 5 Years) of Visited Site]

[Bar Chart: Overall Progress]

PART - B: PROJECT ANALYSIS

1.	Quantitative Breakdown (Provided by EA and verified by MEO)
S#	Domain	Activity / Material	Name of the Test	Required	Achieved	GAP (if any)	Unit	Standard	Remarks
a.	Building & Road	Earth Work	Excavation	-	N.A.	N.A.	Cft	-	N.A.
a.	Building & Road	Earth Work	Back Fill	-	N.A.	N.A.	Cft	-	N.A.
b.	Building, Road & Hydraulic Structures	Compaction	FDT	95%	N.A.	N.A.	%	AASHTO	N.A.
		Soil	Sieve Analysis		N.A.	N.A.		ASTM C- 136	N.A.
			Sp. Gravity	2.6 > 2.7	N.A.	N.A.		ASTM C-128	N.A.
			Water Absorption	3%	N.A.	N.A.	%	BS 812-2	N.A.
c.	Building & Road	Cement Concrete	Slump Test	80 > 150	N.A.	N.A.	Mm	ASTM C 143	N.A.
			Temperature	75 > 95	N.A.	N.A.	°F	ACI 305	N.A.
			Water-Cement Ratio	0.45 (Max)	N.A.	N.A.			N.A.
d.	Building	Steel Rebar Gr-40	Tensile Test	40000	N.A.	N.A.	Psi	ASTM A-615	N.A.
d.	Building	Steel Rebar Gr-60	Tensile Test	60000	N.A.	N.A.	Psi	ASTM A-615	N.A.
e.	Reinforced CC	NDT	Schmidt Hammer Test	30 > 50	N.A.	N.A.	N/mm2	ASTM C-39	N.A.
		DT	Core Cutter Test	25000	N.A.	N.A.	Psi	ASTM C-40	N.A.
		DT	Cube Compressive Strength	25000	N.A.	N.A.	Psi	ASTM C-41	N.A.
f.	Discrepancy in Dimension in / Quality of material against design parameters/Structure			N.A.
g.	Discrepancy/deficiency in quality test against approved PC-I / PEC standards			N.A.

2.	Project Progress/Component-wise breakdown
	S#	Major Unit/Component as per PC-I	Physical/Financial Progress
Quantity as Per PC-I	S#	Major Unit/Component as per PC-I	Quantity as Per T.S	Total Cost	Payment as per MB	PP (%)	FP (%)	Variance Between PP & FP
a.	Main Building Hospital	1 No	1 No	41.700	41.023	100%	100%	N.A.
b.	Categ. 3 Type Bungalow	1 No	1 No
c.	5th Type Quarter	1 No	1 No
d.	C/Wall i/c Steel Gate.	1 No	1 No
e.	Garage	1 NO	1 NO
f.	External Development	Lumpsum	Lumpsum
g.	Earthwork	-	-
h.	Paver	-	-
i.	Revenue Components			29.435	17.982
TOTAL				71.135 (M)	59.005 (M)	83%	83%	N.A.

PART - C: QUALITY MANAGEMENT
Note: Addition of other relevant checks/tests may be included by initiating MEO in the following tables as per the type of structure/scheme.

1.	General Check
Domain		Activity / Material	Name of the Test	Readings Actual at Site (YES/NO)	Found in # of Places	Standard	Remarks (+ / - )
Buildings / Roads / Bridges / Underpasses / Irrigation Banks		Observed Defects	Honey Combing	N.A.	N.A.	IS	N.A.
			Visible Cracks	No	N.A.	IS	N.A.
			Misalignment	N.A.	N.A.	IS	N.A.
			Salinity	N.A.	N.A.	IS	N.A.
			Seepage	Yes	N.A.	IS	N.A.
			Uneven Plaster	Yes	N.A.	IS	N.A.
			Uneven Tiling	Yes	2	IS	-
			Tor Steel used	N.A.	N.A.	IS	N.A.
			Termite Found	No	N.A.	IS	N.A.
			Low Quality Paint	Yes	N.A.	IS	N.A.
			Dumped Rusted Steel		Quantity in Tons	IS	N.A.
			Dumped Rusted Steel		N.A.	IS	N.A.

PART - D: DOCUMENTS

1.	Project Approval Documents (Provided by E/A)
Item #	Items	Availability (Yes/No)	Observation
a.	PC-I / PC-II (If framed)	Yes	PC-I digital version on P&D website.
b.	Administrative Approval (AA)	Yes	-
c.	Bid Evaluation Report (BER)	No	-
d.	Work Order Issued to contractor(s)	Yes	Copy provided of Main Building work award.
e.	Technical Sanction (TS)	Yes	-
f.	Construction / Architecture Drawings	Yes	-
g.	SEPA EIA/EA/NOC	No	-
h.	Any Other Document (_____________________)	N.A.	-

2.	Project Implementation Documents (Provided by E/A)
Item #	Items	Check (Yes/No)	Observation
a.	Implementation Schedule / Annual Work Plan (As per RBM)	Yes	PC-I
b.	Measurement Book (MB)	Yes	-
c.	Soil investigation report	No	-
d.	HSE Audit (whether activities have been carried out through HSE audit or not)	No	-

PART - E: MONITORING ANALYSIS/ASSESSMENTS

1.	Earned Value Analysis
S#	Items	Result	Remarks
a.	Planned Value or BCWS	71.135	Budgeted Cost of Work Scheduled
b.	Earned Value or BCWP	59.05	Budgeted Cost of Work Performed
c.	Actual Cost of Work Performed (ACWP)	59.005	Current Financial Progress
d.	Schedule Performance Index (SPI)	0.830	SPI = 1.0: The project is exactly on schedule. SPI > 1.0: The project is ahead of schedule, completing more work than planned. SPI < 1.0: The project is behind schedule, completing less work than planned.
e.	Cost Performance Index (CPI)	1.001	CPI > 1.0: The project is under budget and performing efficiently. CPI = 1.0: The project is exactly on budget. CPI < 1.0: The project is over budget, spending more than planned.

2.	Field Officers Analysis
	a.	MONITORING & EVALUATION OFFICER (MEO)
		OBSERVATIONS
		i. Physical	a) The civil works (capital component) of the scheme were completed by the Works & Services Department in 2018, with financial utilization of the approved capital component nearing 100%. The completion and satisfactory execution of civil works were subsequently reflected in earlier MEC visits (2017 and 2020) and further supported through submission of PC-IV in 2021. b) The Executing Agency has stated that the completed hospital building was formally handed over to the Administrative Department (Health Department) in 2018, and that the facility has remained under the custody of the Health Department thereafter. Any occupation, usage, or non-usage of the building since that time falls within the post-handover administrative domain. c) During later field inspections, certain construction-related deficiencies were observed, including: i. Settlement of glazed tiles at the entrance of the main hospital building. ii. Deterioration and termite-related damage in the Main Building, 3rd Category Bungalow, and poor condition of the staff quarter. iii. Non-use of KVA generator due to non availability of POL d) These deficiencies appear to have developed over time after handover, during a prolonged period of non-functional use and lack of routine maintenance. e) It is noted that similar deficiencies had been flagged in earlier monitoring reports. The Executing Agency clarified that all financial obligations under the capital component had already been settled, and therefore no further budgetary provision existed within the completed scheme for post-handover rectification works. f) The Executing Agency has reiterated, and records confirm, that the civil works were declared “Satisfactory” during earlier MEC visits conducted in 2017 and 2020, prior to prolonged non-operational status of the facility. g) The Executing Agency provided a scanned copy of PC-IV, confirming that the Project Completion Report was submitted in 2021, shortly after completion and handover of the civil works under the capital component. h) Following revision of the scheme, and from FY 2021-22 onward, the remaining allocations primarily pertain to the revenue component, which has continued to be reflected in subsequent ADPs. i) Currently the civil work was found in more deteriorated conditions than before due to long time left abandoned condition of scheme. j) Revenue components were found stored in hospital and were not operational at all. Utilization details for remaining revenue component budget was also not provided by AD. k) Furthermore, refer PART - F: COMPLIANCE OBSERVATIONS, for compliance status of previously raised observations of MEC team.
		ii. Financial	a) Expenditure was incurred of entire approved budget of civil work / capital component viz Rs. 41.023 million until June 2021 as per data provided by E/A and finance department dashboard. b) After revision of scheme and from fiscal year 2021-22 remaining budget mostly pertain to revenue components is kept in Allocation since then. c) E/A has made expenditure under revenue component and procured medical equipment and furniture which was verified and found available as per list shared by E/A during visit on site. d) While E/A is unable to consume remaining revenue component budget (details were not provided where it will be consumed) as previous MEC report was declared unsatisfactory.
		iii. Earned Value Analysis	0.830 value of SPI reflects that the scheme is delayed and had completed less work than planned. CPI value 1.001 reflects that the project is under budget and performing efficiently.
		iv. PC-I / T.S Compliance	Civil work of found to be carried out as per approved PC-I scope.
		v. Institutional Support / Project Management	Institutional Support / Project Management found satisfactory of Executing Agency as the civil work was completed and PC-IV was submitted timely. While Institutional Support / Project Management was not found satisfactory of AD left scheme non-functional and let deteriorations occur due to post-handover operational and maintenance gaps.
		vi. Good practices	N.A.
		vii. Specific	Reflected at PART - G along with Site Pictures
		RECOMMENDATIONS (to mitigate the above observations/risks)
		1) Health department should complete the of remaining SNE and provide operational and maintenance cost for facility to keep it running and serve its purpose. m) Works & Services department should be provided with funds for maintenance of facility as Revenue Component & Operationalization was Responsibility of Health Department and procurement, installation, staffing, medicines, and O&M were not timely executed which resulted in prolonged non-functionality and deterioration of assets.
	b.	REGIONAL MEO
		i. Observations	a) The site was not visited in person. However, on examination of the report submitted by the visiting officer, certain issues have been highlighted regarding the scheme components, particularly the revenue component.
		ii. Recommendations	The E/A is directed to rectify the issues highlighted in the report at the earliest so that the scheme is made fully functional, enabling public benefit and achievement of the scheme's intended objectives.
	c.	SECTOR MEO
		i. Desk Review Points	a) No rectification of earlier observations/flaws. b) EA has not provided any test reports. c) BER not provided
		ii. Recommendations	RMEO assessment is endorsed.
	d.	FINAL ASSESSMENT OF THE PROJECT / SCHEME / UNIT
		MEO	RMEO	SMEO
		Unsatisfactory	Unsatisfactory	UNSATISFACTORY (Even after Compliance Visit) The Scheme is recommended for Departmental Enquiry

PART - F: COMPLIANCE OBSERVATIONS

S#	Last Visit Observation	EA Replies	MEC Compliance Replies	Conclusive Remarks (Satisfactory / Unsatisfactory)
1.	Overall Progress of the project was found unsatisfactory based on Capital work.	The scheme was handed over to the District Health Officer Khairpur in 2018, after Satisfactory issuance Satisfactory Report. Vide letter NO 371/SOM/(MEC) P&D 13 Planning and Development Department MONITORING AND EVALUATION CELL Karachi Dated 19 February 2018. COMPUTER ID# 5153/4091. The PC-IV was submitted to the Health Department Karachi in July 2021. Two Monitoring and Evaluation Committee (MEC) visits were conducted on 19 December, 2017, and January 13, 2021. The scheme's Civil Work was declared satisfactory with comments stating, “Overall quality / Progress of the project was found satisfactory. (Relevant documents are attached.) Satisfactory in terms of civil work”.	Earlier MEC visits declared the scheme satisfactory in terms of civil works. The later “Unsatisfactory” status (2023) pertains predominantly to revenue and operational deficiencies; however, the E/A cannot absolve itself entirely from post-construction rectification obligations. Maintenance-related lapses should have been formally documented and communicated to Health Department.	Unsatisfactory
2.	Mr Riaz Hussain Executive Engineer Buildings Division Works and Services Department Khairpur did not bother join MEC team during visit.	The Monitoring and Evaluation Cell (MEC) During Visit Consequently, Sub-Engineer accompanied the MEC officer, carrying complete scheme records.	During the current compliance visit, the MEC team was facilitated by Sub-Engineer Mr. Muneer Ahmed Kandhro from Work & services dept.. and Mr. Muhammad Bilal, the focal person from the DHO Office, Khairpur. They brought the relevant records for verification.	Satisfactory
3.	Manpower requirement of the Development scheme was not found completed which is a big flaw and lack interest of Administrative Department.	Pertaining to the District Health Officer Khairpur. (Health Department)	03 Medical Officers found deputed along with 01 H.T, 01 W.S, 1 Dai and 01 Chowkidar were posted at hospital (Copy of Muster Roll attached for reference). While proposed complete SNE list was not shared by E/A.	Unsatisfactory
4.	As per statement of E/A the Civil work was found completed in 2018 but till the visit date of MEC team scheme was non Functional, as Main Building as in worst condition and revenue items were found dumped and damaged.	The scheme was handed over to the District Health Officer in Khairpur in 2018. After Revised PC-I Remaining Work (External Development) Completed & Handed Over To Health Department July 2021.	The observed deficiencies found to be pertained to the post-handover phase of the scheme and relate to operational readiness, revenue utilization, and maintenance aspects, which are institutional responsibilities of the Administrative Department.	Unsatisfactory
5.	Moreover, Hospital was not Functional, as few staff hired which are not doing their duties including Doctor, and unavailability of medicine due to which patients suffering.	Pertaining to the District Health Officer Khairpur. (Health Department)	During current visit 2 doctors were available at hospital, but no equipment found operational as all equipment’s were stored in storerooms and no patient observed visiting the hospital. The Health Department is requested to take immediate corrective measures for: Installation and utilization of procured equipment Posting of sanctioned staff Provision of medicines and consumables Rectification and maintenance of the facility
6.	The E/A constructed one IV Type of staff Quarter rather to construct two quarters which is as per PC-I requirement.	Construction of One No Staff Quarter had been as per PC-I Provision.	Agreed to E.A. response.	Satisfactory
7.	Worst condition of Main Building of the hospital and 3rd type category bungalow and IV Type quarter, as termite is prevailed throughout in building which is damaging building.	Anti termite work had been Done during construction.	No corrective or rectification work has been carried out by the E/A to mitigate the termite issue since last visit of MEC. The observed deficiencies found to be pertained to the post-handover phase of the scheme and relate to operational readiness, revenue utilization, and maintenance aspects, which are institutional responsibilities of the Administrative Department.	Unsatisfactory
8.	Plinth level of Main Building, 3rd type Category Bungalow and IV Type quarter was found at low level with respect of internal and External Road of the hospital.	Provided for the Land of this Scheme before Construction very low laying area, but after construction Project construction done by above External main Road level. During Construction work MEC team also visited and satisfied cited above letter No.	Agreed to E/A response also the building was at raised level to adjacent road.	Satisfactory
9.	Settlement of floor was observed in Main Building and tiles were found misaligned at many places.	During the fixing of tiles work MEC team visiting site and satisfied work with Comments “the tiles fixing was done in a good quality and proper protection was done in every room to cover the tiles with cardboards. After Heavy monsoon rain 2022 the building was in under rain water.”	No corrective or rectification work has been carried out by the E/A to mitigate the termite issue since last visit of MEC.	Unsatisfactory

PART - G: PICTORIAL OBSERVATIONS
Note: MEO to add only relevant pictures / corroborating major project deficiencies / deviation, etc, and performance indicators/achievements.

S#	Specific Observations	Pictures
1.	Google Maps view of 10 bedded hospital Atta Muhammad Shahani Pic 2: View of Inauguration Stone of Main Building, Reflects Inauguration Date as 04-04-2017.	[Image: Google Map View] [Image: Inauguration Stone]
2.	View of Entrance Corridor.	[Image: Corridor 1] [Image: Corridor 2]
4.	Pic 1: View of Broken/settled Glazed Tile flooring at Entrance Lobby. (Previous Visit) Pic 2: View of Broken/settled Glazed Tile flooring at Entrance Lobby. (Current Visit)	[Image: Broken Tiles 1] [Image: Broken Tiles 2]