Medical Imaging Center Construction in Abra Minch Town, Ethiopia

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Executive Summary

As part of its diversification ETH is proposing to tap into the Ethiopian medical care market by establishing an imaging center in Minch town. It is planning to lobby the ministry of health to assist in setting up the facility after completing all the legal requirements. The company realized the existence of a big market opportunity in Ethiopia that it intends to tap into and make profit while providing the services to the poor. Currently, there are a few imaging centers in the country and most of them are concentrated in large cities and towns but limited in the rural areas of the country. It will strike to keep its services focus local and tailoring its products to meet the communities’ demands and in a way that respects the cultures and traditions of the people. To actualize this venture, it will hire well trained medics and offer them more capacity building courses on using and managing medical imaging machines in a way that protects patients’ safety.

The company plans to use raw and auxiliary material such bricks/blocks, cement, sand, timber, aggregates, timber, iron sheets, tiles, and paints to complete the construction of the facility. Further it will install imaging equipment including X-Ray, Ultrasound, Mammography, CT scan, MRI Suites, Urethrographic, and pharmacy. It will install a cutting-edge picture storage and communication system (PACS) that will enable the viewing of digital images almost instantly upon completion of every assessment. Additionally, the PACS will reduce the turnaround time of report results. There will be specialized pharmacists who understand the incorporation of pharmaceuticals as adjunct agents in the extract of diagnostic imaging information. ETH consider this service critical because in several instances the procedures will mostly depend on the administration of agents. In addition, the center will have urgent care facilities such X-ray machines, specialized equipment for ultrasounds, mammograms, and digital X-rays.

The ARBA Minch town has an approximate population of about 200,000 people and it is the gateway to the rural riches of the southern part of the country. However, it is phasing the challenge of utilizing and managing vacant land, pointing to a problem of scarcity. ETH management team will engage the Minch local town government to get allocation of one hectare of land for the construction of the facility, and installation of other utilities. The city is connected to the national grid, however, electricity is highly affected by a continuous power interruption and outage from the main grid. Hence in its plan, the company will use automated generators to provide the facility with stable power supply in case there is electricity outrages from the national grid. In the assessment of the company, the best location would be around the Sikella settlement area of the town because of its vicinity to majority of the city’s population who reside there.

ETH Company will be managed by a board of directors who will be critical in shaping the policy and making decision on the best way to run the medical imaging center. Below, there will be a team of middle level managers and technologist. The company shall employ the center manager, accounting and finance manager, sales and marketing manager, and director of medical services to run the day to day activities. Additionally, it will bring on board experts such as radiologist, medical doctors, pharmacists, orthopedic technician, X-ray tech, Mamo tech, Ultrasound tech and audio visual and electricians. Further down, will be receptionists, bookkeeper, Janitor, grounds keeper and maintenance, and security guards contracted from a security firm.

The total investment cost of the project including working capital is estimated to be $668,000, of which 60% will be generated from the shareholders and the remaining 40% raised from bank loan. ETH management team expects revenue flow to start in the fourth year of the project implementation after the successful completion of phase 1. It is expected to scale up in the fifth year when the phase 2 of the project implementation is completed and by the end of the sixth year the first full revenue generated will be realized. Accordingly, the company projects that its initial profits will be realized by the fourth year in operation. However, full profit margin estimates will be estimated in the sixth year after completion of phase 2.

Introduction

A project is proposed to construct a Medical Imaging Center that consist of X-Ray, Ultrasound, Mammography, CT scan and MRI Suites at ARBA Minch town government in Ethiopia. This Imaging center are medical facility that will consist of Doctors and Radiologist office, Patient intake area, Imaging suits for different modalities, Patient rest area, Pharmacy, Cafeteria, conference halls and urgent care facility. Imaging in the medical context refers to different technologies using ionizing (plain x-rays and computed tomography CT) and non-ionizing radiation (ultrasound, magnetic resonance imaging MRI) to diagnose, monitor, or treat medical conditions. Imaging is an integral part of healthcare; however, there is a huge shortage of imaging equipment and facilities in Ethiopia specifically in Arba Minch and the surrounding area. This shortage of equipment is accompanied by a huge workforce shortage affecting radiologists, radiographers and medical physicists.

The facility is expected to sit on a one hectare of land with the building covering approximately 2,500 meter square. Imaging in the medical context means using various technologies such as ionising (plain x-rays, computed tomography, nuclear medicine) and non-ionising radiation (ultrasound, magnetic resonance imaging) to diagnose and monitor different conditions (Frija et al., 2021). It is key part of healthcare, however, there exist a big shortage of imaging equipment in low- and middle- income countries (LMICs) (Hricak et la., 2021). For example, there is less than 1 CT scanner for every one million people in LMICs against close to 40 per million in high-income countries (HICs). Further, the shortage is made worse by lack of qualified workforce who can operate these technologies in LMICs where there are only about 1.9 radiologists, radiographers, and medical physicists per one million people.

Access to imaging is critical for the detection and treatment of non-communicable diseases (NCDs) and other communicable illnesses like tuberculosis. Further, imaging is essential to ensure timely appropriate treatment of diseases and it would be unethical not to transfer the benefits that state-of-the-art imaging provides in developed countries to low-income countries like Ethiopia. Therefore, lack of these facilities in hospitals, clinics, and healthcare centers compromises the achievement of sustainable development goals (SDGs) in LMICs including Ethiopia (Frija et al., 2021). SDG stress the need to focus on primary prevention of diseases and risk reduction as crucial mechanisms for diseases control.

A gap exists in Ethiopia being one of the LMICs in the sense that it does not have a state-of-the-art imaging facilities across the country particularly in the rural parts of the country. Additionally, the country has weak plans to invest in purchasing the equipment required with no priority given because it is believed to be a capital- and labour-intensive initiative (Frija et al., 2021). ETH Investment Company plans to bridge this gap by proposing to build an imaging center covering about 2,500 meter square. Thus, the company is requesting ARBA Minch town government in Ethiopia to allocate it one hectare of land within the town for construction of the facility.

Objectives of the Project

Medical imaging in this facility assist in tracking the progress of an ongoing illness for various patients. MRI’s and CT scans will allow the physician to monitor the effectiveness of treatment and adjust protocols as necessary for every patient. The detailed information generated by medical imaging shall ensure that the patients get better, and more comprehensive care. Further, it will increase access to early and quality diagnosis of all non-communicable disease, thus boosting chances of survival among many patients. In addition, it will increase the range of radiology services such that individuals will get opportunities according to their needs and demands.

Company’s Overview and ownership

ETH investment group trading under Ethereum is the second-largest cryptocurrency by volume after Bitcoin. It was started by programmer Vitalik Buterin in 2015 as a Blockchain network with an associated cryptocurrency called (ETH). Therefore, it is a software platform developers use to create new applications that can make buying, selling, and using cryptocurrency a smoother process. The company envision an investment that gives freedom to the investor to choose when to make the profit and what ventures to get involved with (Haar, 2022). Further, it looks to create an easy platform that takes care of all crypto currency for all cadres of investors. It equally purposes to provide a diverse array of income streams through the use of the Ethereum Blockchain. As part of its diversification and future plans, ETH is proposing to tap into the Ethiopian medical care market by establishing an imaging center in Minch town.

Government Relations

Health sector is one investment potential area in Ethiopia today and investors can take full advantage of this opportunity through direct investment or joint ventures with locals. Ethiopia regulates business ventures through a commercial code of 1960 that provides a legal framework for undertaking business in the country. Additionally, the investment proclamation (769/2012) gives ETH Company the right to own immovable property necessary for its investment. After completing the paperwork and all the other legal requirements, ETH investment will lobby for support from the Ministry of Health in its selected priority area in the sector. The imaging is a high-end tertiary health service and is exempted from income tax exemption in Ethiopia, thus, ETH will have the opportunity to transfer these benefits to the clients.

Market Study and Strategy

There is a big demand for imaging services in Ethiopia and this presents the opportunity for the company to make profits. The availability and quality of imaging service in the developing countries are mostly poor. Ethiopia is one of the countries where general health service has been compromised by inadequate facilities, poorly maintained infrastructure, and scarcity of medics. There is an increased number of non-communicable diseases (NCDs) in the country that was estimated to account for about estimated to account for 39% of all deaths (Market Insights, 2019). In addition, many of the NCDs occur among the country’s productive age groups of between 20 and 35 years. Hence, the quality of service is compromised by the lack of imaging centers across the country required to conduct advanced diagnosis and monitoring of diseases (Market Insights, 2019). This limitation in local provision has seen emergence of medical tourism in Ethiopia as some small segment of the population seek foreign care. Further, the available centers are concentrated in large cities and towns but limited in the rural areas of the country.

The healthcare system is changing rapidly, and imaging is no different. ETH investment must thus, stay ahead of other facilities, by being in front of other referring providers, patients, and employees in ways that its competitors cannot do. It will have to develop a listening culture to its customers so as to offer services that are customized to their needs (Claikens, 2021). The company will strike to keep its services focus local and tailoring its products to meet the communities’ demands and in a way that respects the cultures and traditions of the people. Additionally, the personnel who will work at the facility will always stay relevant by demonstrating personality traits such as love, kindness, reliability, trustworthiness, transparency, accountability, and taking responsibility for their actions.

Patients and Doctors need and present demand

Medical imaging is key in many medical settings and at all major healthcare facilities. The use of diagnostic imaging services is essential in confirming, assessing, monitoring and recording the course of many illnesses and response to interventions. Ethiopia like several other low and lower-middle income countries cannot afford imaging equipment (World Health Organization, n.d.). This oftentimes is coupled with the shortage of properly trained and qualified medics to use the machines that aid in providing the services. There exists a demand for imaging services particularly in rural Ethiopia, therefore, ETH had decided to tap into this opportunity by offering solutions through its proposed facility at a local town in ARBA Minch. It will equally hire well trained medics and offer them more capacity building courses on using and managing medical imaging machines in a way that protects patients’ safety.

Raw and Auxiliary Materials

Primary raw materials for this project will be bricks/blocks, cement, sand, timber, and aggregates. On the other hand, auxiliary material tiles, iron sheets, paints, and nails will be Raw material needed to construct any permanent house are of two categories namely natural types and synthetic ones. It is expected that about 60% of the total cost of building goes to the materials and inputs used (BuildersMart, 2020). Further, the estimation of the cost of materials is dependent on the build-up area.

Firstly, cement will be required in large quantity for preparing concrete RCC structures, in brick masonry works, and for plastering the walls. Approximately 0.4 cement is used per sqft, thus 1000 bag of 50 kg cement will be needed for 2,500 sqft house (BuildersMart, 2020). Secondly sand will be used for preparing RCC, mortar, plaster, filling, and flooring. 1.8 cubic ft. of sand is used for 1 sqft, therefore, 4500 cubic ft. will be needed for 2,500 sqft building (BuildersMart, 2020). Thirdly, about 3357 cubic ft. of aggregates for mixing sand, cement, and water will be used. About 5250 kilograms of steel bars to be used for reinforcement of cement concretes. Bricks or blocks of the same size and color should be used in the construction, and about 8500 of them will be used.

The building’s finishing will require paints and finishers that are waterproof, durable, and highly resistant to climatic conditions. The building will need to use paints for both interior and exterior sections. Build-up area walls will consume 350 and 100 liters of paints for internal and external parts of the building respectively. There will be tiles for floor sections of the building that will approximately be around 500 in total for 2ft x 2 ft tiles (BuildersMart, 2020). Other materials will be in the form of iron sheets, plumbing and electricity items, wooden products for doors, windows, tables, chairs and others. However, these are just estimates, the materials may vary depending on quality, location and brands.

Services in the Imaging Centre

The imaging center will be equipped with the latest digital enabled systems that have the capacity to provide advanced services. The services will include X-Ray, Ultrasound, Mammography, CT scan, MRI Suites, Urethrographic, and pharmacy (Imaging & Radiology, 2021). This will be actualized by a highly skilled and experienced team of doctors, radiologist, and radiology technologists working around the clock to meet demands of the clients. It will install a cutting-edge picture storage and communication system (PACS) that will enable the viewing of digital images almost instantly upon completion of every assessment (German Medical Center, 2022). Further, the PACS will reduce the turnaround time of report results. Lastly, all the services at the facility will be offer on daily basis for 24 hours per day.

Imaging Pharmacy Service

Imaging focuses on visuals of the interior parts of the human body through the use of an array of technologies. ETH will involve the use of specialized pharmacists who understand the incorporation of pharmaceuticals as adjunct agents in the extract of diagnostic imaging information. This will be critical because in several instances the procedures will mostly depend on the administration of agents. For example, in X-ray, pharmaceuticals are used to give various levels of contrast between the organs and the body to aid in clarity of the picture (Weatherman, n.d.). The ETH team understand the risks some of these agents carry and the potential of causing serious reactions that must be monitored. Therefore, it will employ the best Pharmacists with unique knowledge and understanding of drug therapy as providers of drug data related to diagnostic imaging.

Urgent care service

The center will have urgent care facilities such X-ray machines, specialized equipment for ultrasounds, mammograms, and digital X-rays. In addition, there will be a team of staff with excellent experience ready to serve emergency cases. The urgent care services will be managed by well trained and qualified medics in all modalities that patients will seek from the facility (Watson Image Center, 2020). All the staff working at this care unit will be individual radiologists who are registered and certified by the board in Ethiopia and are dedicated to deliver precise and accurate services.

Radiology Reading Service

ETH team will provide an on-site radiology and interpretation solutions to clients. This will be made possible through a team of certified and subspecialty trained radiologists that will give a range of services such as on-site radiology services, teleradiology setup services, radiology department support services, and radiology-related IT services support. The group will be at hand to help both at the medical imaging center in ARBA Minch and remotely (Flatworld Solutions, 2022). The company will equally provide technology consultation, imaging protocol assistance, powerful data storage, and imaging accreditation assistance.

Location and Infrastructure

This medical imaging center will be located in ARBA Minch town in Ethiopia. The town has an approximate population of about 200,000 people and it is the gateway to the rural riches of the southern part of the country (Ker & Downey, n.d.). It is made up of two small centers called Shecha which host the administrative duties and Sikela which serves as the commercial hub of the town. Currently, the urban center is experiencing rapid urbanization and it has grown from the fragmented shanty of 1950s to mid-1970s to a modest town (Jenberu & Admasu, 2020). Its built-up land mass has increased by 780 hectares, and the population increase has compromised the settlement leading to housing shortage and proliferations of informal settlements in different parts of the town.

Further, the town management has over the years been facing serious challenge of poor or mismanagement of vacant land spaces. Clearly, pointing to the scarcity of land availability for any massive physical infrastructure development. The major sources of water in the town are underground and “forty spring “which are natural. The city is connected to the national grid, however, electricity is highly affected by a continuous power interruption and outage from the main grid (Ahmed, 2016). Therefore, the reliability of power in ARBA Minch is poor which calls for other mechanisms to mitigate on interruption interruptions each day.

Land

ETH management team will engage the Minch local town government to get allocation of one hectare of land for the construction of the facility, and installation of other utilities. This will be done in accordance with Ethiopian national government laws and regulations governing the acquisition of land for private commercial development. Further, the company will seek to get full rights to use the allocated land within the town from the local, through the approval of the regional government.

Location of choice

RBA Minch has two settlements where the Secha area predominantly host the administrative offices of the town’s local government and those of the national government of Ethiopia. On the other hand, the Sikella urban center is where many residential settlements of the people working and living town are based. The best location of choice will around the Sikella settlement area of the town because of its vicinity to majority of the city’s population who reside there. This will save them the transport cost, time they use to move to the Secha section of the town and will be easily accessible even during night hours (Diagnostics Marketing, n.d.). Therefore, ETH investment is proposing that the ARBA Minch town government should grant its management one hectare of land around Sikella settlement of the city. Although, there is the need to have the center close to a referral where physicians are readily available, that cannot of override the convenience it should offer the clients and can always be mitigated.

Radiology room types

Radiographic equipment and room

The radiology rooms will be designed to meet the diagnostic demands and needs of all types of patients’ challenges. The rooms will enable comfortability of clients and shorten their waiting time by reducing examination through the use of innovative tools that enhances workflows efficiency. They will be versatile, have digital diagnosis C90 live tube head camera configurations and exam automation technologies that allows excellent patient through put (Philips, 2022). Further, the cameras will have ELEVA tube head that assist with speeding up of workflow by 28 seconds per examination, thereby giving easier collimation through an integrated touchscreen. The facility will have a state-of-the art PAC system for archiving, retrieving, presenting and sharing all digital image files.

Ultrasound Room

Room setup is essential and must be to both the physician and patient satisfaction. The assessment pedestal table and ultrasound gadget will be suited to accommodate the medic’s handedness and to enable the client and the practitioner to have ergonomic single visual field viewpoint of ultrasound images needle guiding purposes. The room will have a 36-42 inch flat screen on a tilting ceiling to give the best image viewing of the patient (radiology Key, 2018). Additionally, there will be a second screen of the same size to enable the client’s neck, the biopsy needle, and the ultrasound image to be seen by the physician through a single narrow visual field.

Mammography Room

Based on FGI Guidelines: 2.2-3.4.3.4, a Mammography room on minimum 100 square feet. It will have a visual privacy for patients and viewpoints by the public or other paints will be block when it is in use. Additionally, it shall have a hand washing station in the procedure section (Guest Contributor, 2019). Further, changing units for the patients will be immediately accessible to the waiting area and procedure sections. Mammography room will be made in such that when clients are brought in from the waiting unit, they will sit in a sub-wait area until the technician is ready to start working on them. There will be individual lockers where patient will keep their items as they wait for the radiologist to conduct the assessment. Once the operations for each day are complete, all dressing rooms will be restocked and the gown hamper made empty.

Computed Tomography

Cross-sections of the tomography will be reconstructed from measurements of attenuation coefficients of x-ray beams passing through the volume of the object. CT will be placed to enable the remodeling of the density of the body, by a two-dimensional section perpendicular to the axis of the accession system. There will be CT X-ray tube with energy levels of about 20 to 150 keV that shall emit photons per unit time (Foster, 2022). Attenuation figures of the x-ray beam will be recorded and the information used to build a 3D representation of scanned tissues. The computer used will have an inbuilt algorithm for image reconstruction, so as to give quality tomographic images of the patient from the processed CT data.

MRI Room

MIR room will be designed to have scan unit where the magnet will be placed and patients are scanned. There will equipment section that will hold electronic gadgets and connect to the magnet, the control, and changing units as well. MIR suite facility will have enough space approximately about 800-850 sqft to accommodate the suite, waiting sections, hallways, and offices (Rentz, 2021). In general, the room layout will in such a way that it will offer excellent patients comfort and staff workflow.

Building and Room Construction and civil works

ETH proposes to construct a medical imaging building that shall covers 2,500 meter square. Phase 1 that will involve the raising up a house and installation of the equipment shall take about three years to complete. In this period, X-RAY, ULTRASOUND and Mammography suit alongside with urgent care center and Pharmacy will be fitted into the new premise. Further, the structure will have patient intake area, Doctors and Radiology office, Patient waiting area, Conference center, shop and cafeteria facility for patients. There will be a cafeteria together will a shop unit that will be open to all visitors for breakfast, lunch, dinner, buying of items (St. Mary’s General Hospital, 2022). However, it will have a strict procedure in which patients will only be served food that is recommended and approved by authorized caregivers and ordered through the diet office of the facility as a way of complying with nutritional requirements for each patient.

In Phase I the company Plan to construct the building and will install the equipment that consist of X-RAY, ULTRASOUND and Mammography suit alongside with urgent care center and Pharmacy. In addition, the building consists of patient intake area, Doctors and Radiology office, Patient waiting area, Conference center, shop and cafeteria facility for patients. In phase 2, the company projects to have used 100% of all its funding cost that currently stand at 15 million at this proposal stage of the project. Further, it is focusing on generating profits from the phase 1 by the end of the 4^th year of the project, thus, it will use these proceeds at the 5^th year to install CT SCAN and MRI Scan equipment.

Table 1: Showing budget for construction and equipment for phases 1 and 2.

	Construction	Equipment Installation
Phase 1	Building cost 10 million	Cost of Digital X-ray for 2 = $30,000
		Cost of Ultrasound for 2 = $20,000
		Cost of Mammography machine = $12,000
		Cost of installation = $50,000
Phase 2		Cost of CT scanner = $150,000
		Cost of MRI scanner = $300,00
		Cost of installation = $100,000

Water and Electricity

The major utilities needed for the facility will be water and electricity. At all the times the ETH investment will ensure there is a constant supply of drinking water because, it is important that the patients have their bladder full before ultrasound test is carried out. Drinking water will allow urinary bladder to expand, thus, giving a medic a clear view of the patient’s kidneys, and its surrounding structures (Innovative Open MRI, 2022). Additionally, women are required to have their bladder full when they go for ultrasound; this enables the visualization and examination of the baby and the pelvic organs. Apart from this clean water will be used for all other operations, services, and washrooms within the facility.

ETH team will ensure that there is access to energy because it is critical to the functionality of all the imagining facilities. Electricity supply shall at all the time quality and reliable for 24 hours a day at the medical center. Electricity is necessary for the operation of basic amenities including lighting, cooling, ventilation, communications, and clean water supply (World Health Organization, 2022). The company will not compromise on power supply or allow it to be inadequate and unreliable at the facility because that could negatively impact the quality of health-care services, thereby making the patients to feel unsafe. To mitigate on the unforeseen electricity outrages, the plans to install and automatic generator that shall stabilize the supply whenever there is fluctuation or power is lost from the national grid.

Management team and labor

Table 2: Proposed employees’ salaries.

Staff Role	Monthly Salary
Center Manager	30,000
Accounting and Finance Manager	25,000
Director of Medical Services	22,000
Radiologist	50,000
Medical Doctors	40,000
Pharmacist	28,000
Orthopedic Technician	12,000
Receptionist	8,000
Bookkeeper	6,000
Audio Visual and Electricians	7,000
Sales and Marketing Manager	15,000
X-Ray Tech	15,000
CT Tech	18,000
MRI Tech	20,000
Mamo Tech	17,000
Ultrasound Tech	16,000
Janitor	5,000
Grounds Keeper	6,000

Patient capacity

The ETH team will use a mathematical algorithm in making decision on the number of patients to be allowed in different rooms at any given time. This will be dependent on whether the patients are classified as inpatient (hospitalized), outpatient, or emergency cases. The Markov Decision Processes (MDPs) will be used to model the dynamics of the system to provide the best feasible solution (Zattar da Silver et al., 2021). This system called advanced scheduling will determine the number of patients to be admitted and how the available capacity shall be distributed among different patients who are waiting to get the service.

Financial Analysis of the Project

The total investment cost of the project including working capital is estimated to be $668,000, of which 60%will be generated from the shareholders and the remaining 40% raised from external sources like bank loan. After the first 4 years immediately phase one of the projects is completed in the third year of its implementation, the company expects to start realizing profits that will seal the shortfall which could arise during the full implementation cycle.

SWOT Analysis

The strength of the project lies in its unique services that are tailored to the local demand and cultures of residence of Minch town. Further, the ability of the company to employ highly qualified staff and leveraging on the technology and innovation to drive its service delivery. On the other hand, weakness could come in the form of the choice of location as it could limit access to the services to many people who are in the rural parts of Ethiopia. Opportunities for this facility is seen in the tapping of online system to roll out massive remote services to reach many people in the entire country. However, the threats arise when the Ethiopian government make or review laws that might affect the operations in future.

Socio Economic Benefits

The center will create direct jobs for a good number of its staff who will in turn boost their disposable income and increase their purchasing power. Additionally, complementary services will be established around the facility and this will further, create employment for many people (Dunham & Associates, 2019). Consequently, the establishment of the imaging center will generate revenue in the form of taxes such as pay as you earn and direct income tax it will pay to the government of Ethiopia. In addition, the firms and individuals engaged with the supply of items and consultancy services will be able to generate more revenue and expand their profit margins. Lastly, it will assist with detection of various non-communicable disease, thereby helping people getting early treatments that makes them stay healthy and economically productive.

Waste disposal strategies

All the waste will be treated close to the point of its production as recommended by WHO. Therefore, the management team will demand 100% responsibility from all employees of the imaging center who will be directly in the processes for the segregation of the waste to be done at the places where they were created. Further, the hospital will shred the waste to ensure maximum penetration of the steam more effectively and it reduces the waste volume to about 20% (Celitron, n.d.). Additionally, the ETH team will use other disposal mechanisms such as incineration, chemical disinfection, wet (autoclaving) and dry thermal treatment, microwave irradiation, and inertization.

Bank Loan and Repayment

The ETH investment took a loan worth 40% of its all its initial costs of construction, installation and other expenses in the immediate term. The company will commence payment of its loan obligation six (6) months after the completion of phase 1 of the project in the third year. The structure of the payment proposed will be on monthly equal installments. However, should the cash flow at the initial stages of the implementation be weak, the company and the lending bank agreed to revert to the annuity repayment structure (Yescombe, 2022). This method maintants principal and interest payments level throughout the loan term.

Conclusion

ETH management team expects revenue flow to start in the fourth year of the project implementation after the successful completion of phase 1. It is expected to scale up in the fifth year when the phase 2 of the project implementation is completed and by the end of the sixth year the first full revenue generated will be realized. Accordingly, the company projects that its initial profits will be realized by the fourth year in operation. However, full profit margin estimates will be estimated in the sixth year after completion of phase 2. During the project’s life cycle, important ratios such as profit to total sales, net profit equity, return on total investment, and profit and loss statement will be used to predict the trends in the profitability of the investment.

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