HEALTH CENTER

ALEJANDRINO, JOBEL C. ARCH. KYRENE CHIARA FELIX-PAJ

BS ARCH 2-1 ELA,UAP
ARCHITECTURAL DESIGN 3
HEALTH CENTER
Primary health care is a package of basic health
services, which should be available, accessible,
affordable and
acceptable to the whole population. It is usually t
he first
contact children and their communities have with
the
national health system.

In addition to health promotion and disease prev

ention
services, a primary health care centre provides
ambulatory curative care. It may for this purpose
have a
few beds for observation or for awaiting referral/
transportation to a higher level hospital. Further
more, it also serves as a facility which patients ar
e referred to
from dispensaries and village health workers for
services and activities such as ante- and post-na
tal care or family planning, nutritional advice and A centre that only includes the first few rooms (Treatment, Injection/
health Dressing,
education. Waiting area) is a nurse station or health post. When the facility also
provides
Commonly it is run by paramedical staff, with doc consultation/examination and resuscitation services, it is a health ce
tors on scheduled visits. The team includes at le ntre.
ast a registered nurse, a midwife, a medical assi Further extending the scope of services results into the centre beco
stant, and two or three ming a
auxiliary staff. The typical catchment area would rural hospital.
 GUIDELINES IN THE PLANNING AND
 Environment


Occupancy
Safety
DESIGN OF A HOSPITAL AND OTHER


Security
Ventilation HEALTH FACILITIES
 Patient Movement •Environment: A hospital and other health facilities shall be so located that it is readily
 Lighting accessible to the community and reasonably free from undue noise, smoke, dust, foul
 Auditory and odor, flood, and shall not be
Visual Privacy
located adjacent to railroads, freight yards, children's playgrounds, airports, industrial p
 Water Supply
 Waste Disposal
lants,
 Sanitation disposal plants.
 Housekeeping
 Maintenance •Occupancy: A building designed for other purpose shall not be converted into a hospi
 Material tal. The
Specification location of a hospital shall comply with all local zoning ordinances.
 Segregation
 Fire Protection •Safety: A hospital and other health facilities shall provide and maintain a safe environ
 Signage
ment for
 Parking
 Zoning patients, personnel and public. The building shall be of such construction so that no ha
 Function zards to the
 Space life and safety of patients, personnel and public exist. It shall be capable of withstandin
g weight and elements to which they may be subjected.
○ Exits shall be restricted to the following types: door leading directly outsid
e the
building, interior stair, ramp, and exterior stair.
○ A minimum of two (2) exits, remote from each other, shall be provided for
each
floor of the building.
○ Exits shall terminate directly at an open space to the outside of the buildi
ng.
 GUIDELINES IN THE PLANNING AND
 Environment


Occupancy
Safety
DESIGN OF A HOSPITAL AND OTHER


Security
Ventilation HEALTH FACILITIES
 Patient Movement
•Patient Movement: Spaces shall be wide enough for free movement of patients, wh
 Lighting
 Auditory and ether they are on beds, stretchers, or wheelchairs. Circulation routes for transferring
Visual Privacy patients from one area to another shall be available and free at all times.
 Water Supply ○ Corridors for access by patient and equipment shall have a minimum w
 Waste Disposal idth of 2.44 meters.
 Sanitation ○ Corridors in areas not commonly used for bed, stretcher and equipment
 Housekeeping transport may be reduced in width to 1.83 meters.
 Maintenance ○ A ramp or elevator shall be provided for ancillary, clinical and nursing ar
 Material eas
Specification
located on the upper floor.
 Segregation
 Fire Protection ○ A ramp shall be provided as access to the entrance of the hospital not
 Parking on the same level of the site.
 Signage •Lighting: All areas in a hospital and other health facilities shall be provided with suffi
 Zoning cient
 Function illumination to promote comfort, healing and recovery of patients and to enable perso
 Space nnel in the
performance of work.

•Auditory and Visual Privacy: A hospital and other health facilities shall observe ac
ceptable sound level and adequate visual seclusion to achieve the acoustical and pri
vacy requirements in
designated areas allowing the unhampered conduct of activities.

•Water Supply: A hospital and other health facilities shall use an approved public wa
ter supply
system whenever available. The water supply shall be potable, safe for drinking and
 GUIDELINES IN THE PLANNING AND
 Environment


Occupancy
Safety
DESIGN OF A HOSPITAL AND OTHER


Security
Ventilation HEALTH FACILITIES
•Sanitation: Utilities for the maintenance of sanitary system, including approved w
 Patient Movement
ater supply
 Lighting
 Auditory and
and sewerage system, shall be provided through the buildings and premises to ens
Visual Privacy ure a clean
 Water Supply and healthy environment.
 Waste Disposal
 Sanitation •Housekeeping: A hospital and other health facilities shall provide and maintain a
 Housekeeping healthy and
 Maintenance aesthetic environment for patients, personnel and public.
 Material
Specification
•Maintenance: There shall be an effective building maintenance program in place.
 Segregation
 Fire Protection The buildings and equipment shall be kept in a state of good repair. Proper mainten
 Parking ance shall be provided to
 Signage prevent untimely breakdown of buildings and equipment.
 Zoning
 Function •Material Specification: Floors, walls and ceilings shall be of sturdy materials that
 Space shall allow
durability, ease of cleaning and fire resistance.

•Segregation: Wards shall observe segregation of sexes. Separate toilet shall be

maintained for patients and personnel, male and female, with a ratio of one (1) toile
t for every eight (8) patients or personnel.

•Fire Protection: There shall be measures for detecting fire such as fire alarms in
walls,
peepholes in doors or smoke detectors in ceilings. There shall be devices for quen
ching fire such as fire extinguishers or fire hoses that are easily visible and accessi
 GUIDELINES IN THE PLANNING AND
 Environment


Occupancy
Safety
DESIGN OF A HOSPITAL AND OTHER


Security
Ventilation HEALTH FACILITIES
•Signage. There shall
vidual visual
be an effective graphic system composed of a number of indi
 Patient Movement
 Lighting aids and devices arranged to provide information, orientation, direction,identification
 Auditory and , prohibition, warning and official notice considered essential to the optimum operati
Visual Privacy on of a hospital and other health facilities.
 Water Supply
 Waste Disposal •Zoning: The different areas of a hospital shall be grouped according to zones as fol
 Sanitation
lows:
 Housekeeping
 Maintenance
○ Outer Zone – areas that are immediately accessible to the public: eme
 Material rgency
Specification service, outpatient service, and administrative service. They shall be loc
 Segregation ated near
 Fire Protection the entrance of the hospital.
 Parking ○ Second Zone – areas that receive workload from the outer zone: labor
 Signage atory,
 Zoning pharmacy, and radiology. They shall be located near the outer zone.
 Function
○ Inner Zone – areas that provide nursing care and management of pati
 Space
ents:
nursing service. They shall be located in private areas but accessible to
guests.
○ Deep Zone – areas that require asepsis to perform the prescribed serv
ices:
surgical service, delivery service, nursery, and intensive care. They shall
be
segregated from the public areas but accessible to the outer, second an
d
inner zones.
 GUIDELINES IN THE PLANNING AND
 Environment


Occupancy
Safety
DESIGN OF A HOSPITAL AND OTHER


Security
Ventilation HEALTH FACILITIES
 Patient Movement
○ The surgical service shall be located and arranged to prevent non-rela
 Lighting
 Auditory and ted traffic.
Visual Privacy The operating room shall be as remote as practicable from the entrance
 Water Supply to
 Waste Disposal provide asepsis. The dressing room shall be located to avoid exposure t
 Sanitation o dirty
 Housekeeping areas after changing to surgical garments. The nurse station shall be loc
 Maintenance ated to
 Material permit visual observation of patient movement.
Specification
○ The delivery service shall be located and arranged to prevent non-rela
 Segregation
 Fire Protection ted traffic.
 Parking The delivery room shall be as remote as practicable from the entrance t
 Signage o provide
 Zoning asepsis. The dressing room shall be located to avoid exposure to dirty a
 Function reas
 Space after changing to surgical garments. The nurse station shall be located t
o permit
visual observation of patient movement. The nursery shall be separate b
ut
immediately accessible from the delivery room.
○ The nursing service shall be segregated from public areas. The nurse
station
shall be located to permit visual observation of patients. Nurse stations s
hall be
provided in all inpatient units of the hospital with a ratio of at least one (1
) nurse
ACCORDING TO DEPARTMENT OF
HEALTH
 Room Description and Planning of Health
Center
ACCORDING TO UNICEF:

Waiting/Multipurpose (25 m2) Nurse Station (10 m2) Administration of equipment an

The waiting area should be situated as clos The nurse station is situated adjacent to the waitin d
e as g area, easily accessible from and to the rest of th funds:
possible to the entrance of the PHC centre. e clinic. Requisition forms;
It must Sufficient space should be allocated to this area to Stock ledgers;
be large enough to accommodate the chair accommodate the furniture and ease staff flow. Issue vouchers and inventori
s and Activities: es;
space for the activities as discussed below. This area is utilized as a communication and corre Cash books, receipts and
Activities: spondence centre: petty-cash vouchers;
Waiting area; Patient problems – Patient-referral letters; Minutes of meetings.
Health education sessions concerning the Administrative problems – Letters to and from Medicine control point.
prevailing health problems and the methods supervisors; Information and patient reporti
of Communication for patient referrals to higher le ng,
preventing and controlling them available to vel providers (first referral level and/or ambulance and a reference point for the a
the services, as well as health workers.) ppropriate area for treatment o
population of the country. The scope of Administration health care activities: Toilets (public) r a (8 m2)
clinic
health education is determined by the need Registration; Sufficient and session.
accessible toilets facilities s
s of the community, but mainly centres arou Clinic records; hould be allocated to manage the patient l
nd Laboratory records; oad including
the basic elements of primary healthcare: Ward register; handicapped patients. The public toilets sh
Maintenance of general health and well b Discharge letter; ould be situated in such a manner that the
eing; Antenatal card; normal
Nutrition; Child health card; functioning of the clinic is not impaired with
Safe water and basic sanitation; Report forms; patients waiting to utilize ablution facilities.
Mother and child; Monthly report form; Hand wash and hygiene posters posted on
Immunization; Posters and leaflets. walls, strengthen the educational aspect.
Local endemic diseases;
Prevention of blindness;
General illness and injuries; and
The provision of essential medicines.
 Room Description and Planning of Health
Center
Clean Utility (8 m2) Resuscitation (optional) (20 m2) Consultation/Examination (including
The clean utility should be situated in clos This area is optional and activities can also reproductive health) (15 m2)
e be conducted within the treatment room fo Patients needing privacy should be
proximity of the clinical activities e.g. deliv r practical accommodated here. The room should
ery and economical reasons. The equipment i be
room,resuscitation room and treatment/ n this fitted with a door. If there is no door,
consulting room. Due to operational spac area should then be allocated to the operat bed screens should be provided in the f
e ional orm of a screen on wheels or a curtain t
limitation, sterilising for clinic use is done i space (e.g. treatment room) where these o shield the
n this area. Sufficient space and shelving activities will take place. This area is used couch area. This room should be close
should be to to the
allocated to accommodate storage of dive stabilise adult and paediatric patients, in th waiting area where seating is available
rse e and easily accessible. The booking sch
utensils. course of emergency, to maintain an airwa edule
Activities: y and should be known to all employees and
•Immunization vaccine to be kept in the fluid maintenance for transfer to the next le care
refrigerator and controlled at 4 °C and rec vel taken not to overbook the facility.
orded; of care. Activities:
•Cold chain maintenance; Activities: •Ante-natal clinic sessions;
•Packing and sterilising of instruments an •Performed by a medical practitioner or •Baby weighing should be performed in
Toilet
d (staff) (6 m2) registered nurse/midwife; this
Staff
drapes; to be utilized by staff only, to
toilet •To diagnose emergencies; area or moved to the waiting area, whe
•Instrument
be kept locked
setsatallocated
all times,inspace for pe
the different •Basic resuscitation of maintaining airway re a
rsonal
areas with, well baby” clinic could be held;
•Maintenance of sterility; and
belongings. airway tube and manual resuscitation equi •Educational material could be used in t
•Storage utensils with control of minimum pment; his
and •To place a I.V. cannula and maintain fluid area or moved to the reception area for
maximum levels. balance group
•To utilize emergency drugs if qualified to d education;
o so; •Vital signs monitoring; and
Room Description and Planning of Health
Center
Treatment/Dressing/Injection (14 Toilet (Patient) (3 m2)
m2) This toilet is for in-patients who are stay •A delivery bed with the infant c
This area is optional and activities ca ing in the two-bed room or the delivery ot
n be area. and resuscitation equipment sh
conducted in the consultation/examin ould be allocated here.
Delivery Room (19 m2)
ation room if space is limited. It shoul •Adequate space to accommod
The delivery room should be easily access
d be ate
ible
considered as a clean area where sut furniture, patients and medical s
from the corridor passage at any time. Pati
ures taff
ents’
and wound care are rendered. during the delivery procedure;
privacy should be ensured. Adequate spac
Activities: •Vaginal delivery with the mothe
e and
•Immunization clinics and preparation r in
furniture for delivery management as well
of the lithotomy position (accordin
as for
mass immunization; g to
the mother’s partner is required. There sho Toilet (patient) (3 m2)
•Minor suturing; protocol and staff availability per
uld be adequate space for any procedures This toilet is for in-patients who
2-Bed Room
•Patients (Optional)
referred (14 m2)
from hospital for clinic and the country where this
necessary are staying in the two-bed roo
Should the need arise; patients
dressing changes, or any wound dres can be clinic is situated).
for resuscitation and/or the maintenance of m or the delivery area.
accommodated
sing overnight in the clinic.
a
The
to be done in the dressing room; and clear airway.
staff working intherapy.
•Re-hydration the primary healthcare
Activities:
clinic should be adequately trained an
•Only trained staff e.g. midwife/doctor to w
d
ork in
qualified to attend to these patients.
this area;
If the patients’ condition is of concern,
•Only uncomplicated deliveries to be done
the
in this
patient should be referred to the first
delivery room;
referral hospital within the region.
•Access to ambulance or emergency trans
Activities:
port
•Basic nursing care;
should be available to transport patients
•Monitoring of vital signs.
with undiagnosed complications to the first
referral hospital;
 Room Description and Planning of Health
Center
Soiled utility/Laundry (8 m2) Primary Health Laboratory (14 m2)
All cleaning utensils for housekeeping are stor Activities:
ed Some common diseases in developing countries for
here. The room also serves as the temporary which the primary health care laboratory might play a
storage point and testing area for specimens. determinant role
In this include:
room, the products and specimens are Parasitic diseases diagnosed by direct microscopic
collected if a disposal room is not allocated. T examination or after staining: malaria,onchocerciasis,
here trypanosomiasis, filariasis, schistosomiasis, vaginal
should be easy access to cleaning equipment trichomoniasis,amoebiasis, ancylostomiasis and othe
and materials for emptying and filling of bucke r
ts, and the routine servicing and cleaning of parasites diagnosed in stools [2];
equipment. There should be unrestricted acce Bacterial diseases diagnosed by microscopic examin
ss to ation
the sink – which should have hot and coldwat after staining: Tuberculosis,leprosy, sexually transmitt
er. The ed
room should be well ventilated so that cleanin infective agents, and meningococcal and
g pneumococcal meningitis, acute respiratory infection
equipment can dry quickly. s,
Activities: diarrhoeal diseases;
•Urine testing; Other conditions, particularly non-communicable, suc
REFERENCES
•Examination of placentas; h as anaemia, diabetes and eclampsia [3].
•Washingof
Department of Health( November 2004). Guidelines in the Planning and Design of a Hospital and
instruments;
•Linen
other Health soaking and washing; and
•WasteRetrieved
Facilities. management. from https://www.doh.gov.ph

Unicef (August 2005). Primary Health Care Centres and First Referral Level Hospitals. Retrieved
from
https://www.unicef.org