OVERSEAS HOSPITAL CONSTRUCTION
Flexible healthcare models for sub-Saharan Africa
Polly Barker, director and Healthcare lead at independent architectural, design, and planning practice, tp bennett, discusses how, over the past 11 years, the business has worked on a number of hospitals across sub-Saharan Africa for NMS Infrastructure, ‘developing a flexible, adaptable, and low-impact model for delivering much-needed district and clinic hospitals across several countries’.
The hospitals we are delivering in Ghana, Côte d’Ivoire, Zimbabwe, Kenya, Zambia, and Gambia, are being built in response to the demand for quality, accessible healthcare in sub-Saharan Africa. A World Health Organization report, published in 2007, estimated that between 550,000 and 650,000 extra beds were needed across sub-Saharan Africa to meet the expected ‘healthcare gap’. This needs to be addressed. Thanks to increasingly buoyant economies, African governments feel empowered to tackle the issue head on with hospital building programmes. However, such activity takes time; time to organise and time to deliver. In Ghana, spending on healthcare in rural
areas is only now starting to close a gap which has existed between the existing healthcare estate and the needs of the population, nearly three quarters (70%) of whom live in communities that are over five kilometres from the nearest healthcare facility. There is also a recognition that good healthcare facilities could boost tourism. A current hospital project in Zimbabwe has been driven by this. Some
The design components and building materials are adaptable to different terrains, different budgets, and different requirements on the ground.
of the airline companies will not commit to scheduling flights into an airport unless there is a hospital of reasonable size and facilities within a nearby radius.
Impact on life expectancy This distance to the nearest healthcare provision, exacerbated by lack of access
to transport, has had a dramatic impact on the health and life expectancy of rural communities in recent years. The region also suffers a high mortality rate among children. A report by the Ghanaian Ministry of Health in 2001 reported that child mortality in areas remote from healthcare was 40% higher than in communities within five kilometres of it, while infant mortality in rural areas was 60% higher than that in urban areas. Tackling this has become a priority for the authorities. Historically, healthcare in Ghana has been concentrated in the main urban centres, where the more affluent population tends to live, and benefits disproportionately from public sector healthcare – particularly secondary and tertiary care, as well as private healthcare provision.
A landscaped outdoor space at Shai-Osudoku Hospital, where people can be in fresh air, with awnings to offer protection from the sun.
Among the country’s rural population, which is often poor, the informal and charitable sector has been an important provider, with patients also paying for their care at the point of delivery. The Ghanaian Ministry of Health’s District Hospital programme, which we worked on, has aimed to counterbalance these trends, creating high-quality secondary care within communities across the country. However, building a large hospital in the middle of a remote rural area is one thing; it is another to do so in a way
October 2022 Health Estate Journal 75
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96 |
Page 97 |
Page 98 |
Page 99 |
Page 100 |
Page 101 |
Page 102 |
Page 103 |
Page 104 |
Page 105 |
Page 106 |
Page 107 |
Page 108 |
Page 109 |
Page 110 |
Page 111 |
Page 112 |
Page 113 |
Page 114 |
Page 115 |
Page 116 |
Page 117 |
Page 118 |
Page 119 |
Page 120 |
Page 121 |
Page 122 |
Page 123 |
Page 124
