Professional Documents
Culture Documents
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Report 12 Room 04
400
Room 03 Room 02 Room 01
400
ceramic tiles ceramic tiles ceramic tiles ceramic tiles
20
20
2.0m wide covered verandah
200
ce ramic til es
400
Room 03
ceramic tiles
3 ROOM
ceramic tiles
20
HEALTH POST
open to sky
400
Room 02
ceramic tiles courtyard
open to sky
1,210
20
courtyard
4 ROOM
400
Room 01
MCH / ceramic tiles
HEALTH CENTRE
20
150
open to sky
200
200
20
20
1,240
3 ROOM
400
MODULAR Room 03 Room 02 Room 01
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CONSTRUCTION
GUIDELINES FOR
HEALTH FACILITIES
SOMALIA
Authors:
Austen Davis
Moyiz Ebrahimjee (Architect)
Ali El-Amine (Engineer)
Joseph Aduda (Architectural Assistant)
This document was written by and produced with the financial assistance of the European Union. The views
expressed herein can in no way be taken to reflect the official opinion of the European Union.
2
Contents
Acronyms...................................................................................................................................................... 4
CHAPTER 1: Introduction....................................................................................................5
3
Acronyms
ANC Ante Natal Care
BoQ Bill of Quantities
EPHS Essential Package of Health Services
HC Health Centre
HP Health Post
IPD In-Patient Department
JNA Joint Needs Assessment
MCH Maternal and Child Health Clinic
MoH Ministry of Health
NEZ North East Zone
NGO Non Governmental Organization
NWZ North West Zone
OPD Out-Patient Department
PHU Primary Health Unit
RHC Referral Health Centre
SCZ South Central Zone
UN United Nations
UNICEF United Nations Childrens Fund
UNOPs United Nations Organization for Project Services
4
1 Introduction
The Somali health sector has been characterized professional staff and especially the diversity of
as under-funded, fragmented and ineffective. technical staff necessary to run a full hospital service.
Government, UN, NGO and community providers
struggle to provide services with limited and With the extreme diversity of facilities and the variability
unpredictable inputs and a lack of centralized and in range of services extent of support and type of
strategically directed financing or direction/policy. support offered (UN agency, NGO, government) it is no
wonder there is little uniformity in the quality and range
In the South Central zone, NGOs and local community of services offered between facilities and within a tier
organizations typically run health facilities broadly in line of service level.
with three tiers of service provision. In the 2 Northern
zones government is also a main provider of primary Recognizing the extremely dilapidated state of much
health care services. of the Somali health infrastructure, The Joint Needs
Assessment (JNA) for Somalia determined the need
Health posts (HPs) are the lowest tier of service for the development of standardized blueprints for
provider: They typically consist of one or two semi- health facilities as an important technical task to allow
trained staff without formal salaries or supervision a move towards the standardization of services offered
operating out of a 1 -2 room facility or a local house or within a particular tier of service delivery. Standard
shop (no formal facility). building guidelines also offer the potential for costing
construction and infrastructure elements of health
Maternal and Child Health Centers (MCHs) are system development and therefore are an important
the inter-mediate tier of service provider: they are component of planning for a future health system.
highly variable. They have from 1 12 staff some
with professional nurses and midwives, others with In a workshop in 2007, representatives from the health
no professional higher than an auxiliary (especially in sector came together and agreed to try and establish
rural areas). The range and quality of services varies operating norms and standards for what levels of care
enormously with some MCHs seeing 3,000 patients a each tier should follow. The UNICEF health systems
month and others seeing less than 50! strengthening programme developed a process of
Hospitals are the highest tier of service provision: they extensive consultation and review and eventually
are also highly variable with 10 hundreds of staff produced an Essential Package of Health Services
and most with a medical doctor and some professional (EPHS).
nurses or midwives. However, even hospitals lack
5
The EPHS defines the range of services (and therefore This also means we can develop standard blueprints
supplies and staff competencies) necessary to offer at for health facilities at each level. The EPHS defines a
each tier level. Projecting from the range of services standard:
and staff required, it is possible to define the level of
facility needed to house each tier of service provision.
The new names of EPHS facilities have been will follow specifications to the letter. All facility
changed to disconnect levels of service provision from blueprints need to be adapted to the site and conditions
political administrative boundaries/unit names (districts/ of the site at hand rural MCHs may have to be
regions) so that facilities can be planned for according constructed on relatively small sites. Rural facilities
to need and not political calculus. And to highlight will need to take into consideration soils, water supply,
the need for real change as in each case, significant drainage and ventilation. However basic designs,
changes in focus are prescribed for each tier of service. floor layout plans and indicative Bills of Quantities are
This cannot be created piecemeal and is essential developed for each structure and these BoQs can be
to start generating real performance and returns on modified to allow adaptation to the local site and needs.
investment I the health sector.
Furthermore, innovations are encouraged (for example
This report presents concepts for standard health in areas where there is more regular rainfall throughout
facility design at each tier of service. The design the year, constructors may wish to include submerged
concept is modular. In consultation with health tanks to collect roof run-off). Lastly these plans can
authorities we agreed a basic PHU/HP. The PHU be developed over time as experience grows with
building is used as part of the MCH/Health Centre and construction and planning.
this HC facility is used as part of a referral centre etc.
so that any building can be upgraded to a higher tier of This report presents basic floor plans and elevations
service and to keep overall construction costs and the however there are a large range of detailed drawings
types of buildings required as simple (and cheap) as to guide constructors that should be printed out on A3.
possible. In addition there are BoQs that can easily be adapted
to promote professional construction in any setting
All buildings have been designed to use simple but high adapted to the local constructions challenges (soil
quality building techniques with simple roof structures type, drainage, water availability, ventilation, coastal/in-
and external corridors etc. land). The detailed booklets for each building type are
available on diskette or through the health coordination
While all designs are simple relatively cheap and bodies and at MoH offices.
locally appropriate, it is not expected that all facilities
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2 The Modular Health Centre
REFERAL HEALTH
Room 04 CENTRE
400
TOILET BLOCK
20
20
ce ramic til es
2.0m wide covered verandah
WC cess
400
400
Room 03 gents
ceramic tiles ce ramic til es pool
WC
whb
240
480
3 ROOM
ceramic tiles
20
WC
whb
HEALTH POST ladies
ce ramic til es
WC
open to sky
410
400
Room 02
ceramic tiles courtyard
200
20
courtyard ladies
shwr
ce ramic til es
280
dhobi
sinks
staff room staff room
320
shwr
Room 01
MCH / ceramic tiles
310 310
HEALTH CENTRE
620 420
20
SHOWER
150
BLOCK
open to sky
200
200
FURTURE
1,240
3 ROOM DEVELOPMENT
400
7 620
2.2 Health Centre: Elevation
3 ROOM
HEALTH POST 4 ROOM
MCH / HEALTH CENTRE
3 ROOM REFERAL HEALTH
MODULAR HEALTH CENTRE
FACILITY
TOILET
BLOCK
TOILET
REFERAL HEALTH BLOCK SHOWER
CENTRE BLOCK
4 ROOM
MCH / HEALTH CENTRE
FUTURE
3 ROOM DEVELOPMENT
HEALTH POST
3 ROOM
MODULAR HEALTH
FACILITY
Perspective View
from front Courtyard
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3 The Primary Health Unit
(PHU) or Health Post
3 3
20
20
145
60x60x5cm
125
5cm thick conc shelves
precast concrete
Consultation Store Consultation paving slabs
Room Room laid to falls
210
ce ramic til es
cera mi c til es cera mi c til es
420
440
420
150
150
150
400
400
03 04
+0.30 +0.30
90
640
640
125
145
100
145
2 2
20
20
beam above
step up
step up
200
180
200
Covered verandah
180
180
180
180
20
20
20
20
960
A B A 01
C D
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3.2 The PHU: Elevation
10
GI corrugated roofing sheets
15 o degrees roof pitch
Perspective View
60x60x5cm precast
conc. paving slabs laid
to falls
4 The Health Centre - OPD
02
A B C
640
200 420
20 180 20 400 20
60x60x5cm
100mm dia 20 180 145 150 145 precast concrete 30X30cm box frame with
PVC RWP
paving slabs steel wire mesh for
laid to falls ventilation of the roof
20
20
200 420
60
GI corrugated roofing
sheets 15 o degrees
98
47
(ri ng bea m le ve l)
beam above
Room 04
step up
420
150
ceramic tiles
400
400
400
80
painted
80
+0.30
300
window to schedule
step up
20 90
20
20
0.0 0
20
step up
(g round l evel)
90
30
80
step up
Room 03
420
420
150
400
400
400
ceramic tiles
A A
150
+0.30
03
Covered verandah
60
1,700
1,700
3 3
270
ceramic tiles
20
20
20
60
400
04
beam above
150
0.00
step up
Room 02
420
420
150
400
400
ceramic tiles
400
A B C
20 90
GI corrugated roofing
20
20
20
sheets 15 o degrees
90 20
step up
98
(ri ng bea m le ve l)
80
painted
80
step up
Room 01
420
420
300
150
400
400
400
ceramic tiles
sliding aluminium
130
0.0 0
1 beam above 1 (g round l evel)
20
20
20
30
100mm dia
PVC RWP 20 180 145 150 145
elevation 02 scale 1:100
line of roof overhang
20 180 20 400 20 above
200 420
640
01
A B C
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12
4.2 The OPD Block: Elevation
GI corrugated roofing sheets
15 o degrees roof pitch
60x60x5cm precast
conc. paving slabs laid
to falls
Perspective View
4.3 The Maternity: Floor Plan
Indicative Construction Cost (see BoQs): 18,000 USD
The maternity block is designed to house an observation room and a delivery room. The third room (not inter-
connecting can be used inter-changeably (i.e. for ANC services).
A A B 02 C D
1,280
420 420 420 60x60x5cm
precast concrete
100mm dia 20 400 20 400 20 400 20
paving slabs
PVC RWP 0.00 laid to falls
20 400 20 400 20 400 20
20
20
20
beam above
beam above
+0.15 Covered verandah +0.15
200
200
180
180
cera mi c tile s
180
180
03
60 150 80 90 100 150 80 90 60 90 80 150 60
step up step up step up
2 2
20
20
145
line of roof
640
overhang below
640
290
420
150
400
400
145
1 1
20
20
A A B 01
C D
Ground Floor Plan scale 1:100
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4.4 The Maternity: Elevation.
GI corrugated roofing sheets
15o degrees roof pitch
60x60x5cm precast
conc. paving slabs laid
to falls
Perspective View
5 The Health Centre IPD
The ward is to be added to all Health Centres or MCHs More wards can be added to the HC as it grows or as
to allow them to offer Basic Emergency Obstetric Care it is upgraded to a Referral Health Centre (RHC) (see
and minimal in-patient services (depending on a full expansion plans 2.1, 2.2).
compliment of professional staff).
YELLOW = HEALTH CENTRE/IPD
The ward is generic it has room for 6 beds, a staff room
and a storage room or isolation room.
5 5 sheets 15 o degrees
98
47
140
120
120
600
hw timber fascia board
painted
300
410
410
150
150
150
150
255
255
255
30
400
1,200
150
150
150
150
03
8bed inpatient ward
ce ramic til es
04
1,560
1,560
3 3
325
325
325
325
B A
620
410
410
GI corrugated roofing
sheets 15 o degrees
98
step up
+0.00
+0.00
180
180
180
47
20
20
2 2
300
sliding aluminium
115
115
20
window to schedule
75
75
+0.3 0
textured paint finish to
300
320
150
150
150
150
75
95
95
20
1 1
20
15
5.2 The IPD: Elevation
5 4 3 2 1
15.0 deg. 410 400 410 320 GI corrugated roofing
sheets 15 o degrees
roof pitch
98
+3.3 0
(ri ng bea m le vel)
sliding aluminium
300
window to schedule
+0.3 0
(g round flo or l evel)
textured paint finish to
0.0 0
external plastered walls
(g round l evel)
5 4 3 2 1
15.0 deg. 320 410 400 410 GI corrugated roofing
sheets 15 o degrees
roof pitch
98
+3.3 0
(ri ng bea m le vel)
sliding aluminium
300
window to schedule
+0.3 0
(g round flo or l evel)
textured paint finish to
0.0 0
external plastered walls
(g round l evel)
GI corrugated roofing
sheets 15 o degrees
roof pitch
sliding aluminium
window to schedule
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6 Shower Block
The shower block is a wash place for people, clothes etc intended for all facilities with an in-patient capacity.
0.0 0
20
20
(g round l evel)
sh wr sh wr dhobi sinks
0.00
200
200
180
180
280
ladies gents
ce ramic til es ce ramic til es
400
400
03
+0.15 04
20
20
+0.15
B A
B B
180
180
160
GI corrugated roofing
90
90
30
20
20
dhobi dhobi
sinks
aluminium windows
sinks
to schedule
60 60 60 60 60 line of roof overhang
240
20 above
20 120 120 20 +0.3 0 textured paint finish to
(g round flo or l evel) external plastered walls
140 140
0.0 0
300 (g round l evel)
A 01
B
A elevation 02 scale 1:100
Ground Floor Plan (Shower Block)
scale 1:100
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6.2 Shower Block: Elevation
GI corrugated roofing
sheets 15 o degrees
roof pitch
aluminium windows
to schedule
step
60x60x5cm
precast concrete
paving slabs laid to falls gents front side
perspective
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7 Toilet Block
The toilet block should be seriously considered for all In this report we have detailed a toilet block served by
levels of facility (even PHUs). The numbers of toilet running water and septic tank (toilet block) and a more
blocks will necessarily rise or fall depending on patient simple option for pit latrines draining into a pit.
volumes and IPD facilities/volumes.
+2.7 00
430 (ri ng bea m le vel)
1 (g round l evel)
15 160 20
scale 1:100
04
02
ladies gents
480
460
GI corrugated
150
ce ramic til es
G ce ramic til es
G roofing sheets
60
whb whb B A 1 2
0.00 0.00 430 460
15
80
step up
100
-0 .1 5 -0 .1 5
aluminium windows
2
20
to schedule
20
30
+0.0 00
30 450 30
(g rond floo r le vel)
60X60cm precast 20 195 20 195 20 -0 .3 0
paving slabs -0.300
450 (g round l evel)
01
H
19
7.2 Toilet Block: Elevation
A B 2 1
430 314
A B 15cm dia.metal
H vent pipe
A 03
B 430
+2.7 00
open ing wi th
(ri ng bea m le vel)
450 mo squito gau ze
240
100mm dia rain water gutters +0.0 00
(g round flo or l evel) door to sch edul e
35 60 45 60 50 60 45 60 35 PVC RWP sl ope of gutte r
-0.30 0
(g round l evel)
60
70
1 1
15 160 20
234
slope
slope
-0.30
314
334
314
GI corrugated roofing B A 1 2
02
ladies gents sheets 10 o degrees 430 314
roof pitch
120
80
70
60
-0 .3 0
aluminium windows
to schedule
60X60cm precast building line below
20 195 20 195 20
paving slabs
240
+0.0 00
430 (g round flo or l evel) do or to sched ule
01
450
Roof Plan showing -0.30 0
(g round l evel)
H
slopes (latrine block) scale 1:100
Ground Floor Plan elevation 03 scale 1:100 elevation 04 scale 1:100
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7.4 Latrine (Pit) Block: Elevation
15cm dia.metal
vent pipe
GI corrugated roofing
sheets 10 o degrees
roof pitch
removabe slab
for pit emptying
60X60cm precast
paving slabs step
GI corrugated roofing
sheets 10 o degrees
roof pitch 15cm dia.metal
vent pipe
window to
schedule
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8 Waste Disposal
Medical waste is a serious issue. During construction All facilities will need a waste pit to burry medical waste
of any level of facility plans must be made for medical and this pit should not be open to the public/playing
waste disposal. For larger facilities producing large children.
quantities of dangerous medical waste an incinerator
is highly recommended despite the additional costs of
construction.
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12
12
1
11
MS hinges to site
primary
Engineer's approval
65
100
100
combustion chamber
76
76
65
12
12
11
200 187
110mm wide fire clay brick wall
for the main body of incinerator
11 1 11
11 1 11
12
100
25
54
76
54
54
1 11
11
1
11
12
11
11
11
200 200
110mm wide fire clay brick wall 110mm wide fire clay brick wall
for the main body of incinerator for the main body of incinerator
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8.2 Incinerator: Elevation
40x100x5mm MS channel
150mm dia,3mm thick MS section as the top frame 150mm dia,3mm thick MS
pipe chimney welded onto pipe chimney welded onto
the chimney base plate loading door handle
the chimney base plate
4m height
16
16
(6 course brick leve l)
frame, oil painted to approval.
5
5
110mm wide outer fire clay 110mm wide outer fire clay
brick wall of the incinerator brick wall of the incinerator
51
51
51
+0.580
(2 course brick leve l)
114
114
+0.410
3mm thick MS plate ash door on 150x230mm RC lintel to
17
17
17
(4 course brick leve l)
30x30x3mm MS angle frame, support bricks above
oil painted to approval.
+0.075
(i ncine rator b ase level ) 3mm thick MS plate ash door on
33
33
33
fire clay bricks as 30x30x3mm MS angle frame,
+0.000 the base for the incinerator oil painted to approval.
(flo or l evel)
7
7
fire clay bricks as
the base for the incinerator
More detailed and scaled drawings are available with BoQs on the attached diskette. Drawings should be printed
on A3 format paper
chimney rain cap
Completed Incinerator
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