How Location Affects the Planning of Healthcare Facilities, Part 2

As was discussed in Part 1, this is a continuation of the previous article on how location affects the planning of healthcare facilities.

In the book WHO District Hospitals: Planning and Design by the World Health Organization (Western Pacific Division), Chapter 2.3 talks about how to locate a healthcare facility to maximize and provide it with the optimum space to operate. A common nuance of healthcare facilities is that they are also spaces that are meant to operate during disasters and emergency situations.

Listed below (in italics) are the considerations provided by the World Health Organization, along with my observations and applications of the items:

2.3 Factors to be considered in locating a district hospital

1. It should be within 15-30 min travelling time. In a district with good roads and adequate means of transport, this would mean a service zone with a radius of about 25 kilometers.

The nearness of the healthcare facilities to potential patients is a major consideration regarding locating such projects. But a general observation I have made over the years is that a healthcare facility should both be walkable (i.e. easy for pedestrians) and have proper transport connections (usually in terms of vehicular traffic and in some cases, aerial traffic via helicopters). When a space can be reached in many easy ways, more visitors and patients will be able to access healthcare services.

2. It should be grouped with other institutional facilities such as religious (church), educational (school), tribal (cultural), and commercial (market) centers.

A healthcare facility should always be part of a general community space within the area it occupies. Such facilities are part of a combination of what I would call mutually complementing activities; having these different services adjacent to each other increases the desirability of an area. Examples of such complimentary spaces would be structures such as churches, schools, shopping centers, cultural landmarks, and government buildings. As such, when one is locating a healthcare facility, it pays to have an analysis done of the general locations of such services so as to find a good spot where the healthcare facility will have connections to the said complementing services.

3. It should be free from dangers of flooding; it must therefore not be sited at the lowest point of the district.

As mentioned at the start of this article, healthcare facilities should be designed to survive emergencies and disasters since the medical services that the healthcare facilities will provide are essential in aiding the region it is located in. Aside from locating it away from potential flood areas, the healthcare facility should also be located in a way that it can secure itself from outside threats (i.e. terrorist actions, military conflict) as well as from earthquake faults. Another aspect to note is that if the healthcare facility is near the ocean, it should also be designed and located to mitigate the effects of storm surges, tsunamis, and high tides on the functionality of the healthcare facility. The healthcare facility should also be located AWAY from potential sources of fire or chemical disasters, such as fuel stations, chemical plants, or factories.

4. It should be in an area free of pollution of any kind, including air, water, and land pollution.

Obviously, if it is located in a place where pollution gets concentrated in the site development, the general health levels of the staff, patients, and visitors of the healthcare facility will be affected.

5. It must be serviced by public utilities: water, sewage, and storm-water disposal, electricity, gas, and telephone. In areas where such utilities are not available, substitutes must be found, such as a deep well for water, literatures for electricity, and radio communication for telephone.

The potential location of the healthcare facility should also be surveyed to ensure that basic utilities are available in the site. As mentioned in number 3, the healthcare facility should be one of the last standing places in a disaster event; as such, it always needs to have access to such utilities. As this book was written in the 1990s, an additional requirement in the 2020s will be Internet connectivity, along with data systems and information technology.

Part 3 will be a future blog post.

"A general observation I have made over the years is that a healthcare facility should both be walkable (i.e. easy for pedestrians) and have proper transport connections (usually in terms of vehicular traffic and in some cases, aerial traffic via helicopters). When a space can be reached in many easy ways, more visitors and patients will be able to access healthcare services."