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DESIGN OF AN EFFECTIVE PRIMARY HEALTH CARE CENTRE

CHAPTER ONE 

INTRODUCTION 

1.1   Brief Description of Primary Health Care Building Type

Primary Health Care (PHC) is driven by a political philosophy that emphasizes a radical change in both the design and content of conventional health care services. It also advocates an approach to health care principles that allow people to receive health care that enables them to lead socially and economically productive lives (Dennil et al. 2015: 2). The Alma-Ata declaration of September 1978 defined the concept of PHC as essential care based on practical, scientifically sound and socially acceptable health care methods and technology, made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination. It forms an integral part both of the country’s health system, of which it is the central function and main focus, and of the overall social and economic development of the community. It is the first level of contact for individuals, the family and the community within the national health system, bringing health care as close as possible to where people live and work, and constitutes health care services (WHO 1998: 15). 

In addition, Alma-Ata declaration states that any Primary Health Care program should include at least the following components, namely, education about prevailing health problems and methods of preventing and controlling them; the promotion of food supply and proper nutrition; an adequate supply of safe water and basic sanitation; maternal and child health care, including family planning and care of high risk groups; immunization against the major infectious diseases; prevention and control of locally endemic diseases; appropriate treatment of common diseases and injuries and the provision of essential drugs, including vaccines. Primary Health Care Centre is the cornerstone of rural health services- a first port of call to a qualified doctor of the public sector in rural areas for the sick and those who directly report or referred from Sub-Centres for curative, preventive and promotive health care (India, 2012).  Primary Health Care Centre is a basic health unit to provide as close to the people as possible, an integrated curative and preventive health care to the rural population with emphasis on preventive and promotive aspects of health care.   We are in a period of major change, with more being provided at primary level rather than in hospitals. 

1.2   Client Background History The Client/User 

As part of the “change” campaign of the current administration in the State of Osun, the Obokun Local Government of the state under the leadership of the Local Government Chairman, has proposed an efficient Primary Health Care Centre for the benefit of the people in Obokun Local Government Area, as the current Centres in the area are inadequate in terms of quality of the services they render/offer. 

Brief History of Obokun Local Government Area 

Obokun is a Local Government Area in Osun State, Nigeria. Its headquarters are in the town of Ibokun at 7047’00”N 4043’00’E / 7.783330N 4.716670E. Other towns in Obokun Local Government Area include Imesi-Ile, Otan-Ile, Esa-Oke, Ilase, Iponda, Ikinyinwa, Idominasi and Ora.

Project Location: The Primary Health Care Centre is being proposed to be located in Iponda town in Obokun local government area, Osun state, Nigeria, Africa. Its geographical coordinates are 7o 44’ 0” North, 4o 43’ 0” East. Obokun local government covers a total land area of 527km2 (203sq mi), and a total population (according to 2006 census) of 116,511.

1.3    Statement of the Problem

Primary medical care is only an aspect of Primary Health Care. Primary care is “front line” or “first-contact care”. It is person-centered (rather than being disease or organ system-centered) and comprehensive in scope, rather than being limited to illness episodes or by the organ system or disease process involved (Emeka & Masemote, 2011). Therefore, Primary Health Care Centre, being a person-centred centre is expected to provide integrated and accessible health care services by having adequate building structure which is aesthetically pleasing and homey, together with a nice and well landscaped environment.

Based on what is on ground presently, it is conclusive to admit that the Primary Health Care system at Iponda, Obokun local government area is trying to be effective in addressing the health problems in the community. But, the fact remains that the Primary Health Care Centre will only continue to strive for effectiveness, and can never be effective with the facilities on ground. The facilities presently are simply inadequate and cannot effectively address the health problems in the community. The inadequacies that this project aims to tackle include poor building structure, inadequate treatment departments, inadequate support facilities, not-so-pleasing environment, etc. Moreover, the proposed building will be adequate enough to serve the neighbouring towns such as Ilase and Ikinyinwa.

1.4    Justification of the Study

Apart from the personal interest in Primary Health Care Centre design, it is observed that the people of the Obokun Local Government Area are not satisfied with the existing Primary Health Care Centres in the area. Also, the treatment departments and the support facilities in the existing buildings are inadequate. That is why this project is coming up to provide solutions to the problem and looking forward to bridging the gap of satisfaction.

1.5    Aim and Objectives

The aim of this research is to prepare a program for the design of an effective Primary Health Care Centre dedicated to improving the health status of the people in Obokun local government area of Osun state. To achieve this aim, specific objectives put forward to be pursued are, to:

1.      Carry out case studies on primary health care centre.

2.      Assess the brief and requirements of the client

3.      Assess the reaction of users (the patients and the health workers) to the existing facilities.

4.      Assess/analyze the site and the environmental factors.

5.  Propose a scheme that enunciate and encompass the client’s and users’ requirements.

1.6    Purpose of Preparing the Program

The purpose of this study is however, is to prepare a program for the design of a Primary Health Care Centre for Obokun Local Government Area, to be located in Iponda, Osun state. The purpose of the program is to gather information that is related to the project’s aim and objectives. How people would use the building, the space requirements for specific areas, relationships and adjacencies, and the desired level of quality. The purpose of the program is also to compile information that will be used to translate the findings on how the building will function into design criteria.

1.7    The Organization of the Program Report

The program will be organized into a conceptual framework which is as a follows;

Chapter one:  Introduction – this will include a brief description of the building type, the client, the history of the client, demographic characteristics of the location, philosophy of the client, aims and objective of the program.

Chapter two: The state-of-the-art – this will include a historic review of the building type, category of the building type, functions, spaces and relationships between spaces common in the building type, technological and environmental solutions commonly used for this building type. Conceptual approaches to this building type, summary.

Chapter three: Case studies. Design criteria: project goals and objectives, functional/spatial criteria, technological and environmental criteria, legal and planning regulations, behavioural criteria.

Chapter four: - Site and Environmental Analysis. Site and Environmental Analysis: analysis of the topographical and the environmental conditions of the site, analysis of the immediate environment or the area of the city in which the site is located (in terms of  activities and other relevant issue).

Chapter five: Approach to the design – the designer’s idea/concepts (at different levels of the facility) illustrated with the sketch designs.