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http://freakincars.com/?q=viagra-purchase-in-mexico Ikyatha Yerasala talks to experts from the healthcare and design industry, who share the key considerations to be kept in mind while designing a rural public healthcare facility..

The state of rural Public healthcare in India is often deplorable. A staggering 70 per cent of our people live in rural areas and have no or limited access to hospitals and clinics. The 71st National Sample Survey (NSS) conducted in 2014 revealed that out of the total hospitalisation cases in rural areas, 42 per cent were said to be in public hospitals. According to a report by Hindustan Times, with healthcare in rural areas often being inaccessible to the population there, many people are opting for alternate therapy, falling prey to quacks or end up relying on public health services which are inefficient. Improving our public health infrastructure is something India is in dire need of. Designing a healthcare facility for rural areas involves focusing on many aspects – from sustainability to infection-control and privacy. Experts in the field of healthcare design share their views on the key considerations to be kept in mind while creating a rural public health facility…

Infection Control-and Privacy

Creating an infection-resistant environment is of utmost importance. Talking about how this can be done, Architect and urban designer Arun Mathai who works at Hosmac, Middle East, says, “Considering the adjacencies of departments, segregation of clean and dirty areas, movements of public and staff, delineation of public access and access-controlled areas right at the design level are important. It’s crucial to understand the transition from the non-sterile to sterile areas. Rooms such as ICUs, Surgical suites, etc. follow the same hierarchy while transitioning from a non-sterile to sterile zone. Access to a sterile space is generally regulated by the introduction of a transitionary space or ante-room. Gowning or change areas also indicate the same kind of transitionary spaces. Since these considerations are design-based and moreover functionally critical, they are applicable and required even when it comes to a facility that caters to the rural populace.” He goes on to add that one should avoid overlaps in clean and soiled movements. “Apart from the basic design methodology, steps are also taken to maintain clean environment through the use of better air filtration systems, Individual air handling units catering to the sterile zones exclusively and pressure differences into the sterile areas to maintain a higher level of infection- control.”.

Reducing infection risk is not rocket science, it is often common sense, with good evidence to support it, states Upali Nanda, Associate Principal and Director of Research at HKS, Inc.  “The tenets of creating infection-resistant environments are pretty universal- you want to use surfaces that are easily cleanable, make sure you have a minimum of crevices and difficult to clean spaces, good education around cleaning protocols, a robust air flow system that separates out the clean from the contaminated air, a clear separation of clean and soiled supplies, and careful planning of visitor and patient pathways so there is no risk of cross-contamination,” she says.

Giving more insight into the guidelines to be kept in mind while designing a public health facility, Gayathri Krishnamurthy, a freelance architect who works for Karnataka Health System Development and Reform Project shares, “The key drivers of design are: maintaining efficient circulation, separation of anti-septic areas and requisite privacy for different user-groups. Certain functions such as the OPD, the laboratory, records, waiting areas and pharmacy are overlapping. The flow of uses (medical, nursing and administrative staff, in-patients, out-patients and visitors) has to be designed according to the sequence of functions within the healthcare facility. Functions have to be zoned in a way that minimizes unnecessary cross circulation and interference between user groups. Areas such as the OT and the Labour rooms have to be kept well-isolated from other public functions in order to minimize the risk of spread of infection in and out of these rooms. The special nature of activities in these zones also imply that their finishing and interior treatment have to be designed to enable maintenance of their anti-septic nature.”

Privacy

Privacy is a critical concern where women and their use of the facility are concerned, mentions Gayathri. “Privacy is especially important in labour and post-delivery rooms. They need to be kept secure and private from the public areas. The internal circulation of the facility should be visually well-connected in order to enable administrators and staff nurses to keep an eye on various activities and respond to situations immediately.”

Material used

The material used for construction is another key factor to be kept in mind. “It should be locally sourced as much as possible, while also being appropriate for the function of the building. This will help in designing a low maintenance building,” reveals Gayathri.

Healthcare architect Pradeep Kulkarni, who has designed a plethora of hospitals, too endorses the idea of ‘going local’ and adds, “It’s better if the material and technology used is local. The people there will be adept at handle local material and it will make them proud that they’re contributing to the area.” Adds, Arun, “Going local can prove to be more economical and contributes to the local economy.”

Location

As for the location of the facility, Arun opines that it would depend on the kind of facility that is proposed. “If it’s a primary health centre (as would be the case in a rural setting), the location would mean easy accessibility for the users of one specific rural jurisdiction. A higher tiered hospital or a hospital with specialties and super-specialties will need to be accessed by more number of villages or towns and hence the location should be thus suited. From the design stand point, a PHC is the first point of treatment in rural areas and should be available easily to the population. The idea being that immediate care be provided before being transferred to a hospital with specialty, should the need arise.”

Climate Responsiveness and Sustainability

As for the location of the facility, Arun opines that it would depend on the kind of facility that is proposed. “If it’s a primary health centre (as would be the case in a rural setting), the location would mean easy accessibility for the users of one specific rural jurisdiction. A higher tiered hospital or a hospital with specialties and super-specialties will need to be accessed by more number of villages or towns and hence the location should be thus suited. From the design stand point, a PHC is the first point of treatment in rural areas and should be available easily to the population. The idea being that immediate care be provided before being transferred to a hospital with specialty, should the need arise.”

http://freejobseeker.com/?q=generic-viagra-super-active-%28tadalafil%29-20mg Since healthcare facilities are service intensive, it’s vital that these services are designed to help the building function in an optimum manner and at the same time, reduce the environmental impact without any compromise on the function. Adds Gayathri, “Energy demand of the building is often driven by lighting and other domestic uses. Energy conserving fixtures should be used to reduce this. Relying on renewable sources for energy is relevant. Solar hot water system should be used to meet domestic hot water requirement. Solar photo-voltaic systems that can meet a substantial portion of the energy requirements of the building can be installed on the roof top or in an open space nearby. Appropriate land development practices like use of site topography, plantation as per local climatic conditions, hard landscape, etc. are encouraged. Water conserving fixtures and faucets should be installed to reduce the potable water use as well as waste water generation.  Rain water harvesting infrastructure should be planned asking with the water supply and plumbing layout.”

Talking about sustainable building materials, Arun says, “They would be predominantly locally sourced like bricks and use of alternative basic building materials like concrete made with flyash, flyash bricks, bamboo, hempcrete, etc. Recycled building materials also provide to be the best form of sustainable building. Adherence to green building codes would be  recommended as it provides a better indication of sustainable materials used, renewable energy sources etc. Good construction practice also contributes to the sustainability in design and construction.”

Safe sanitation practices are important too.  “Segregation of waste at source and its disposal in a scientific way should be done in order to avoid or reduce polluting the surrounding environment. Bio-medical disposal facilities should be integrated into site and building design, following applicable bye-laws/ standards,” adds Gayathri.

Designing for a rural public health facility means focusing on local materials, sustainability and ensuring infection-control, among many other aspects that need to be given attention. India is no less than the West when it comes to the wealth of knowledge possessed by healthcare architects and designers in the country. It would be extremely satisfying to see their knowledge being put to good use for the betterment of our rural public health system.