Salus journal

Healthy Planet. Healthy People.

Healthcare / Quality improvement

European Healthcare Design 2019

Developing an eco-system of place-based healthcare infrastructure in developing markets

By Jabulile Nhlapo 16 Aug 2019 0

Achieving universal health coverage remains key to the Sustainable Development Goals and the New Urban Agenda. This talk addresses how to overcome a sparse or lack of formal facilities across remote and rural areas.


In many developing markets, however, challenges to attaining these targets in the set time frames are precipitated by existing infrastructural barriers of often ageing, oversubscribed medical facilities. These challenges are compounded by rapid urbanisation, growing populations and changing demographics, rising consumer demand, and continued economic uncertainty.

Adding to the pressures are wide gaps in access between cities and rural communities, as well as between primary, secondary and tertiary tiers of health services. Where a sparse or lack of formal facilities across remote and rural areas leads to large populations not having sufficient access to quality health services, people’s health tends to deteriorate into more complex illnesses, including increasing occurrence of chronic diseases and co-morbidities.

How do we change this? In remote and rural areas – particularly where even basic healthcare services may be lacking – a more decentralised approach is needed. This can be achieved through place-based wellness centres, which creates an opportunity to give weight to a larger number of smaller facilities to deliver quality services and care across wider geographic areas.

Whether a standalone facility in a remote area or an add-on to existing primary healthcare clinics, placed-based community wellness centres can be designed and constructed with modular units – making them flexible, adaptable and suitable for the evolving needs of the communities they serve.

Based on our experience in Africa, our findings address: 

  • characteristics of the modular community wellness/healthcare units (building design and construction, core offerings, building services, etc);
  • rendering of a workable case study concept design; and
  • the potential of integrating community wellness centres into existing healthcare infrastructure ecosystems, including: the impact that digital transformation and advanced technological developments will have on the ability to provide better care (from centralised patient information systems to telemedicine to access specialists, or UAVs/drones used to deliver essential medical supplies, etc); and opportunities for collaboration with local public transportation systems for patient transportation to hospitals in town or cities.

Organisations involved