Achieving universal health coverage (UHC) certainly remains key to the Sustainable Development Goals (SDGs) as well as the New Urban Agenda – or Agenda 2063 in the African context – as it has a direct impact on improving the well-being of a country’s population, which in turn effects the country’s productivity and prosperity. The World Bank describes UHC as people having access to the care they need without financial hardships. Yet, joint research by the World Bank and the WHO found that although some progress has been made towards UHC, currently at least half of the world’s population still don’t have access to essential health services. The research also noted that close to 100 million people a year are falling on financial hardship and even poverty due to health expenses. 

While there is definite scope in emerging markets, including across Africa, for high-tech and high-performance hospitals that deliver state-of-the-art care, this should not be the sole focus.
Laura Swanepoel Head of Healthcare, WSP Building Services Africa

Laura Swanepoel, Head of Healthcare, WSP Building Services Africa, says: “This reality is not hard to imagine, especially across developing markets. For example, in many developing markets the challenges to attaining these targets in the set timeframes is precipitated by existing infrastructural barriers of often aging and oversubscribed hospital and medical facilities. These challenges are further compounded by rapid urbanisation, growing populations and changing demographics, rising consumer demand, and continued economic uncertainty - despite regional pockets of recovery – that continues to be experienced in many developing markets.”

Adding to these pressures is the often wide gaps in access between cities and rural communities, as well as between primary, secondary and tertiary tiers of health and medical services. Where the sparse or even lack of formal facilities across remote and rural areas leads to large populations of people not having sufficient access to quality health and medical services. 

“As a result, often what may start out as a minor illness or conditions tends to deteriorate into more complex illnesses, including increasing occurrence of chronic diseases and comorbidities,” suggests Jabulile Nhlapo, mechanical engineer and healthcare specialist, WSP Building Services Africa. 

Nhlapo describes that in today’s rapidly changing world, the engineering process is no longer just technically demanding. “We need to infuse technical capabilities with the social, cultural, environmental and economic aspects of our world. As we work towards achieving universal health coverage, when designing healthcare and medical facilities, priority consideration must be given to the patient; who is either awaiting diagnosis or undergoing treatment. We need to design facilities that not only meet regulatory requirements, but also help keep patients comfortable and, where possible, accelerate the healing process.”

As a result, often what may start out as a minor illness or conditions tends to deteriorate into more complex illnesses, including increasing occurrence of chronic diseases and comorbidities.
Jabulile Nhlapo Mechanical engineer and healthcare specialist, WSP in Africa

However, patients are not the only [people] consideration, as healthcare workers are also a key consideration. Healthcare workers are a critical part of speedy patient recovery -where they also work under enormous pressure and strain. “Attention must be given to better understand healthcare workers’ procedural protocols and work functions, so that facilities and systems are designed to be easy to use and complimentary to the needs of healthcare workers,” says Nhlapo. 

Further to this, Swanepoel indicates that while there is definite scope in emerging markets, including across Africa, for high-tech and high-performance hospitals that deliver state-of-the-art care, this should not be the sole focus. “A community thrives on a well-integrated social system, and healthcare facilities are often at the centre of this. Therefore, in remote and rural areas – particularly where even basic healthcare and/or medical services may be lacking - a more decentralised approach that can [bring] care to where the people are is needed.”

“This can be achieved through place-based wellness centres, which creates an opportunity to leverage a larger number of smaller facilities to deliver quality services and care across wider geographic areas,” says Swanepoel. “Whether a standalone facility in a remote area or an add-on to existing primary healthcare clinics within same complex, placed-based community wellness centres can be designed and constructed with modular units – making them inevitably flexible, adaptable and fit-for-purpose to the evolving needs of the communities they serve.”

Achieving universal health coverage – and within the targeted timeframes – that is also resilient and futureproofed will certainly be no small feat. A careful balance between environmental, economic and social sustainability will need to be incorporated into designs of future proofed facilities that not only aim to address a community’s current needs but is also cognisant of what their future needs are likely to be.

“As engineers, we must be strategic advisors to clients, thoughtful intermediaries for patients and healthcare workers, as well as technical creatives who are driven to find sustainable solutions. By adopting a nuanced approach to the medical and hospital facilities we are building we make a massive, positive impact on the delivery of health services that are suited to the communities they will serve – and thereby enable these communities to flourish and grow into well rounded societies,” concludes Nhlapo. 

WSP Healthcare Advisory Services

We deliver a comprehensive range of advisory services to support our clients in all aspects of the funding, delivery and operation of healthcare estates. As a trusted partner to health care provider organisations around the world, we deliver a comprehensive range of advisory services to support our clients in all aspects of the funding, delivery and operation of healthcare estates.

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