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AT MlCROFllCHE REFERENCE LIBRARY A project of Volunteers in Asia Ji Model Health Centre Published by: Council for World Mission British Council of Churches Edinburgh House 2 Eaton Gate London SWlW 9BL England Paper copies are 4.50 British pollnds. Available from: Teaching Aids at Low Cost Institute of Child Health 30 Guilford Street London WClN 1EH England Reproduced by permission of the Council for World Mission, British Council of Churches. Reproduction of this microfiche document in any form is subject to the same restrictions as those of the original document. . i’ 1 A MODEL HEALTH CENTRE A Report of the Working Party appointed in 1972 by the Medical Committee of the Conference of Missionary Societies in Great Britain and Ireland Conference of Missionary Societies in Great Britain and Irelhnd~ , Copyright 0 1975 The Chairman of the Medical Committee of the Conference of Missionary Societies in Great Britain and Ireland, Edinburgh House, 2 Eaton Gate, London SW1 W 9BL. Permission must be sought should any of.the material be used for the purpose of financial or other gain. The purpose of this copyright is particularly to protect the design of the Model Health Centre from copyrighting by others so that reasonably open access to the nutterialinay be maintained. Rinted in the United Kingdom by R.K. Hudson, 53, ElmfIeld Road, London SWI 7 8AF _ A------ __ -- CONTENTS Contents Foreword Members of Medical Committee Members of Special Committee Introduction Chapter I. The background, the Model, important areas for further study and the future Chapter II. A description of the Model plan Chapter III. The drawings Social area and kitchens Under fives clinic Ante-natal clinics and family plannine General outpatients Waiting areas PharmacyorW laboratory Centrd facilities Reception and office Clerical work Admissions Wards Hostels Staff housing Sterilizers and sterile supplies Notes on an immunization area Disposal Stores and store-keeping Equipment lists Extended room list and expansion options Treatment types Part-time workers Communications and responsibilities Duties of the doctor in relationship to the Health Centre (iii) Page iii, iv Y vi vi vii 1 5 9 Appendix 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Appendix Teaching and staff training Some teaching aids and their use Homevisiting School visiting Eval~ting the work of the Health Centre and the use and design of records Some examples of patient retained records The use of school children for record making Community hygiene Nutrition and food TheOStlUCOfdbSSfJ Costs and materials Foundations and roads Flexibility, expandability, mass production and standardization of buildings Latrines and sewage disposal Water supply, purification and storage lktqy and plant site rizer; thtlaIclinics Very small clinics Numbers of people served, the distribution and grouping of Centres and some wider planning problems The d&n of simple operating theatres Producing, handling and assessing statistics . . Setting up a Centre Orientation of buildings, their construction and environmental considerations Reference reading in relation to a Model Health Centre Examples of diagnostic and treatment routines serialized for use in Health Centres A description of a small rural Health Centre Further drawings 25 26 27 28 29 30 31 32 33 34 3s 36 37 38 39 40 41 42 43 44 4s 46 47 48 49 so 51 52 . . FOREWORD At the International Hospital Federation’s Seventeenth International Hospital Congress held in Dublin in June,] 97 1, one session considered the value of standardizing buildings and methods when planning for the provision of health care in developing cduntries. Those involved in the medical work of voluntary organi- zqtrons expressed immediate interest. Several of the architects present offered their help in making a detailed study of this approach to health care. The idea of a Model Health Centre was presented by Dr. D. A. Andersen to the meeting of the Medical Committee of the Conference of Missionary Societies in Great Britain and Ireland, (CBMS) on 27th October, 1972 and found such favour that a special committee was appointed, under Dr. Andersen’s chairman& to bring in expert opinion. At the first meeting of this special committee a working party was se! zp to prepare a report describing the buildings of a Model Health Centre, its staff, eqipment and the work which should be undertaken from and in it. The names of members of the Medical Committee, special committee and working party are @ven on page vi. The working party met on twelve occasions and, in presenting its report, wouid lie to express its appreciation for the valuable !idvice and criticism received from many persons with special knowledge and experience in the field of he&h care in developing areas. Acknowledgements The Medical Committee, in receiving the report, gratefully acknowledges the special contribution of Mr. Mark Wells in undertaking the major share of the work involved in the preparation of both text and diagrams. It also expresses its thanks to Mrs. Phyllis Head who served as secretary to the working party, 1~) Mr. Jamrs (‘. McCilvray who produced the reading hst, to Mr. Graham Stone who made the fair copies oi the diagrams, to the Witney Press who printed the large dia ram at the end of the report, to Mrs. Gladys Hunt who read the proofs, to Mrs. $, ouisa Grant, Lt. Cdr. Roland fiudson and Mr. George Moore who provided the ways and means for typing, printing and binding the final document and to the many people, too numerous to mention individually, who have read drafts of manuscripts and given helpful advice and criticism. It gratefully acknowledges the financial assistance received from the Christian Medical Commission, the Medical Institute at Tiibingen and MISEREOR at Aachen. The spezial committee records with deep regret the sudden death of Dr. D. A. Andersen on 4th December, 1973. He had made a major contribution to the work involved in the preparation of this report and guided the committee with unfailing skill, tolerance and good humour. Dr. D.A. Anderson&h&man to 2.12.73) Dr. Kathleen G. Wright (man from 3.12.73) Rev. C.B. Firth (Secretary) Dr. 15. Acres Mr. A.D. Askew Dr. H.H.W. Bennett k FEBzx$- Mis 6. ‘aeal Miss D. Dykes Canon AS. Neech Rev. T.C. Patterson Miss R.E. Ranhin Dr. Nancye M. Ridley Miss J.M. Sharp Dr. Elizabeth G. Sloan Dr. Ii. Souster Miss B. Spanner Dr. J.L. Tester MambemoftheBpfdalcommittee In addition to the members of the Medical Committee who attended the Special Committee meetiagr, the following consultants were invited: Dr. W.A.M. Cutting, London School of Hygiene and Tro Dr.~4’~;o~~, Foreign and Commonwealth Of R ical Medicine ce, Overseas Development . . Professor N.RE. Fendall and Dr. David Stevenson, Department of Tropical and Commusdty He&h, Uverpool School of Tropical Medicine Mr. G.H. Franklin, Department of the Environment, Building Research Establishment Mr. G. McRobie aad Miss Pamela J. l&e, Intermediate Technology Development Group Ltd. Mr. AE. North, AKhitectUre Department, Polytechnic of North London Dr. P.N. Swift, Children’s a)epartment, Famborough Hospital Mcmke!8ofthewerIdngParty Dr. David Morley and Miss Margaret Woodland, Institute of Child Health Mr. Mark Wells and Mr. Brian Brookes, architects Dr. Kathleen Wright and Dr. Daniel Andersen, Missionary Societies Miss M. Lethbridge, formerly Institute of Child Health Dr. William Cutting, London School of Hygiene and Tropical Medicine INTRODUCTION This report is a contribution to the study of the problems associated with the provision of health care services in developinS areas. Such services usually have their outreach into the community by means of small clinics, sometimes in isolated positions. Shortage of money and staff preclude the establishment of any larger units, at least in the fmt inst;;nce. The small clinic is fully described in the Appendices to the report. From such small beSinning it may be that a site’on which a small clinic has been established will become well placed for the care of a growing community. The report shows how, with careful forethought in the siting of the first