Health Promoting Life Style Centre
A salutogenic approach to health by design
Salutogenic design promotes health by
manipulating the built environment for
maximum exposure to salutary factors.
The Built Environment and Health
Can Architecture cure AIDS?
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Built environment can promote health
Evidence based design for proven outcomes
Salutogenic approach to cities and buildings
Ideas Precede Design
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Systems thinking
• Systems science shows that living systems cannot be understood by analysis. The
properties of the parts are not intrinsic properties, but can be understood only
within the context of the larger whole (Capra, 1997)
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Health equity and global health
• “Health security, our ability to reduce and manage these natural and man-made
threats, has become a matter of concern to us all. We are now beginning to
understand fully that the health of one nation affects its neighbours and that we
need to share our knowledge and build our defences together. We are only as
strong as our weakest part, wherever that may be.” (Crisp, 2010)
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Community based primary health care
• Bio-psychosocial-cultural sensitivity
• Evidence-based and cost-effective health care
• Health promotion by means of information, education, communication, advocacy, participation
and partnership
• Treating patients at the appropriate level of care
• Multidisciplinary health care
• Intersectorial collaboration within society
• Community involvement in asserting their rights and interests
• Continual monitoring and evaluation of the effectiveness, efficiency and equity of health
services.
Ideas Precede Design
Strategic Priorities for Health in Africa
WHO Regional Office for Africa - 2010
• Primary health care
• Mothers and children
• HIV/AIDS, Malaria,
Tuberculosis
• Disease Prevention
• Health Promotion
Components
Components of a health supportive life style centre for Africa
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Primary health care clinic
Community space
Landscaped garden
Vegetable garden
Transition housing
Crèche
Support facilities: Security, green infrastructure, Staff accommodation
Design Considerations
Salutogenic Design
Salutogenic design promotes health by
manipulating the built environment for
maximum exposure to salutary factors.
Sense of Cohesion (SOC)
Built environment can facilitate a sense of life’s…
• Comprehensibility
• Manageability
• Meaning
Considerations/Salutogenic design
Psychoneuroimmunology (PNI)
- Mitigate stress
- Strengthen immunity
The built environment can do this by:
- Positive psychosocial stimulation
- spaces where people linger
- Restorative environments
- Biophyillic design and biomimicry
Considerations/ Health Supportive Design
Health Supportive Design
Patient Safety
Patient health outcomes
Staff outcomes
A review of the evidence shows the greatest benefits are gained by:
• Adequate daylight and task lighting
• Views of nature
• Family/support zones
• Minimise distractions
• Acuity adaptable patient rooms
• Single bed rooms in patient wards
Considerations/ Health Supportive Design
Risk of TB transmission from 24hrs in
rooms shared with TB patients are:
• Windows and doors closed
• Mechanical ventilation
• Natural ventilation – health adapted design
97%
39%
11%
WAITING…
TO BECOME INFECTED
Design Shortcuts/ Matrix
Design
Shortcuts
Matrix
Daylight
Salutary Factors
Health Supportive Design
Efficiency and Green Design
Boost immune strength
Sense of security
Sense of wellness
Speed up recovery
Patient safety
Staff accuracy
Staff satisfaction
Reduce staff stress
Reduce medical errors
Reduce pain
Reduce artificial lighting
Reduce space heating
Alertness
Thermal comfort
Reduce infections
Passive climate control
Community participation
Benevolent authority
Social support
Reduce transport waste
Access to Nature
Sense of wellness
Biophyllic association
Increased satisfaction
Speed up recovery
Restorative distraction
Reduce pain
Awareness of eco-systems
Defensible Space
Sense of security
Staff effectiveness
Passive systems
Predictability
Family support
Less spatial disorientation
Staff efficiency
Improved communication
Staff effectiveness
Reduce medical errors
Reduce patient stress
Ventilation
Co-Location
Wayfinding
Noise reduction
Water harvesting & reuse
Drinking water
Healthy diet
Hygiene
Reduce water waste
Reduce energy waste
Soil erosion
Design Shortcuts
Create daylight openings to deep
spaces.
Orientate buildings along an east west axis.
Locate habitable and working
spaces along north.
Provide for long term waiting outside clinic in
covered walkway and semi enclosed spaces.
Position windows higher for better light
penetration and internal redistribution.
Have windows on opposite sides of rooms –
preferably at low and high positions.
Daylight opening size to be at least 10% of
floor area.
Locate health centres near important day-to-day activities and
transport nodes. Seek out connectivity to recreational green
space.
Design Shortcuts
Create a hierarchy of public to private
space with defined thresholds.
Create pockets of defensible space
overlooked by passive surveillance.
Separate staff areas from public areas. Have
designated areas where they overlap. Keep staff
movement out of view while community movement
under passive surveillance.
Arrange points of access to distinct activities
along health centre “high street”.
Create green spaces accessible from main
waiting and circulation routes. Locate
spaces where people linger close where
they can overlook and view out towards
scenes of nature.
Put the front desk and
main circulation
elements in a prominent
position that is easily
seen from the main
entrance.
6.6.1 Arrange buildings to
shield courtyards from external
noises.
6.6.2 Locate spaces where
people linger closer to these
courtyards.
6.6.3 Put noisy elements like
generators in basements or
beyond blind walls. Mitigate
noise escape by screening /
isolating.
6.6.4 Use appropriate
technology to acoustically
insulate rooms that may
generate noise like procedure
and labour rooms.
6.6.5 Make consultation rooms
private to ensure acoustic
privacy.
Collect water from roofs and store. Filter for use in gardens.
Collect grey water and store. Filter and use where appropriate.