Primary care health centers : a guide to planning and design with limited resources

To help alleviate this problem, this guide provides a clear, succinct framework for planning PHC services along with the centers to house them. Emphasis is placed on the need for a team effort between program planners (doctors, nurses, midwives, officials, etc.) and building designers (architects and engineers, etc.) and on avoiding problems arising from inadequate assessment of needs, poor communication, failure to consider operating costs and space requirements, and insensitivity to local customs and political factors. Seven major major tasks are envisioned in establishing a PHC center: (1) evaluating PHC needs and desires of target area; (2) deciding the program of PHC services; (3) estimating PHC service utilization; (4) deciding on staffing patterns and roles; (5) designing the PHC building; (6) specify the building"s furnishings; and (7) preparing a budget that carefully distinguishes initial (capital) costs from operation costs and anticipates revenues sources. Rather than specifying particular steps to be taken in accomplishing these tasks, the guide provides questions for the planning and design team and checklists of issues requiring its attention. Considerations discussed relevant to the building design stage include: the space implications of the plan of services; site selection and planning (e.g., availability of water, sanitation, renovation or new construction, building regulations); and whether a PHC center should include beds. The guide concludes by discussing the following issues arising in the context of PHC: referral services, supervision of PHC workers, balancing curative and preventive care, and the relationship of the public and private health sectors. A 102-item bibliography (1966-81) is appended.