Why are we doing this?
Almost 70% of the Myanmar population resides in rural areas, however, the rural population often still choose to travel to urban hospitals instead of local facilities. Not only does this result in the disuse and gradual disrepair of Rural Health Centres (RHCs), the general hospitals in urban areas are being stretched to their capacities.
RHCs are a key part of Myanmar`s healthcare system, playing a significant role in providing assistance across the country, especially in remote areas where geographical and financial access to health services is difficult. Decentralising the healthcare system hold immense benefits and we think better designed RHCs are key to achieving this vision.
The Rural Health Centre project is an initiative spearheaded by Article 25 that aims to support Myanmar’s healthcare system by developing a design guide with recommendations for design improvement of existing and new RHCs in Myanmar. An extensive analysis of the opportunities and challenges faced in existing RHCs and how these are related to infrastructure forms input for the design guide. This study promotes the potential of RHCs to decentralize healthcare demand and take off pressure from general hospitals. The project ties in with the MoHS’s strategy for Myanmar’s wider healthcare system.
Cycling Expedition Myanmar
Fieldwork and on-site investigations
To support this project, the Cycling Expedition Myanmar challenge was launched in 2017. A team of 14 riders cycled around central Myanmar over 10 days to carry out key field research into Myanmar’s healthcare system, building knowledge and capacity. The 550km cycle expedition raised £33,000 to fund future Article 25 work in Myanmar.
Thank you to our riders, supporters and sponsors for supporting us in this expedition. Our riders are a team of international and local architects, engineers, and experts in the field of sustainable, climate adaptive design and healthcare specialists.
A key aspect was of the research was the inclusivity of RHCs. These centres are a key part of Myanmar’s healthcare system, providing assistance to those in remote areas where geographical and financial access to health service is limited. RHCs face constant challenges related to architectural, environmental, social and organisational issues, which impacts healthcare in Myanmar as a whole. Our riders visited 10 of these sites during the expedition, spanning the Saigang Region, Mandalay Region, Shan State and Kayah State.
This project is made possible thanks to our partners from:
What insights have we uncovered?
Note: Below are some draft guidelines that are undergoing feedback and revision. Our guidelines will be regularly updated until the final version is launched online.
Layout and building configuration
Due to the tropical climate in Myanmar and intense heat from the summer sun, buildings are best built in an elongated east-west fashion, to maximize cross-ventilation, while reducing the effect of direct sunlight.
Moreover, an open plan layout with minimal interior partition walls allow for natural ventilation from the prevailing wind breezes during both the wet and dry seasons. This flow of air not only increases comfort within the building, but is critical for maintaining a hygienic environment.
Stilts are highly recommended as direct heating from the ground can increase internal building temperatures. Instead, a stilt foundation increases thermal comfort since heat from the ground can be diffused away and allows for land breezes to naturally ventilate the flooring.
The site of the RHC cannot be considered in isolation. Its proximity and distance to community centres, residential areas and toxic waste sites, among others have to be considered.
Temporal considerations are also important. The development of the RHC is not static, and future expansion opportunities should ideally be considered at the most nascent stages of planning. Free lots of adjacent properties and land create future potential for expanding the capacity of RHCs and therefore increasing the population capture it could serve.
Access and navigation
Accessibility is important to encourage people to visit the RHC and to enhance delivery of emergency services to and from the hospital. Ideally, the site should be located next to public transport routes and pedestrian paths that link to local communities.
Another way to improve the accessibility of the RHC is to highlight its prominence on street-level. To this end, a hierarchy of public entrances and access points could be built into the facade of the RHC. Features such as signage and lighting could also be used to enhance the visual permeability of the RHC, especially at night.