Because health-care is universally necessary for all people, the universal design of health-care facilities is also important. In a developing country, there are certainly people who are much more dependent on health-care than others. These include people with disabilities, (either temporary or permanent) elderly people, mothers with children, and anyone who has a medical condition, disease, or injury which requires treatment once or many times.
Therefore, universal design when applied to health-care is both necessary and essential. In this area, participation by the user community and health care professionals, as well as specific consultation with targeted user groups is appropriate in project design. This participation will provide input to designers, builders, and equipment suppliers to accommodate the full range of human needs and abilities. It is particularly important to involve people with a variety of disabilities and local disability organizations in assessing universal design.
In addition to consultations, project planners should check local and national building codes as well as anti-discrimination laws if available. While universal design varies from one place to another, here are some elements to consider:
- Health-care facilities should be optimally built at ground level, but when this is not possible because of local terrain and weather, at least one entrance ramp and level internal design is a minimum prerequisite for treating patients.
- In the reception area, counter service windows or receptionist stations should be located at a lower level with knee space. Chairs can be placed for use by people who cannot stand while transacting business. There should be enough open space left in the waiting areas for wheelchair users, luggage, etc.
- Doors should be sufficiently wide for wheelchair users and people who assist patients.
- Directional signage for the reception desk, bathrooms, doctor’s offices should be visible and easily understood (pictographs will help those who are illiterate).
- There should be accessible, spacious toilets and dressing rooms available.
The Cambodia health sector support program, funded by the World Bank, included the construction of health centers and referral hospitals. It was necessary to persuade the borrower that health-care facilities should be accessible by people with disabilities. After a long discussion, it was agreed that all new health facilities would be built with access ramps of the maximum gradient of 5 degrees, equipped with handrails, and with double door entry. Fortunately, the project was still in its primary design stage and universal design was still possible. Other universal design features include clear signs including labeling of all doors in Khmer and English in all clinical and support rooms.
In September, 2006, at a meeting of the African Decade for People with Disabilities in Addis Ababa, Ethiopia, representatives of the Swedish International Development Agency (SIDA) presented a paper on their HIV-AIDS prevention project in Southern Africa. In the Paper, universal design factors of the project were highlighted. For instance, all written material distributed or used in the project was also available in alternative formats such as Braille, large-print, recorded form, multiple languages, and included pictographs for those unable to read. This is a good example of programmatic universal design.
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