measure. design. heal.
Measure.Design.Heal. solves adverse outcomes for patients in LMIC-settings caused by poorly planned health care facilities. Maternal health infrastructure is failing in many low- and middle-income countries, contributing to poor clinical outcomes. Locally informed, evidence-based research and design can improve patient outcomes, empower local leaders and international donors, and catalyze human-centered health infrastructure.
For the majority of the world’s population, childbirth remains a life-threatening event for mother and child. Hemorrhage, eclampsia, infection, obstetric fistula and death are among the serious outcomes that threaten the more than 190 million pregnancies occurring in low-resource settings. [1] Many more women experience disrespectful, unsupported or undignified care ((Rosen et al. 2015; Berg 2017; Peca and Sandberg 2018; WhiteRibbonAlliance 2018).
Despite great strides in improving access to maternal care for women in childbirth, Malawi still has one of the worst maternal mortality rates in the world —439 per 100,00 live births [3], rates of infection, C-section, and other adverse outcomes are on the rise across various metrics. One contributing factor to these adverse outcomes are the buildings themselves.
In high-income countries with very different architectural settings, for decades research has proven that health facilities affect health outcomes. Design can promote or prevent dignified care, rates of infection, and medical errors. Most critically, the shape of a floor plan affects mortality rates in intensive care settings [4–13]. Studies of the design of facilities for childbirth (while primarily based in western European and US settings) have begun to explore the impacts of design on patient outcomes, quality of care, rate of infection, privacy and dignity, length of labor, rate of labor augmentation, labor pain, and mode of delivery (vaginal vs. cesarean), and medical costs associated with hospital stay. However, few studies have attempted to gather measurable architectural data for correlation with maternal health outcomes in LMIC contexts.
Without better, locally informed and evidence-based data, health facilities will continue to be designed and constructed to meet the lowest cost, minimum quality standards as funders seek to impact number of patients over quality of care. The result is the propagation of health facilities that often harm, rather than heal the populations they serve.
Health infrastructure in low- and middle-income countries is often designed and built through haphazard alliances when funds are sporadically made available, through grants or donor windfalls—the result can be disorganized, inappropriate or even unsafe facilities. Local ministries of health and donors, may opt for designs that minimally satisfy government or third-party standards, often an out-of-the-box design that has been stamped out across the country without regard to local site conditions or the specific needs of the patient population.
Public health infrastructure in Malawi is an excellent setting to assess and impact this challenge. Nearly 70% of health infrastructure in Malawi is funded through international donors. The scene from a typical maternity ward in Malawi (like many LMIC maternity facilities) is grim—women crowded in dark stagnant rooms, with often three times more patients than beds., Nurses stations are often far from the patients nurses serve, leading to delays in care which affect rates of sepsis. Staff navigate through crowded wards, where each patient brings a family guardian who provides labor support, prepares food and linens, and acts as the patient advocate, doubling the number of people in a ward. These guardians often sleep under the bed of the patient, or in makeshift shelters outside the wards. All affecting quality of care.
Image: Postnatal Ward, Kasungu District Hospital, Lilongwe, Malawi.
Image: The labor and delivery ward is cramped and the facility is in disrepair , Queen Elizabeth Central Hospital, Blantyre, Malawi.
Image: The facility cannot accommodate guardians who have come to prepare food, clean and provide labor support, Kamuzu Central Hospital, Lilongwe, Malawi.
At the campus scale, this pattern is readily observed in the aerial imagery of Kamuzu Central Hospital in Lilongwe, Malawi—new construction develops tetris-like, as additions are added on to an existing building, then connected by longer and longer covered walkways in an uncoordinated attempt to create a cohesive campus plan.
Aerial view of Kamuzu Central Hospital Campus, Lilongwe, Malawi. Image courtesy Google Maps.
The solution is Measure. Design. Heal.: an integrated, evidence-based, locally-informed assessment and design tool Ministries, donors, and local architects can use to evaluate the impact of health infrastructure on patient outcomes, and inform future design strategies in these unique contexts. Using proven methods tested in global healthcare facilities, our tool will more broadly link patient-outcome quality of care research with locally-informed infrastructure assessment methods to provide evaluation and guidance to local public- and private-sector health facilities planners.
Our tool uses familiar, industry-standard drafting software to gather architectural metrics from facility floor plans, benchmarking a facility’s performance against a database of peer facilities. Design strategies to address “problem spots” will provide a range of budget options to maximize impact on health outcomes. The results will inform scaled design interventions that significantly impact health outcomes in existing and proposed health facilities.
Measure. Design. Heal disrupts the cycle of sub-standard facilities by evaluating existing and proposed new facilities, ensuring design interventions are made to yield the highest impact on patient outcomes.
Modeled on the work-flows outlined in Designing Capacity for High Value Healthcare: The Impact of Design on Clinical Care in Childbirth [14] and the award-winning user interface developed by Spatio Metrics (https://www.spatiometrics.com/), our tool will allow architects and health facility-planners to compare design options and achieve evidence-based benchmarks. While this recent work has demonstrated the feasibility of assessing architectural metrics in birthing facilities and explored the relationship to maternal health outcomes such as cesarean delivery, little research and design implementation exists in LMIC settings.
Figure 1. Graphic data report from Designing Capacity for High Value Healthcare: The Impact of Design on Clinical Care in Childbirth, research by MASS Design Group + Ariadne Labs, funded by Robert Wood Johnson Foundation (RWJF). Image courtesy MASS Design Group, https://www.massdesigngroup.org/work/research/impact-design-clinical-care-childbirth.
Figure 2. Sample of Spatio Metrics user interface and data output. Spatio Metrics is a design tool that allows architects and health facility-planners to compare design options and review benchmarks. Image courtesy Spatio Metrics, https://www.spatiometrics.com/...
Spatio Metrics Overview:
Implementation Phasing:
Phase I: Evidence-based assessment methodology
In partnership with the Malawi Ministry of Health and Queen Elizabeth Central Hospital (QECH) Department of Obstetrics and Gynecology (Blantyre, Malawi) we will first pilot our method in a Malawi Ministry of Health maternal health facility. Meetings with an advisory board composed of key local stakeholders ( including OB/GYNs, midwives, and nursing staff, Ministry of Health administration, Malawi University of Business and Applied Sciences (MUBAS) Architecture faculty, local AEC professionals, patients & partners/families) will help our team identify and differentiate key maternal health indicators architectural metrics for inclusion in our tsool that reflect the unique clinical requirements and outcomes of a LMIC health facility setting.
Phase II: Open-source Data Resource
With an adapted prototype tool, we will collect maternal health facility architectural and clinical outcomes data (maternal infection, hemorrhage, fistula, cesarean, etc.) from QECH for analysis. We will review our findings with the Advisory Board comprised of key local stakeholders including representatives from the MOH, University architecture faculty, key hospital staff, and community members and (1) begin to develop a benchmarking scheme based on our findings; we will publish our findings and (2) develop scaled interventions ($-$$$$) for existing and proposed facilities in response to our initial data..
Phase III: Database Expansion
Develop a database to gather future data, roll out in (1) additional maternal health facilities in Malawi then (2) other LMICs throughout Southern Africa.
Phase IV: Guideline Development
As database grows, evidence for guidelines is strengthened and refined. Tool is made available as open-source resource to LMIC public sector, local academic programs promote training to next generation of health architects (at reduced cost or free of charge), with training provided to strengthen local capacity for evidence based health design.
Consulting and Engagement
Development of platform for engagement with local architects to manifest a rigorous evidence-base design method, building local capacity for healthcare design in country. Consulting with Global funders in planning of health infrastructure. Grant funding related to academic engagements, etc.
Clinical medicine relies on rigorous testing of therapeutic interventions as a basis for appropriate and high-quality care. In contrast, health infrastructure is often designed without concern for the serious health impacts that result from poorly-planned spaces. In addressing shortcomings of the built environment, our tool offers a novel method of evaluating LMIC maternal health care, promoting a safer, better experience of birth.
2. Malawi Demographic and Health Survey 2015-16. National Statistical Office ; Available: https://dhsprogram.com/pubs/pdf/FR319/FR319.pdf
3. Maternal, Neonatal, and Child Health. 12 Jul 2021 [cited 21 Jul 2022]. Available: https://www.usaid.gov/malawi/global-health/maternal-neonatal-and-child-health
4. Pati D, Valipoor S, Cloutier A, Yang J, Freier P, Harvey TE, et al. Physical Design Factors Contributing to Patient Falls. J Patient Saf. 2017. doi:10.1097/PTS.0000000000000339
11. Rechel B, Buchan J, McKee M. The impact of health facilities on healthcare workers’ well-being and performance. International Journal of Nursing Studies. 2009. pp. 1025–1034. doi:10.1016/j.ijnurstu.2008.12.008
14. Galvin G, Plough A, Rosenberg D, Shah N, Shao A, Sullivan B. Designing Capacity for High Value Healthcare: The Impact of Design on Clinical Care in Childbirth. Robert Wood Johnson Foundation; Available: https://massdesigngroup.org/sites/default/files/file/2017/170223_Ariadne%20Report_Final.pdf
15. Polis C, Mhango C, Philbin J, Chimwaza W, Chipeta E, Msusa A, et al. Malawi. In: Guttmacher Institute [Internet]. [cited 29 Jul 2022]. Available: https://www.guttmacher.org/geography/africa/malawi
Women + Communities
In Malawi, most women now deliver with a skilled attendant but many of the facilities in which the deliveries take place are often crowded, poorly-lit, and unsanitary. Improvements to maternal health infrastructure has the potential to significantly impact their care and health outcomes of more than 860,000 women who have pregnancies each year in Malawi [15]. The impact of improved maternal health has a positive ripple effect throughout communities. Research shows that poor maternal health outcomes have a devastating impact not only on the woman and her immediate family, but entire communities - reducing rates of child survival, education and introducing a significant financial burden for generations to come. [16–19]
Healthcare Staff
Poor health infrastructure contributes to reduced patient safety, efficiency and difficulty retaining skilled professionals to provide staffing—who may choose to practice in higher-resourced settings in urban areas or even outside their country of origin. Evidence-based esign interventions will impact staff in their ability to provide higher quality healthcare by streamlining clinical processes, improving patient safety and hygiene, and increasing capacity to deliver respectful, dignified health services to a greater number of patients.
Healthcare Architects + Facility Planners
With access to an evidence-based design tool, local-based healthcare architects and facility planners will be equipped to compete for local infrastructure bids for repairs, renovations and new construction.
Government Ministries of Health (MOH) + Donors in Global Health Development
Governments ministries, NGOs and private foundations may not know where their capital can have the biggest impact on clinical outcomes - this tool will help ensure maternal health infrastructure funding is appropriately placed and high-yield. Access to an evidence-based, health outcomes-oriented design tool will help funders ensure their capital is allocated to have the biggest impact.
Our team is a strategic interdisciplinary alliance of experts in obstetrics/gynecology, maternal health architectural design, and Malawian health infrastructure. We could not conceive of a project of this scope without the breadth and depth of experience working locally with local partners, including the Malawi Ministry of Health (MOH), physicians and other staff of ministry hospitals, including Queen Elizabeth Central Hospital, (QECH) and the Department of Architecture at the Malawi University of Business and Applied Sciences (MUBAS). Collectively, our team has spent decades working in low- and middle-income countries in Africa, including Rwanda, Somaliland, Ghana, and Democratic Republic of the Congo.
Deb Polzin-Rosenberg
RN, AIA, Founder + Principal, Better Birth Design is both a registered nurse (RN) and registered architect (RA). She is the founder and principal of Better Birth Design, an architecture firm with a mission to transform childbirth through design. Her unique background allows her to move fluidly through the worlds of medicine and architecture, where she enjoys challenging the status quo in the name of better health. While working for MASS Design Group, she was a key member of a research team which produced the report Designing Capacity for High Value Healthcare: The Impact of Design on Clinical Care in Childbirth, a project funded by the Robert Wood Johnson Foundation (RWJF). Their findings were also published in the Journal of Midwifery & Women’s Health and Health Environments Research & Design Journal (HERD). She developed an appreciation for the unique constraints of health facilities in LMICs while working on health infrastructure design and construction administration in Rwanda for two years. She is soon-to-be based in Gaborone, Botswana.
Prof. Chris Harnish
Associate Professor, Architecture Program; Director, Malawi Health and Design Collaborative, Director, Jefferson Consortium of African Partnerships; Fulbright Scholar, University of Malawi, The Polytechnic, 2017 -
Associate Professor of Architecture at Thomas Jefferson University, Chris Harnish is the Director of the Health and Design Collaborative (HDC), and Jefferson Consortium of African Partnerships; he holds an honorary faculty position at the Kamuzu University of Health Sciences (KUHeS). The HDC examines architecture’s impact on patient outcomes, quality of care, and infection control; as well as community resilience and system strengthening. The praxis emphasizes human-centered and evidence-based design, informed by medical research and qualitative community-engagement methodologies. His research champions designs engaging to humans, empowering to communities, and resilient in fragile environments. The HDC collaborates with the Malawi Ministry of Health, KUHeS, Malawi University of Business and Applied Sciences, and multiple leading hospitals in Malawi. Recent research and design endeavors include: infectious disease unit design, and a performative health centre prototype for the Malawi Ministry of Health; master planning for the Kamuzu, and Queen Elizabeth Central Hospitals, and ongoing research on the architectural factors informing patient privacy and dignity in MOH Maternity Wards. In 2016, Professor Harnish was awarded a Fulbright Teaching Scholar Fellowship for his proposal, “Equity, Sustainability and Resilience: Architecture as a Social Force in Humanitarian Development”. The fellowship sponsored his teaching at the University of Malawi Polytechnic in 2017 where he brought this work to Malawian architecture students.
Dr. Lauri Romanzi
MD, MScPH - Operations Lead, Jefferson Consortium of African Partnerships; Lecturer, Jefferson College of Population Health; Assistant Professor, Thomas Jefferson University Hospital, Dept of ObGyn - Dr. Romanzi is an academic leader in women’s health with decades of collaborative, reciprocal experience working in maternal/newborn and sexual/reproductive health in over 20 countries throughout Africa and South Asia. Her experience includes mentoring, clinical and public health research; quality improvement and assurance; clinical and public health education, skills training, curriculum development, systematic needs assessments, strategic planning, public-private partnerships for health equity and quality; and advocacy coalition-building.In the United States, she is licensed to practice medicine and surgery in New York and Pennsylvania, with dual certification from the American Board of Obstetrics and Gynecology; one for Obstetrics and Gynecology and another in the subspecialty of Female Pelvic Medicine & Reconstructive Surgery. She is a Lecturer in the Department of Global Health and Social Medicine and Faculty in the Program in Global Surgery and Social Change at Harvard Medical School. She serves as an International Technical Advisor to the Global Affairs Division of Thomas Jefferson University and a Quality Assurance Specialist in severe maternal morbidity to the NYC Department of Health and Mental Hygiene’s Maternal Health Quality Improvement Network. She has played foundational roles in the launch of the College of Obstetrics and Gynaecology of the East, Central and Southern Africa Health Community (https://ecsacog.org ) in addition to the development of Urogynaecology/FPMRS accredited fellowships and residency program curricula in East and West Africa and in South Asia. In 2020 she launched the podcast Sister Surgeons that is dedicated to enlightening healthcare workforce students and colleagues, as well as the general public, on contemporary issues germane to global health equity with a focus on safe surgery. Whether local or global, Dr. Romanzi is dedicated to health education and health systems equity, productive integration of health systems siloes, navigation across the humanitarian-development continuum, evidence-based quality assurance frameworks, and cross-sector dynamics that make real women's health, well-being and empowerment.
Dr. Luis Gadama
Chief of OB/GYN Department, Kamuzu University of Health Sciences (formerly University of Malawi College of Medicine )
Dr. Gadama is the Head of OB-GYN Department, based at Queen Elizabeth Central Hospital (QECH) in Blantyre. He is the Principal Investigator for the APPHC study, Integration of the Near Miss Audit tool into the pre-existing Maternal Death Surveillance and Response system in Malawi: Learning lessons with three hospitals. Most of his work is mainly on improving maternal health outcomes through teaching, clinical service provision, community outreach and conducting research that drives into policy. Dr Gadama's works mostly involve interacting with patients and their guardians hence getting views from these stakeholders on how architectural designs can impact to their well being won't be difficult.
Prof. Khumbo Francis Chirwa
MSc. Construction Management, BSc. Arch., Dipl. Arch. Tech., MIA, CIPM, SCIOB. Head of Architectural Studies Department, Malawi University of Business and Applied Sciences -
Khumbo Chirwa is currently the Head of Architecture Department in the Faculty of the Built Environment at the Malawi University of Business and Applied Sciences (MUBAS). Khumbo is a registered architect with the Malawi Institute of Architects (MIA). On top of lecturing, Khumbo is the Managing Architect of a 7-man architectural firm that worked on a number of health facilities in Malawi. We are currently working on a concept for a 200-bed Infectious Diseases Hospital in Blantyre, Malawi.
Before establishing space+time Khumbo Chirwa had worked with Kamwaza Design Partnership (KDP) for over five (5) years. He joined KDP from IM Designs in Lilongwe where he worked for a year.
- Employ unconventional or proxy data sources to inform primary health care performance improvement
- Leverage existing systems, networks, and workflows to streamline the collection and interpretation of data to support meaningful use of primary health care data
- Provide actionable, accountable, and accessible insights for health care providers, administrators, and/or funders that can be used to optimize the performance of primary health care
- Pilot
We are seeking support through funding and mentorship in order to adapt and test our tool for use in low- and middle-income maternal health settings. While our team is well-positioned to conduct the necessary research with community and clinical stakeholders, we can benefit from support for strategizing around technology development and building a sustainable financial model to meet our goals for financial accessibility and adaptability to other LMICs. We are eager to engage with the network of support available through the MIT Solve Challenge and the Bill & Melinda Gates Foundation, through which we hope to attract the attention of mission-aligned donors.
We anticipate challenges in disrupting the typical process of designing health infrastructure. Both healthcare and architecture industries can be resistant to change and protective of intellectual property. We are prepared to tackle medical, legal and cultural obstacles through thoughtful engagement with our Malawi-based partners and communities. With the support of MIT and the Bill & Melinda Gates Foundation, we can take further advantage of an opportunity to demonstrate an evidence-based process to improve measurable health outcomes.
More specifically, the manners in which we are prepared to address challenges are listed below:
Legal Challenges: Access to medical facilities, patient data, staff interviews, architectural archives
These issues will be solved by direct engagement with the Malawi Ministry of Health, with which we have an existing MOU to conduct research in MOH facilities. We have a proven track record of collaboration with the MOH, which is prepared to sign letters of support for these activities.
Cultural Challenges: Cultural Variance in maternal preference and behavior
These issues will be solved by in-country, evidence-based design research, and conducted by Malawian medical professionals in design team. The key component of this endeavor is to find locally-informed data to guide a more strategic, refined design process. Additionally, we will use the same research team at KUHeS and QECH we’ve used on previous related grants, and they are keen to continue this collaboration.
Financial/Market-based Challenges: Innovating in an emerging market
This is a novel approach to more directly link health infrastructure planning to evidence-based, country specific patient/maternal outcomes and planning. There is evidence of the need for hand-on consulting in the construction process, and the success of those businesses. Prof. Harnish has consulted in ad hoc manners with the international donor community. We have also gained financial support via various funding support including grant funding and consulting fees. This activity simply streamlines and formalizes these funding opportunities with a more strategic platform.
With Measure.Design.Heal. for the first time planning of health infrastructure will be evidence-based, locally-informed, relevant to health facility planners in low- and middle-income countries, and impactful to patients. Numerous top-down health infrastructure design guidelines from the WHO, CDC and other international organizations exist. However, these guidelines are not informed by local evidence-based research. As such, there is abundant evidence of local leaders ignoring these guidelines due to financial or feasibility concerns.
Measure.Design.Heal provides the evidence local leaders need to push-back against one-size-fits-all international guidelines which simply do not fit LMIC settings, and do not support improved maternal outcomes.
This platform transforms the future of health infrastructure in LMIC settings. The work starts in Malawi, where a significant deficit of healthcare facilities exists. In order to achieve MOH goals in ratio of health facilities to population, more than 20 new Community Hospitals, 300 new Health Centres, and 10 Infectious Disease Units are currently being planned. Maternal Health Services are the most sought after form of health care. When impact is proven in maternal health infrastructure linked patient outcomes, this platform can catalyze the transformation of the entire health infrastructure system for 18-million Malawians.
Improve maternal health outcomes in Malawi
Measure. Design. Heal.
-Impacts the overall quality of maternal health facilities in Malawi as measured by maternal health outcomes
-Gives local architects access to evidence-based strategies for the design of maternal health facilities.
-Increases oversight and accountability of local MOH
-Lives students of health architecture tool for evaluating and improving on designs, builds local design capacity
-Provides indicator of quality to local government/donors
-Facilitates procurement of funding for health infrastructure development in LMICs
Measure. Design. Heal. develops metrics local leaders and global funders may use to develop strategic goals at the local, national, and global level.
THEORY OF CHANGE
Mission: To impact patient outcomes, by design.
Vision: Evaluate.Design.Heal empowers local health strategists and architects to improve health infrastructure, impact patients and healthcare worker experience, and save lives.
Assumptions:
Patient outcomes and experience can be improved by evidence-based research and design
Health professionals require better evidence to transform health infrastructure
Architects will be empowered with the tools to design better health infrastructure
Educators can evolve teaching methods to transform the future of health design education
Actions/Activities:
Employ proven qualitative research to link patient outcomes and quality of care to health infrastructure indicators
Evaluate environment performance, infection control/WASH, and economic cost considerations to establish metrics relevant to Ministries of Health and International Donors
Consult and train local architects in the Measure. Design. Heal platform
Integrate the Measure. Design. Heal method into design education in-country and globally
Team leaders:
Deb Polzin-Rosenberg, Dr. Lauri Romanzi and Dr. Luis Gadama
Deb Polzin-Rosenberg, Profs. Khumbo Chirwa and Chris Harnish
Profs. Khumbo Chirwa and Chris Harnish
Profs. Khumbo Chirwa and Chris Harnish
Stakeholder Feedback Loops:
KUHes, QECH, and MOH Healthcare Workers (MOUs in place)
MOH Department of Planning (MOUs in place)
Malawi Institute of Architects (Members: Profs. Chirwa and Harnish are members)
Malawi University of Business and Applied Sciences, Thomas Jefferson University (MOUs in place)
Business Model / Funding Mechanism:
Grant funded research / MIT-Solve Award, provides enduring and free platform for research and design outputs
Grant funded research / MIT-Solve Award, provides enduring and free platform for research and design outputs
Consulting Fees paid by international donors, linked to individual projects
Donor Consulting Fees provide value-add to donors, and include training of educators and students in E.H.D. platform
Short-term Impact:
Patients and staff begin to recognize design impact on patient experience and staff performance
Health facilities become more sanitary, more comfortable, and more cost effective, satisfying donors and local health professionals
Architects have more tools at their disposal to evaluate and improve health design.
Educators pilot and test health design methods
Long-term Impacts:
Improve patient outcomes
Empower local health professionals and the international donor community with the data to make locally-informed, evidence-based decisions
Strengthen local design professions with improved building performance data
Transform design education to shape the architects of tomorrow
Our tool is a web-based program modeled on widely available industry-standard architectural design software (CAD programs) that allow users to create precise, scaled, architectural drawings. Using pre-determined and precisely defined metrics (e.g. max distance from nursing station to patient bedside or ratio of ORs to delivery beds), each floor plan can be evaluated and these data will be compiled in a secure database. At the same time, facility-level clinical data are collected (such as number of deliveries per year, rate of infection, rate of cesarean delivery, etc.). After analysis, the tool will present an easy-to-interpret graphic scorecard, comparing the facility’s performance to an evidence base of comparable facilities and including recommendations for design strategies which could improve the clinical health outcomes at that facility.
Each participating facility will contribute both design metrics and clinical outcomes to an ever growing dataset, strengthening the tool’s analysis and recommendations even as data is being collected. In this way, the tool will become more powerful as it scales both within a country and across countries.
- A new application of an existing technology
- Crowd Sourced Service / Social Networks
- GIS and Geospatial Technology
- Software and Mobile Applications
- 3. Good Health and Well-being
- 5. Gender Equality
- 9. Industry, Innovation, and Infrastructure
- Malawi
- United States
- Malawi
- United States
Our team has been collaborating on infrastructural indicators of health outcomes for more than 6 years, and are well-positioned to lead hands-on, locally lead teams of researchers to execute this work without impact on healthcare workers or systems.
- Other, including part of a larger organization (please explain below)
Collectively, our team has decades of experience working in low- and middle-income countries, where the success of a project is almost always determined by the investment and engagement of the local community. Our team is strongly committed to creating a tool that is not only technically robust, but that (1) accurately reflects the culture and practices of childbirth within the local community, (2) becomes integrated in standard design practices by local health design architects and facility planners, including governments and ministries of health and (2) and is taught within institutes of higher education as a standard of practice. In order to achieve these outcomes, it is vital to work closely with local stakeholders as advisors and team members, to build local capacity and expertise in health design.
Business Model / Funding Mechanism:
Grant funded research / MIT-Solve Award, provides enduring and free platform for research and design outputs
Grant funded research / MIT-Solve Award, provides enduring and free platform for research and design outputs
Consulting Fees paid by international donors, linked to individual projects
Donor Consulting Fees provide value-add to donors, and include training of educators and students in E.H.D. platform
As the platform and work evolves, the model will transition from donor-based research funding to an
- Organizations (B2B)
As global donors and local leaders see impact of this design tool, the outcomes will be revealed in economic and health impact.
Then open-source platform will be funded through international donor and grant funding.
Consulting activities will provide financial support for enduring management of the open-source tool, while expanding the knowledge base of the team lead.
Over time, architects and designers will understand the impact and use it accordingly.
Grant funding
Consulting Activities
Architectural Collaborations
RN, AIA, Founder + Principal
Associate Professor of Architecture
Mr
Obstetrician Gynaecologist