Improving healthcare facilities: The importance of indoor environmental quality

Indoor Environmental Quality (IEQ) is a critical issue in healthcare facilities.

Factors like air pollution have worsened air and thermal quality, especially in developing countries. Concerns about IEQ cover various elements, including lighting, ventilation, noise, colour, and cleanliness, all of which significantly impact human health and psychological well-being.

Poor IEQ can lead to respiratory and cardiovascular diseases and increase cancer risks. It is vital for patients and healthcare professionals to have access to clean, fresh air in hospitals and healthcare centres.

In rural Bangladesh, the quality of IEQ in hospitals varies significantly by location.

During winter, IEQ indicators are higher compared to the post-monsoon season. This is particularly important in low- and middle-income countries that rely on natural ventilation, where the risk of SARS-CoV-2 aerosol transmission is less understood and managed.

These countries often lack advanced ventilation technology and may not fully comprehend the associated risks, increasing their vulnerability to infections.

Physical partitions between beds can help protect patients, but higher concentrations of airborne tracers are still present in these settings, especially when windows are closed in winter.

Research by Gilkeson suggests that a hybrid approach combining mechanical and natural ventilation could be the best solution year-round.

Bangladesh is rapidly urbanising. The government has developed rural areas by providing various human facilities, including healthcare. As part of a recent initiative, the Bangladesh government has opened about more than 18,000 Community Health Clinics in sub-districts across the country.

These clinics, affiliated with government hospitals, provide free healthcare services and raise health awareness among the extremely poor rural communities. However, many people are still unaware of these services.

To increase awareness about community clinics, it’s important to identify contributing factors.

Effective research-based evidence is necessary to ensure that community clinics can serve key populations.

The ‘Revitalization of Community Health Care Initiative in Bangladesh (RCHCIB)—Community Clinic Project’ has led to the construction of over 14,000 community clinics aimed at improving access to healthcare.

Despite these efforts, several social, cultural, and economic factors hinder the full utilization of these facilities. Improving healthcare service utilization directly enhances health outcomes, but rural women and children still need adequate health awareness.

Our recent studies at the Department of Architecture, CUET have focused on the physical design aspects of rural healthcare facilities, particularly community clinics.

These studies identify that less educated, poor, landless mothers used community clinic services more often than their wealthier, more educated counterparts. Women living in their own homes were also more frequent users compared to those in rental properties.

The utilisation of these services is influenced by perceptions of the provider’s skill and competence, as well as satisfaction with interpersonal communication and provider attitudes. Factors such as management, administration, physical environment, and satisfaction with health promotion and women’s health issues also affect service utilization.

Human perceptions of physical space play a crucial role in healthcare environments.

Philosophically, space allows beings to project their physical and mental visions into the world, as proposed by German philosopher August Schmarsow.

The concept of place attachment, a key idea in environmental psychology, supports physical and psychological well-being within one’s environment. Generalized design layouts and congested spaces in rural healthcare settings can negatively impact the IEQ and mental well-being of patients.

By considering individual perceptions and experiences, healthcare facilities can improve the conditions for both patients and professionals.

Current architectural design approaches often fail to adequately address the relationship between users’ spatial, environmental, and psychological experiences. Understanding users’ cognitive perceptions and physical responses within these spaces is essential for identifying proper architectural solutions for healthcare environments.

The purpose of this study is to develop the “Environmental Experience Design (EXD)” approach for community clinics, based on a user-centered design framework.

This study will help develop architectural design solutions that enhance the mental well-being of users in healthcare settings both locally and globally.

Understanding and addressing users’ needs and demands is crucial for improving healthcare environments because it ensures that the design and functionality of these spaces are aligned with the actual requirements and preferences of patients and healthcare professionals.

When healthcare facilities are designed with a deep understanding of user experiences, they can better support physical and psychological well-being, leading to improved health outcomes.

This approach can identify specific issues such as inadequate ventilation, poor lighting, and noise levels that directly affect patients’ comfort and recovery, as well as staff efficiency and satisfaction.

By actively involving users in the design process, healthcare environments can be tailored to enhance accessibility, reduce stress, and promote healing. Ultimately, this user-centered approach fosters a more supportive and effective healthcare setting, making it a key factor in the successful delivery of healthcare services.

Dr Sajal Chowdhury. Sketch: Courtesy

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Dr Sajal Chowdhury. Sketch: Courtesy