INTRODUCTION

Healthcare is a core component of human development and a right which underlines the non-
negotiable role of access to health care services in nurturing better well-being and lives. Health was
considered by most as being free from disease, whether physical or mental; but most people suffer
from declining health over time due to which healthcare systems were developed to help alleviate
these problems. Accordingly, it aimed at maximizing health for all people. Based on this principle, the
highest possible level of health for all people should be achieved. However, in the development and
maintenance there are key challenges faced by the global healthcare field. In improving health
services and public health in Africa, there are substantial policy, systems, and infrastructure reforms
imposed with developed countries. Whether developed or developing, countries across the globe are
adopting a decentralization approach to attaining their health objectives; this is greatly and strongly
echoed in the attainment of the Sustainable Development Goals as pointed out by Wanzala et al.,
2019. Similarly, in Greater Manchester, England, life expectation improved immensely after
devolution, especially in areas that were characterised by high levels of financial deprivation, as well
as low life expectancy. This would therefore imply that decentralization can result in reduced health
inequities due to the Coordinated multi-sectoral efforts and better streamlining of care services, as
postulated by Britteon et al. (2022).
Decentralization, conceptually, refers to the dispersion of power, authority, and responsibility
between the higher levels of government and lower levels of government, from central control that is
deconcentration to increased local autonomy, which is devolution, according to Dick-Sagoe et al.
(2020). Community merging, for example, lists smaller municipalities into larger units, occasionally
with a devolution of powers. Proposed in the merge of the 130 barangays in Baguio City of the
Philippines into "super barangays" is to render its governance leaner, increase the city's share in the
National Tax Allocation, reduce administrative costs, and enhance service delivery. Even though these
mergers have been focusing on centralization, they are still decentralized since there is the
transferring of functions, authority, and resources from the central to local levels.
Similarly in health care, decentralization enables the local authorities to manage and make the
necessary adjustments to the health services to improve response to particular needs of the
community _x0007_Guinto 2018_x0007_. It was for this reason that the Philippines adopted the
Republic Act No. 7160, also known as the Local Government Code of 1991. The law passed on the
national government's responsibility for healthcare to LGUs - a fact reiterated by Cuenca, 2018. The
shift was meant to enhance healthcare through allowing local leaders to decide on healthcare based
on the needs peculiar to the communities. This would yield more efficient, accessible, and relevant
health services to each area and would increase local accountability. The whole exercise is meant to
ensure better health care throughout the country as a whole. It is for this reason that the Republic Act
11223, otherwise known as the Universal Healthcare Act (UHC) of 2019, was passed into law.
The UHC Law aims to provide a fair opportunity for all Filipinos to have access to the best possible
care by focusing on three areas in the first six years of implementation: health service delivery,
medical funding, and performance accountability. In health service delivery, what the UHC Law
purportedly demands are new health infrastructures and the renovation of old existing ones. The
most visible of these campaigns is the building of new healthcare centers and expanding the capacity
of those that currently exist.
Healthcare architecture is set, for instance, on developing the right environments that answer
patients' demands. Recognition of the association between architecture and healthcare is, therefore,
necessary in the Slovakian healthcare systems because the two ways of increasing the effectiveness
and sustainability of healthcare institutions include:. Also, according to the World Health
Organization, WHO, in health facilities, the intention of the architectural design is to achieve minimal
spreading of infections in the facility and its environs. In designing health facilities that are healthy,
effective, and efficient, the design must be supported by the healthy architecture approach (Yetti,
2021). Moreover, integration of the IoT amongst other modern technologies could be considered
critical to transform healthcare provision and making the healthcare environment intelligent as well
as competent in every manner. A governmental race or competition could be traced according to
Ghazal et al., to make healthcare facilities competent with advanced technologies, introducing smart
ICU rooms along with intelligent operating theatres in general (Ghazal et al. 2021).
On the other hand, modern challenges that include the rise of telemedicine and the continued effects
of the COVID-19 pandemic have changed the design aspects of healthcare facilities (Sun et al. 2023).
To this end, ED overcrowding is still treated as a major global crisis and thus instigates much concern
in various news headline issues. Overcrowding degrades the quality of care in that most of the care
providers may be unable to give sufficient time or detail to their patients. This leads to a deterioration
in patient outcomes and satisfaction with care due to impending delay from diagnosis to treatment
(Pesareti et al., 2020). Health care in Baguio City, for example, has been overwhelmed by COVID-19
cases. The city struggles very much with the crisis, as bed occupation has risen very high and the
resources are few, for instance, ventilators. Private hospitals have a huge inability to expand their
capacity due to huge financial challenges, though potential improvement at the Central Isolation Unit
could bring partial relief. Due to the continuous rise, the city had furthered mass testing of its people
and striddened restrictions in terms of contact tracing. Overcrowding also diminishes availability and
increases waiting times and limits accessibility to all essential materials and staffing, adding to lengthy
periods of deterioration of health for a patient. Other key challenges of health care in urban setting
include the insufficiency of medical supplies and medicine. These two factors, combined with
overcrowding, make it difficult to provide appropriate care. Shortage contributes to delayed
treatment, minimal optioning in treatments, and stress for health professionals. In densely populated
areas, most of the medical supplies are in demand. Other logistical difficulties in the supply chain
further aggravate such shortages (Collado, 2019; Gela & Caelian, 2021).
In line with R.A. 11223, DOH and CCLCHD launched the Super Health Center concept, which is
basically like a primary care center whose facilities are more enhanced compared to RHUs. These
centres function as a level 1 hospital. Level 1 hospitals, based on the Revised Organizational Structure
and Staffing Standards for Government Hospitals, 2013 Edition, are those institutions offering basic
health care services to address the fundamental needs of a specified community; these include
emergency care, general medicine, pediatric, obstetric, and gynecologic services, and minor surgery.
Level 1 hospitals have basic diagnostic tools like X-ray machines, laboratories, and pharmacies. Its
personnel usually consists of general practitioners, nurses, and midwives so that a wide array of
primary medical care and support can be accorded. This hospital is important in providing accessible
health care services to people in the locality. As Senator Bong Go (2022) echoed, a primary care
center should increase the access of Filipinos to government health services with comprehensive care
locally. This relieves the need to travel to bigger hospitals, which in turn will reduce burdens and
increase the efficiency of the entire healthcare system. With a view to providing timely care closer to
the household, Super Health Centers have the potential to achieve better patient outcomes,
contributing to more equitable delivery of health services-core in helping attain the country's goal of
universal health coverage. More importantly, a primary health centre refers to a facility that has been
set up for purposes of offering health services to the community members based on the principles of
primary health care. According to Van Weel & Kidd (2018),
PHC is provided by general practitioners, nurses, pharmacists, and other allied health professionals.
They provide primary health services like diagnosing and treating various health conditions,
management of chronic diseases like diabetes, periodic health checkups, and counseling to the needy
patients for further care (Behera et al., 2021). Contrary to sub-health centers, the primary health
centers are expandable and also upgradeable with the facilities necessary for patients in response to
any demand. These would include diagnostic testing laboratories, imaging units like X-ray and
ultrasound units, and even dialysis units to care for patients suffering from renal diseases. These
centers are flexible and scalable, making them one of the most important constituents of healthcare
infrastructure in most geographies where access to fully equipped hospitals is limited. For this reason,
primary health care facilities focus on the provision of holistic care at the local level. This is a
significant step in that direction, as such centers, keen on catering to a package of services extending
from primary to specialized treatments, strive for increased access, reducing pressure that always
tends to build upon larger hospitals and en-route to facilitating equitable distribution of health
services. Conceptual Framework
Principles of healthcare needs and challenges related to medical facilities
Continuous, comprehensive and accessible primary care is a guarantee for good health care. In the
words of Van Weel & Kidd, 2018.
However, accessing such services remains a challenge to many diverse communities worldwide; this
makes them have needs which are unmet and hence have growing rates of diseases which are
preventable, and hence poor states of public health. World Health Organization, 2020
Evidence-based principles of design can enhance care environments by improving their functionality,
reducing infection risks, and aiding recovery. Jaušovec & Gabrovec, 2023. The design should also offer
the necessary flexibility to meet emerging demands for health services. It will also address equity,
accessibility, quality, and sustainability regarding healthcare delivery, in addition to discussing
healthcare needs across various communities. First, the framework defines essential healthcare
needs, which include a set of health services in Universal Health Coverage as recommended by the
World Health Organization WHO 2020. These include preventive care, curative, rehabilitative,
palliative services, and mental health services.
These must be informed by taking into consideration population-specific needs and community health
needs assessments to delineate priorities for healthcare services. It must also, therefore, take into
account challenges at facility levels that include infrastructural limitations, human resource shortages,
financial constraints, and accessibility issues to enhance healthcare access. The resolution of these
challenges will be important in the pursuit of sustainable, high-quality care in healthcare operations.
This is also informed by the application of the best guidelines and protocols from the DOH and
insights into the best international health organizations in formulating appropriate health strategies.
According to the Department of Health, national policies in health, license and accreditation
standards, service delivery guidelines, and requirements for data collection help drive quality and
accessibility in healthcare services. International agencies give insight into the prevention and control
of diseases, maternal and pediatric health, and strategies in addressing non-communicable diseases.
By meeting these norms, the proposed primary care center in Baguio City will be able to work toward
the realization of universal medical insurance and better health outcomes for all its people.
Infrastructure development, enhancing human resource capacity, increasing access through new
models of delivery of health care, quality improvement programs, and finally mainstreaming
sustainable practices are some strategies that can be prescribed based on the identified challenges.
This will increase efficiency, effectiveness, and therefore impacts on community health as
implementation of proposed strategies gets underway within the primary care center.
Finally, this conceptual framework is used to direct the identification of unmet needs in healthcare,
the resolution of challenges faced by medical facilities, and conformity with set guidelines, hence
ensuring their advancement in healthcare delivery to achieve equity in health and wellbeing of
individuals and communities. Design Strategy for a Patient-Centered Primary Care Facility
Architectural design and planning of patient-centered health facilities play a decisive role in meeting
the needs, preferences, and comfort of the patients. Therefore, a patient-centered design approach
focuses on accessibility, comfort, privacy, and easy navigation-all qualities that contribute to a more
positive experience for the patient.
The inclusion of individual consultation rooms, sound protection for confidentiality, and ease of
access to designs reduce levels of stress that patients go through during the course of treatment and
thus improve health care. The evidence-based design also plays a very vital role since it's based on
research to inform its decisions in creating a setting that improves healthcare. It includes design
features that prevent the spread of infections, such as antimicrobial surfaces, design features to
prevent falls, and healing environments that incorporate views of nature and natural light to enhance
recovery processes in both mind and body. Designing patient-centered healthcare facilities puts a
spotlight on key design elements related to good experiences of healthcare and therapeutic
environments in hospitals. Some of the recent innovations in the design of health facilities that have
impacted positively on the treatment outcome include colored LED lighting, interior gardens, colored
panel glass on walls and ceilings in operation rooms, humidity-absorbing and odor-controlling wall
paints, modern library space, among others.
These facilities are the backbone of healing architecture, whose focus is the Patients' improvement
both physically and mentally in the healthcare setting (Ismaeil & Sobaih, 2022). Still, there is a need
for assessment to ensure proper fit between individuals and their environment, especially on issues of
functioning, so as to provide a patient-centered environment. People have differential physical
capabilities that are often further compromised during their stay in the hospital; thus, there is a need
to consider how the designed environment can serve to either facilitate or hinder such daily activities
while promoting independence and self-sufficiency.
The scientific design principles, for a while now, have greatly impacted the face of healthcare
facilities. Evidence-based design makes use of scientific processes to define the relationship between
design decisions and any consequent performance, such as safety and efficiency. Despite the fact that
EBD tends to dwell on designing places in respect to the safety and efficiency of the patients and
families, there is a need to look at the wide needs of both in health contexts. In addition, advanced
technologies also become important for patient care and facility management. For example, the
implementation of IoT devices would allow real-time monitoring of patients and improve overall
efficiency in facilities.
Moreover, integration with telemedicine-specific spaces will enable healthcare providers to provide
remote care, thereby extending access to care services (Sun et al., 2023). Because of this view,
flexibility and the ability to adapt in architectural design feature as key to enabling health facilities to
respond appropriately to emerging needs in healthcare. This can be done through modular designs,
multifunctionality of spaces, and scalability of architecture to ensure that the facility adjusts and
expands when need be. This would be analogous to community areas, outreach programs, and
reflection of local culture and aesthetics in architectural design, considering the integration of the
healthcare facility into the community, promotion of public health, and sense of belonging it would
create. Yetti, 2021. Focus on such architectural and design principles that could turn health care
facilities into places treating not only immediate medical needs but also helping to foster overall
health and wellness for the communities they serve. Figure: paradigm of the study
Figure 1 below gives the paradigm of the study: input, process, and output. Page 8.
The first part of the diagram describes the major issues, objectives, and sources of information
defining the work of research.
In this stage, one is expected to describe the outline of the research, highlighting what is to be
covered and where the information will be retrieved. The second part depicts how data collected
from these various sources is analyzed systematically. In this case, one identifies data and studies it
critically with the aim of coming up with useful information. The last part presents the results of the
study. It involves the architectural design of a primary care center in Barangay Santo Nino Slaughter,
Baguio City. Figure 1. Paradigm of the study Significance Of the Study

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_x0007_The study addresses the third, ninth, and eleventh SDG, respectively, dealing with good
health and well-being, industry, innovation and infrastructure, and sustainable cities and
communities.

The present study addresses health care access and delivery, particularly to the less privileged
community of Barangay Santo Niño. It aims at finding out how a center could make a significant
difference in the overall improvement of health conditions of people residing in that area and reduce
health disparities, hence improving their quality of life.
It is among the most paramount concerns in any given community; most especially an urban or
economically empowered setting that is overpopulated hence causing inadequacy in primary health
care access and utilization. This present study, therefore, seeks to fill the existing health care gap that
exists between demand and supply through the establishment of a primary care center in Barangay
Sto. Nino. These facilities in the center will be utilized in providing necessary health care services like
preventive health care, management of chronic disease, and health education that are mostly not
offered to such communities. Minimizing the number of clients seeking health care from the tertiary
health facilities is also part of the study findings as stated by Sun et al., 2023. Mostly, patients with
primary health conditions end up in the tertiary hospitals and specialized health centers. The study of
the primary care center in Barangay Santo Niño will be the first port of call for patients whose
conditions do not need specialized care, freeing up resources of the tertiary healthcare facilities to
attend to more complex cases. The study of a primary care center in Barangay Santo Niño will not be
limited to the question of providing medical service; rather, it is about creating a healthier community
through health education programs and accessibility for all patients, whether they have disabilities or
a language barrier, to provide them with the ability to take control of their health, thereby leading to
better health behaviors and outcomes.
The feeling of security and being comfortable will also be provided by a nearby healthcare facility
because they will know about available and accessible health support. The flexibility in the health care
system will further be extended in adding its capacity and resources, like telehealth and online
services, to provide care where the patients are located. A well-established primary care center
cushions the systematic challenges that occur at the level of pandemics or natural disasters to make
sure that people can continue accessing the most essential health services during crises. Fallah-
Aliabadi et al., 2020 add that services sought to be implemented cover social determinants of health
such as housing, nutrition, and transportation. In addition, support services, or referrals to them, can
be made available through the center to address those broader factors that influence health and well-
being. The results of such a study coupled with the established success of the primary care center will
serve as a model for other regions facing challenges in healthcare access. In fact, results from such
studies may be used to advise policymakers and practitioners of the efficiency of investing in primary
care infrastructure in improving the health of the public and easing up the burden on healthcare
facilities. Objectives Of The Study The research will study appropriate guidelines and design strategies
related to health facilities that can be applied in the planning of a proposed primary care center.
Specific objectives to guide the study are as follows:
1. To understand healthcare needs and challenges regarding medical facilities, based on prescribed
guidelines and protocols set out by the Department of Health and other health organizations.
2. To identify architectural planning and design concepts involved in coming up with a patient-
centered health care facility
3. To develop an architectural design plan of the primary care center basing on the above-mentioned
objectives to ensure that the facility is adequately equipped to serve the community of Barangay
Santo Niño, Baguio City .
MATERIALS AND METHOD
Study Design
The study will use an applied-descriptive research method where the research will analyze the
planning and architectural design needed for a primary care facility.
As the research was descriptive in nature, the information to be obtained will be in the form of (1)
Site Observation - on-site appraisal of the prevailing condition of the physical characteristics,
climatological factors, and other elements of the site that may serve as valuable data to the planning
and design study of the proposed project.
This stage would thus be essential in the insight into the environmental setting and the bearing this
may have upon the adopted design strategy.
(2) Literature Review: This should be based on relevant literature, case studies, online databases, and
existing health organization policies and procedures. These methods will together provide a
comprehensive foundation for the planning and design of the project by drawing from both site-
specific and broader architectural information. An approach will be developed with great care to meet
the fundamental medical and healthcare needs of the building while following guidelines on long-
term viability and flexibility. Context and Locale of the Study Among all barangays in Baguio City,
Barangay Santo Niño is strategically located near the heart of the city to reach a considerable portion
of its population. Residential, commercial, and industrial zones comprise the area, including the well-
named slaughterhouse from which the barangay got its name.
The topography of Santo Niño is hilly, typical of Baguio City, with narrow roads and closely packed
buildings.
This Primary Care Center within the locality would facilitate access to basic health care services to the
residents in Brgy. Santo Nino and from other surrounding communities, which normally have to bear
the burden of traveling to faraway hospitals to access health care services. Moreover, given the
unique needs of the community in Santo Niño, the facility proposed herein could be quite helpful to
the community in improving health and the quality of life for the people within this vicinity. Figure 2.
Vicinity Map Data Collection Instruments
The different tools used to collect data will realize the specific objectives of the study.
Data collection instruments include request letters for securing information to be needed for the
study. An observation guide includes on-site documentation.
Other information will also be obtained through analysis of relevant literature reviews and case
studies.
This shall be undertaken by browsing necessary articles and journals regarding the strategies and
guidelines involving patient-centered healthcare facilities. Data involving guidelines on healthcare
facilities were mainly taken from the Department of Health's (DOH) planning and design guidelines for
hospitals and other health facilities. Data Gathering Procedures Each of the objectives of the study
requires particular data collection methods in order to fully understand it. For objective numbers one
and two, the literature review consisted of the examination of relevant documents like government
publications and healthcare reports, and academic journals, to understand the minimum standards
and specifications that a healthcare facility must adhere to. It also involved related literature about
healthcare design that supports patient-centered care, and the most recent information about
technological advancements and trends relative to healthcare facilities. The third section will be site
observations of the Santo Nino Slaughterhouse on environmental conditions, existing infrastructure,
and community interactions. In planning a facility in Barangay Santo Niño, observation will involve
traffic patterns, noise levels, and potential odor sources coming from activities that take place in the
community. Observations on the prevailing conditions during the site visit to barangay Santo Niño
shall put into essential perspective the local environment and topography and how the community is
laid out for the design of the facility. Case studies regarding other primary care centers, particularly
those serving similar geographical and socio-economic settings, will be reviewed for successful design
strategies and architectural solutions. This shall be backed up through the literature review by
guidelines, standards, and recommendations concerning healthcare facility design that will ensure the
proposed plan is functional and in tandem with the requirements of health organizations.
These data collection processes shall then be used to formulate a fully-informed highly-effective
design plan for the primary care center.
Data Treatment
Information and data collected will be summarized and interpreted to answer the objectives of the
study. The information for objectives 1 and 2 will be synthesized from literature reviews, case studies,
and DOH guidelines to identify key themes relating to common healthcare challenges, requirements
for a facility, and best practices. It will compare and identify the technological solutions that are
functional and relevant for the primary care center. The findings were then used to identify suitable
technologies that can be integrated into the building design for the facility with a view of ensuring
that it is functionally relevant for the modern health care. The final objective is to collate findings
from both site visits, the case studies, and literature review and then analyze them.

The final objective applied site conditions data, existing laws, guidelines, and planning and design
standards to perform a site analysis along with preliminary architectural programming.
This highly integrated process provided a site development plan supported by an architectural
solution that conformed to the regulatory and professional requirements.
These integrated elements ensured the proposed design will be viable and compatible with relevant
standards when the project outcome is well-informed and strategically planned.
Ethical Considerations The data and information gathered during this research will be used exclusively
for academic purposes in order to ensure that ethical conduct, honesty, and source credit are
adhered to. The study protects the rights of its respondents to privacy, confidentiality, and cultural
sensitivity. Its findings are dedicated to providing information to the barangay of Santo Niño, Baguio
City, as well as supporting their activities. The results are likewise open to any interested party for
review and reference in future planning and development.