Designing for Health in Healthcare Deserts: A Medical City Master Planning Project in Nigeria.

ABSTRACT

BACKGROUND: Many countries and communities in sub-Saharan Africa suffer from inadequate access to healthcare and healthy lifestyles as reflected in their high mortality and morbidity rates. Large-scale interventions like the medical city project presented in this article are necessary to address the significant health burdens faced by populations in this region. OBJECTIVES: This article shows how evidence-based approaches and multisectoral partnerships guided the development of the 327-acre Medical City master plan in Akwa Ibom, Nigeria. This is envisioned to be the first-of-its-kind medical city in this medically underserved "healthcare desert." METHODS: The five-phased, seven-year (2013-2020) master planning process was guided by the overarching design framework of "sustainable one health" along with its 11 objectives and 64 performance measures. The data/evidence used to guide the planning decision-making process came from case studies, literature reviews, stakeholder interviews, and on-site investigations. RESULTS: The outcome of this project is a comprehensive medical city master plan that includes a self-contained, mixed-use community anchored by a hospital and a primary healthcare village. This medical city provides access to the full range of healthcare services (e.g., curative-to-preventive, traditional-to-alternative) and is supported by multimodal transportation systems and extensive green infrastructure. CONCLUSIONS: This project offers theoretical and practical insights on "designing for health" in a frontier market while responding to the complex local contexts that present many unique challenges and opportunities. Those insights provide useful lessons for researchers and professionals interested in promoting health and healthcare services in healthcare deserts.