FAR EASTERN UNIVERSITY

Institute of Architecture and Fine Arts

DESIGN 632

MAJOR PLATE NO. 3

TITLE : The PROPOSED 25-bed MOTHER AND CHILD HOSPITAL with Comprehensive
Emergency Obstetrics and Newborn Care (CEmONC)

MODE: Group with 3 or 4 members

INTRODUCTION:

A healthy mother gives birth to a healthy child. Women’s health, in all stages of the life cycle is of
immense importance as it affects the quality of future generation. Mother and Child mortality are
sensitive indicators of a country’s development and telling evidence of its priorities and values.
Women comprise half of the country’s human resource and investing in the health of children and
their mothers is not only a human rights’ imperative, it is a sound economic decision and one of the
surest ways for a country to set its course towards a better future.1 A healthy nation means a healthy
citizenry.

Global statistics shows a great concern on mother and child mortality even with the advancement in
science and medical technology. A woman dies from complications in childbirth every minute – about
529,000 each year -- the vast majority of them in developing countries.2 In 2006, the most recent
year for which firm estimates are available, close to 9.7 million children died before their fifth birthday
while more than one third of all child deaths occur during the first 28 days of life.3

To address the mortality concern, in September 2001, 147 heads of states collectively endorsed
Millennium Development Goals 4 and 5. The UNICEF Millennium Development Goals focuses on
making maternal, newborn and child survival a global priority. Millennium Development Goal 4 (MDG
4) aims to reduce the global under-five mortality rate by two thirds between 1990 and 2015 and MDG
5 focuses on the improvement of maternal health and the reduction of maternal mortality ratio by
three quarters.4 Strongly linked to these is Goal 6: To halt or begin to reverse the spread of HIV/AIDS,
malaria and other diseases.

STATEMENT OF THE PROBLEM:

“In 1996, the World Health Organization (WHO) estimated that approximately 150
million women in developing countries will become pregnant yearly. Of this, an
estimated 600,000 will die. The average maternal mortality ratio (MMR) in these
countries is estimated at 400 per 100,000 live births. At least 7 million pregnancies will
result in still births or infant deaths in the first week of life due to pregnancy related
complications. Pregnancy involves a symbiotic dyad of both the mother and the baby.

The basic premise of the Safe Motherhood Initiative is that childbirth must not carry
with the risk of death or disability for the woman and her infant. Deaths due to
pregnancy and childbirth are both too high in developing countries. The Philippines
being such a country, its statistics show that most of the maternal and infants deaths
could have been prevented. In the Philippines, the situation of mothers although better
than the average from developing countries, has not changed much in the last 5 - 10
years.” 5

Steady progress in the overall health situation of Filipinos has been observed in the past decade.
National health improvements appeared to have benefited the women as shown by the life

1
The State of the Worlds’ Children 2008”. UNICEF. http://www.unicef.org/sowc08/profiles/child_survival.php.
2
Millennium Development Goal 5. http://www.unicef.org/mdg/maternal.html. Nov. 29, 2008.
3
The State of the Worlds’ Children 2008”. UNICEF. http://www.unicef.org/sowc08/profiles/child_survival.php.
4
UNICEF Millennium Development Goals, http://www.unicef.org/index.php. Nov 29, 2008.
5
Safe motherhood Program. http://www2.doh.gov.ph/safemotherhood/safemotherhood_alpha_smwh.htm

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expectancy and mortality rates. However, a review of women’s nutritional, maternal and overall
reproductive health status indicate that despite the many efforts and huge investment, the health
system was unable to adequately address women’s generally poor state of health. In this regard,
there is an urgent need to further improve the health care delivery system through the institution of
reforms that enhance critical capacities to provide quality women’s health and safe motherhood
(WHSM) services particularly maternal care services.6

Maternal mortality reduction determines the appropriateness of interventions in delivering maternal

care services. The country’s current MMR is 162/100,000 live births (roughly about 50 maternal
deaths per day) from 203/100,000 live births at the start of implementation of the first Women’s
Health and Safe Motherhood Project (WHSMP) in 1995. The decline however, cannot be attributed
solely to WHSMP as significant improvements in case reporting was noted during the period. But
while there was a decline within the three-year period (1995-1998) the Philippine MMR remains one
of the highest in the western pacific region. Further, current MMR is far from the national health
objective of 52/100,000 live births by 2015 and the progress in lowering down MMR is very slow.
Moreover, a substantial proportion of infant deaths occur in the first month of life, a reflection of the
state of the mother’s health during pregnancy and the health system’s management of childbirth. A
National Demographic and Health Survey (NDHS) conducted in 1998 also indicated that at least 60-
70% of pregnancies during the year were considered high risk. Three major causes of maternal
death: hemorrhage, hypertensive disease of pregnancy (HDP or eclampsia) and puerperal sepsis.7

SIGNIFICANCE OF THE PROJECT

Current trends in maternal mortality in the country call for urgent attention. The challenge is for the
Department of Health (DOH), to achieve the Millennium Development Health Goals (Health MDGs)
by 2015, a Philippine government commitment to the international community. Beginning in 1995 the
Women's Health and Safe Motherhood Project (WHSMP) was carried out, a 5-year project of the
DOH and local government units at the provincial, municipal and barangay levels. The project was
implemented in 77 provinces in 16 regions nationwide. The project was co- financed by five foreign
donors (ADB, WB, KfW, AusAID, EU) and the Government of the Philippines. 8 WHSMP 2 followed
to augment the previous one. WHSMP 2 objectives are: to increase the access (in selected sites) of
disadvantaged women of reproductive age to high quality and cost-effective reproductive health
services; and develop and implement sustainable and replicable systems, within the framework of the
Health Sector Reform Agenda, for the financing and delivery of reproductive health services.9

Together with the WHSMP 2, a new approach to reduce maternal death has been adopted for
implementation under the FOURmula ONE for Health Program (F1) the network of health facilities
that could cost-effectively provide an integrated package of women’s health and safe motherhood
services. The strategy of the Department of Health (DOH) hews to such an approach. It seeks to
establish in every province a network of health facilities that could cost-effectively provide basic
emergency obstetric and newborn care (BEmONC) during childbirth and Comprehensive
Emergency Obstetric and Newborn Care (CEmONC) for high-risk and complicated cases. To help
ensure that each pregnancy has a favorable outcome and to avoid missed opportunities, the above
services are integrated with other interventions that are deemed critical to the mother’s reproductive
health, e.g., family planning and STI and HIV/AIDS prevention. This integrated package of service is
envisioned to be delivered by highly trained teams of skilled health providers in strategically-located
health facilities.10

Comprehensive Emergency Obstetric and Newborn Care (CEmONC) facilities-can perform the
six signal obstetric function of a BEmONC and in addition, perform cesarean section and provide
blood banking and transfusion services along with other highly specialized obstetric services. It is also
capable of providing the following neonatal emergency interventions, which include at the minimum:
(i) newborn resuscitation, (ii) treatment of neonatal sepsis/infections (iii) oxygen support for neonates,

6
Zeni Recidoro, “Technical Study on Appropriate Intervention to Reduce Maternal Mortality”
1/27/2004
7
Ibid.
8
Bienvenido P. Alano Jr., PhD. “ESTABLISHING THE WOMEN’S HEALTH AND SAFE MOTHERHOOD FACILITY
NETWORK IN FOURmula ONE for Health Program Provinces” October 2007.
9
Loc cit.
10
Loc cit.

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and (iv) management of low birth weight or premature newborn, along with other specialized neonatal
service.

BACKGROUND TO THE PROBLEM:

The Aetas live in the northern part of The Philippines on the island of Luzon. Historians and
anthropologists debate precisely when and how they migrated here, the consensus being that they
crossed from the island of Borneo between 20 and 30 thousand years ago, using a land bridge that
was partially covered by water around 5,000 years ago - the remaining part of which is now the island
of Palawan. Whatever the migration path was, they are without doubt among the first - if not the first -
inhabitants of The Philippines. One area of that country where the Aetas had lived for thousands of
years was Mount Pinatubo. An active volcano, it erupted in June of 1991. The eruption was one of the
worst in history and was devastating to the nearby Aeta population. Around a quarter million people
lost their home - many of them Aetas. Although the Philippines are still cleaning up the ash to this
day, the Aetas have long since re-settled in urban areas of Luzon. One such area is located in Tarlac
It is doubtful they will ever return to their former homeland.

Although the Aetas were among the first inhabitants of The Philippines, natural disasters and
exploitation of their land for natural resources have acted over the years to displace many of them.
However, the Philippine government has recently paid more attention and respect to their heritage
and way of life through organizations such as The Indigenous People Development Plan. As recently
as February 2nd, 2001 the Aetas were granted Ancestral Domain Title to their land.

Like other cultural minorities, The Aetas wants to preserve their tradition and cultural continuity thru
the assurance of a healthy member of its community. Preservation of one’s health should start with
the mother, the bearer of their next generation as well as that of the child, the true testament to
wonders of life.

PROJECT OBJECTIVES:
 To pursue the health care facility’s mission of providing quality, affordable, accessible
hospital care to the Aetas in the resettlement area.
 To provide a comprehensive care for mother and their babies all in a single facility.
 To provide a healthcare facility that integrates the Aetas indigenous culture and their
vernacular forms.

PROJECT SCOPE:
- Written Report
- Space Programming
- Design Development
The project involves the upgrading of the existing facilities and construction of new
Buildings:
1. Site development (Roadway and Fences)
2. Design of the proposed new 25-bed hospital building for Mother and Child.
3. Construction of new Dormitory and staff house, Motor pool and Maintenance Office. (Show
in the site development plan)

SITE/LOT DESCRIPTION:
The proposed Mother and Child Hospital will be located in Brgy Dapdap, Tarlac, a parcel of
land that was allocated for the resettlement of the Aetas who were displaced from their community.
(The students may opt to locate the site through Google map.)

DESIGN REQUIREMENTS:
I. Lobby and information Chief Of Hospital’s Office w/ Toilet
Admitting Office Conference Room
Reception Area Secretary’s office
Public Toilets Business Office- Clerical Pool
Multipurpose Area (50 capacity) ( 3 Staff)
II. Administrative Service Billing – Cashier
Administrator’s Office Printing office

3
 Chief Nurse Office Staffs lounge
COA Office Male/female dressing w/ T & B
Staff Lounge and lockers with Toilet Nursery Room
Facilities Septic nursery
Kitchenette and Dining area Suspect/pathologic nursery
III. Ancillary Services Work room
Pharmacy Breastfeeding room
Pharmacist’s office Central sterilizing area
Pharmacy Storage VIII. Nursing Facility
Medical Record’s Office Maternity Wards
Records Room and Storage Office of the Chief Nurse
Social service Room Nurse Station
Out-patient Department Nurse Counter
OPD Waiting Treatment Room
OPD Admitting and info Toilet
OPD Medical records Clean Utility & Linen Room
Dental Clinic and Dentist’s Soiled Utility & Dirty Linen
Office Room
Doctors Clinic Wards
Medical/ surgical Check-up (2)Typical 2-bed ward
Pediatric check up with common T & B (2)
Ob-gyne/family planning Typical 4-bed ward with
common T & B(2)
IV. Radiology Department Private ward with T&B
X-ray Room, Pediatric Wards
control booth and toilet Nurse Station
Radiologist’s Office Nurse Counter
Dark room and Treatment Room
film/file storage Toilet
Toilet and dressing room Clean Utility & Linen Room
Laboratory Department Soiled Utility & Dirty Linen
Department Head Area Room
Laboratory Wards
Storage (2) Typical 4-bed ward with
common T & B
V. Morgue (2) 2-bed ward
Lobby/Waiting area with common T & B
Autopsy room 1- Private ward with T&B
VI. Emergency Department IX. Dietary Service
Reception/ Info Main Kitchen
Waiting Area Preparation,
Treatment rooms Cooking,
Doctor on duty with T & B Dishing out area
Nurse station with Toilet Receiving area
Observation room with toilet Dry and Cold Storages
Minor Operation Room
Dietician’s Office
Stretchers Nook/Sub-lobby
VII. Surgery/Labor Department Dishwashing, pots & pans
Sterile corridor Waste Holding Area
(2) Operating Room Staff dining room
Operating area Locker room w/ Toilet
Scrub up and Food conveying hallway
sub sterilizing room X. Engineering Service
Surgical Supervisor’s area Central Supply Storage
Anesthesia Office & Storage Laundry and Linen
Sterile instrument supply (Sorting, washing, drying and
Labor room, toilet, Ironing, storage)
and Lamaze area Laundry /linen office
Delivery room Linen storage
Recovery Room – 3 beds Electrical room/emergency power
Nurse area house
Clean up room

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 Janitor and Storage Recyclables
Maintenance Room Sewage treatment
Maintenance office Water tank
2 repair shop XI. Hallways, stairs, ramps Fire exits,
storage etc.
Motor pool XII. Landscape/gardens
1 ambulance, 3 cars Parking
Drivers’ quarters with T & B Service Parking
Central Waste Storage Flagpole and assembly area
Domestic waste XIII. Others
Infectious waste

DRAWING REQUIREMENTS:

Concept Board
Site Plan Scale 1:500 Mts. Colored rendering
Floor Plan/s Scale 1:200 Mts. Black and White
Four Elevations Scale 1:200 Mts. Colored rendering
Two Sections Scale 1:200 Mts. Colored rendering
Exterior Perspective colored Any convenient Scale
Interior Perspective Any convenient Scale

Prepared by:

Arch. ALPHER DE VERA,Ma.Ed.uap