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Disclaimer: The views expressed in this paper/presentation are the views of the author

and do no necessarily reflect the views or policies of the Asian Development Bank
(ADB), or its Board of Governors, or the governments they represent. ADB does not
guarantee the accuracy of the data included in this paper/presentation and accepts no
responsibility for any consequence of their use. Terminology used may not necessarily
be consistent with ADB official terms.

Designing Accessible
Health Facilities
Designing Accessible Health Facilities
• WHAT (is accessibility?)
• WHY (is it important?)
• WHEN (are health facilities accessible?)
• WHERE (are we are now?)
• HOW (do we go forward?)
A. What is Accessibility?
= ability to access.

In healthcare: It is when people, regardless

of age, location, need and disability have the
capability to use, obtain and benefit from a
set of healthcare services provided for them.

To broader definition
B. Why is Accessibility
of health facilities important?
▪Researches show how access to health care facilities always influence usage of health services:
- travel times and great distances are a major obstacle for people to get the health care they need
- high number of patients don’t repeat a visit even if required when faced with those challenges
- vaccination uptake is lower among children the farther they live from the facility
▪ Direct link between the accessibility of patients to health facilities and the reduction of ill health
▪ Increase in the aging population, accessibility has become an even bigger concern for seniors with lower
mobility levels, who have greater health needs but lesser abilities to reach facilities and services.
▪ Emerging needs and trends in lifestyle changes that influence the way people respond to the healthcare
▪For Universal Health Coverage to contribute to sustainable development and global security, it is critical
we build better health facilities and infrastructure that are universally available, equitably accessible,
culturally acceptable and socially appropriate.
C. When are Health Facilities Accessible?
1) Actual Geographical Distance – how far or near from
people’s homes to a health facility
2) Travel time – how much time is takes to travel from
home to reach a health facility
3) Transport systems – the availability of public
transportation like boats, buses and other motorized
means from the patient’s home to the health facility
C. When are Health Facilities Accessible?
4) Spatial Distribution and Population Coverage – the distance
between facilities, and per how many people served.
5) Physical Location – the environmental and surface conditions where
the health facilities are located
6) Availability of Needed Service – opening hours, availability of
qualified medical providers and health solutions, appointment
systems, access to specialists and specialized testing equipment, and
other aspects of health service delivery that allow people to obtain
the services when they need them.
C. When are Health Facilities Accessible?
7) Economic or Financial Accessibility – a combination of the
affordability of health services, the ability of patients to pay
for services, and coverage by health insurance providers
8) Behavior Accessibility or Acceptability – how open people
are to seeking treatment.
9) Easy Access for Disabled – for easy mobility for persons
with disability
C. When are Health Facilities Accessible?
10) Health Information Accessibility – access to seek and
receive health information as needed.
D. Where are we are now?
Accessibility Challenges of Health Facilities
▪ Several analysis tools and methods currently used to measure and quantify accessibility of health facilities –
such as the Simple Additive Weightage, the Fuzzy aggregation method or preference decision analysis, the
Kernel Density Estimation, the Euclidean and network distance, and catchment area models.

▪ How do we make them attractive enough for ethnic minorities and indigenous populations, for mobile
population groups who don’t belong in just one place or have no traditional sense of community?

▪ How do we make them reachable for children, teens and other vulnerable groups? How do we assist those
in far flung mountains and islands?

▪ How do we contain costs so the poorest and marginalized sectors can still access services? With most
doctors preferring to stay in urban centers, and increased use of digital technologies, can access be provided
by embracing use of these?

▪And for blind, persons with disabilities, and those with triple burden of disease – how should health facilities
address and respond to current health care needs and existing practices?
E. How to improve accessibility of health facilities?
1) When creating new health facilities, accessibility must be made a central part,
built in as an integral part of the design and construction process, and not as an
afterthought and retro-fitted after, based on local studies and surveys,
depending on where, how and for whom.
2) For existing health facilities, identify areas where interaction is low and which
accessibility component is weakest to plan interventions needed to increase
usage by target populations.
3) Assist health centers to reconfigure infrastructure and services to respond better to aging populations,
indigenous groups and person with special needs and disabilities, to improve efficiency of systems, the
quality of patient care, expand types of services provided, use of digital technologies and health
promotion to improve health-seeking behaviors
4) Check if it is possible to optimize the public transport network, or if new roads, bridges or pathways need
to be constructed and existing roads rehabilitated.
5) Ensure all health facilities contribute sustainably and strategically to strengthening local and national
government health systems. Advocate for policy actions, share examples of accessibility components,
develop local standards to measure accessibility indicators, and toolkits if needed.
Thank you.