Well planned and managed infrastructure is essential to creating an enabling environment to provide quality health services and to motivate and retain skilled staff. This includes ensuring the safety of patients and providers within health facilities. Making sure that facilities, including buildings, medical equipment and support services operate safely and sustainably requires proper planning and the efficient use of resources. Regular maintenance is equally important to ensure buildings remain operational in the long term.
Effective infrastructure management involves inventory management, needs assessment, appropriate site selection, facility design, transparent bidding procedures, construction, renovation, retrofitting, reconstruction and the repair and maintenance of buildings.
In Nepal, we provide support to the government in the design of health facilities, and oversight of repair, retrofitting and reconstruction. This has been especially important since the earthquake in 2015, following which we coordinated reconstruction activities between government and external agencies. This involved working closely with the National Reconstruction Agency to help Nepal ‘Build Back Better’.
We bring expertise in:
- Technical design of hospitals, health facilities and other public buildings at all levels: national, regional and district; urban and rural.
- Planning repair and reconstruction – structural assessments, site selection, needs assessment for facilities, procurement systems and services, preparation of specifications and bills of quantities
- Support to planning and coordination between government departments and external development partners to ensure the effective use of resources.
- Planning seismic retrofitting of key health facilities to ensure Nepal’s health infrastructure is better able to withstand future seismic events.
- Promoting access to and use of facilities by ensuring design and construction meet community needs
- Monitoring and quality assurance of health infrastructure improvements, to ensure adherence to international and national regulations.
- Development of infrastructure information systems to improve planning and the monitoring of facility conditions,
After the earthquakes in 2015, our team played a leading role in supporting the MoH’s facility reconstruction and recovery efforts. Our ten years of experience in the sector proved invaluable when carrying out damage assessments. We went on to support the ministry in planning and preparing an infrastructure reconstruction plan and policy, framework and guidelines with facility designs and recommended technologies, all within a month of the earthquake. More than 100 facilities were reconstructed with support of our team.
Our advisers have also helped prepare standard bidding documents for civil works for the Department of Urban Development and Building Construction (DUDBC). These provided guidance to ensure consistency in bidding processes and addressed critical legal and negotiation issues.
Our technical advisors also supported the preparation of guidelines for upgrading and constructing health infrastructure to ensure that maximum benefits are achieved as a result of these investments. This included guidelines for selecting land for the construction of new health facilities in order to reduce delays and avoid the high costs associated with poor site selection. .
Key results and achievements
- We helped establish a web-based Health Infrastructure Information System (HIIS) with Google interface for use by DUDBC and District Health Offices. Data for all public health facilities in Nepal and GIS locations of all health facilities, public and private, is available on the system.
- Integrated health facility technical design standards, implementation guidelines and working drawings for the construction of new health facilities were developed for the Ministry of Health. Based on these, more than 800 facilities have been built by DUDBC across Nepal.
- Systems developed to improve decision making over the locations of new health facilities.
- Post-earthquake survey of all facilities in the 14 most affected districts. This included mapping the extent of damage; identifying various repair and maintenance tasks needed, assessing where retrofitting or reconstruction was needed and calculating the associated costs.