Ghanaian President Nana Addo Dankwa Akufo-Addo was present at a groundbreaking ceremony in the Ashanti region of the West African country earlier this week to mark the official launch of Agenda 111 (formerly Agenda 88), a nationwide initiative on health infrastructure that was first announced was launched in April 2020, which, in the words of Akufo-Addo, “will lead to Ghana becoming a center for medical excellence and a destination for medical tourism”.

In total, the ambitious project includes the construction of 111 new health facilities, including 101 district hospitals, two psychiatric hospitals, seven regional hospitals and the renovation of an existing psychiatric hospital in the capital Accra. Adjaye Associates was commissioned by the Hospital Infrastructure Group on behalf of the Ghanaian government to plan all 101 district hospitals. Under the direction of the Ghanian-British architect David Adjaye, who has been awarded the RIBA Royal Gold Medal, the company also has a studio in Accra in addition to its offices in London and New York City.

A view of the central courtyard in the heart of each of the 101 district hospitals. (Courtesy Adjaye Associates)

The more than 100 district hospitals are designed as inviting, green, single-story campuses that avoid the sterile and often disorienting nature of traditional medical complexes. However, each will be highly adaptable to suit the unique geographic conditions of each individual environment. The Denkyem (African dwarf crocodile), a symbol of Adinkra that represents cleverness and the ability to thrive in varied and sometimes challenging conditions, served as a central point of inspiration for the flexible design, which relies on prefabricated construction techniques and natural materials from the region to be more efficient , fast construction process.

“To ensure that each hospital reflects its own location, the main shell of each building is made of stabilized interlocking adobe bricks that create an earth-based infrastructure,” Adjaye said in a statement to AN. “The clay bricks from the region are non-toxic, sound-proof, insect-resistant and fire-resistant, as clay walls do not burn – this is how the architecture as a wellness room can convey further into the environment.”

Depiction of a shaded briseway designed by Adjaye AssociatesBoth butterfly and gable roof constructions will tower over different areas of each hospital, depending on their function. (Courtesy Adjaye Associates)

The program of each individual district hospital set up as part of Agenda 111 will also be largely the same and will include pharmacies, maternity and children’s wards, emergency facilities, laboratories / diagnostics, operating stations, physiotherapy centers, outpatient departments and more. A number of auxiliary structures – including waiting pavilions, family and doctor’s dormitories, morgues and waste disposal facilities – will complement the main components of the basic supply.

A sprawling central garden will anchor each low hospital while smaller public green spaces will spread across campus to “create an overall atmosphere of healing that is critical to patients,” the company said. Starting from the central garden along an easy-to-navigate central spine, patient stations are positioned on the perimeter to ensure maximum natural light and open-air flow. These parts of the complex will be covered with butterfly roofs to further maximize cross-ventilation and natural night-time, while facilities that require a more controlled environment, including operating theaters, can be distinguished by their gable roof constructions, which better protect the building envelope from the elements. Both will collect rainwater and “provide an insulated shell to minimize the heat input into the interior of the building,” according to the company.

Depiction of an infirmary in a hospitalPatient stations are arranged to take advantage of natural light and airflow. (Courtesy Adjaye Associates)

“The overall organizational strategy of the campus and the structure of each building allow the green public spaces to interweave across the entire campus and offer patients and their families dignified moments of relaxation in nature,” explains Adjaye. “With ecologically designed, responsive systems that work with the elements of air, water, nature and land – such as ensuring natural light, outdoor ventilation and proximity to green spaces – hospital and nature come together in a moment when Architecture meets healing. “

Adjaye Associates in the planning team of the Agenda 111 district hospital include Titan Biomedical Engineering, Brix Landscaping, design coordinator Sutherland & Sutherland Architects and Global Engineering & Technology as an electrical and mechanical engineer. The contractors vary depending on the location.

Aerial views of several hospital complexes designed by Adjaye AssociatesAerial views of several district hospitals in both rural and urban contexts in West Africa’s second most populous country. (Courtesy Adjaye Associates)

“By viewing the hospital as more than just a place for the delivery of medical services, the design concept aims to unlock the potential of this ambitious initiative by repositioning the hospital as a piece of community infrastructure that is sustainable, efficient and generous Ecology embodies. “Spaces to enable wellness and healing,” added Adjaye.

As reported by the Ghanaian state news source The Daily Graphic, the government estimates that around 25,000 workers will be employed during the design and construction of Agenda 111; When completed, the new facilities are expected to employ 20,000 medical professionals, which will significantly lower the country’s unemployment rate.