The frontline hospital.

This brief description of the planning process for a frontline hospital is intended as a guide only: there will be a variety of approaches depending on local conditions. However, certain of the principles raised have universal relevance for the construction of health facilities where resources are limited. In brief, these: - The changing role of the frontline hospital should not be allowed to obscure the fact that the small hospital still has a significant role to play and that future, as yet undefined, functional changes will take place necessitating generalized designs that can accommodate those changes. - The erection of new buildings is not always the appropriate solution to apparent problems with facilities. Often a more relevant course is to adapt existing buildings or to provide community-level primary health care services not based on facilities. - The development of standardized, though flexible, briefs for hospitals of different sizes is essential, since ther will, for some years to come, be a shortage of the professional manpower needed to enable completely individual designs to be produced for each facility. Standardized briefs are infinitely preferable to standard or type plans, which tend to be inflexible and lead to overbuilding. - Local involvement in the planning process is essential, not only because it provides useful knowledge but primarily because local commitment is the only way of avoiding the construction of inappropriate facilities. - Architectural expertise must be available within the health system, since very often outside consultants are unable or unwilling, because of the system of payment, to design suitable hospital buildings. - The type of construction used should be the simplest and most economical that will provide an effective environment for the health tasks to be carried out so that the limited resources available can be stretched to serve as many people as possible. - Local building materials should always be preferred- to imported ones in view of the lower initial cost, greater ease of maintenance, and cultural acceptability.