THESIS TITLE

IMPROVISATION AND RECONSTRUCTION OF THE

INFIRMARY HOSPITAL IN MERIDA LEYTE

CUBILLA, JAHZEEL JOSEPH

BSARCH 4 R1
 Chapter 1 - Introduction

1.0 Merida

Merida is a 5th-class municipality in the Philippines' Leyte province, commonly known as

Merida Municipality. According to the 2020 census, it has a population of 31,574 people. The
inhabitants' major source of income is agriculture, which includes fishing. San Isidro Labrador has
a rich and legacy that goes back to the first immigrants and has been passed down through the
centuries. Furthermore, agriculture was their primary source of income throughout the Spanish
conquest.

1.1 Background of the study

There are three study problem categories that describes the poor design considerations of
public health in the Municipality of Merida Leyte in the Province of Visayas, Philippines. First, is
the “Zoning and Land Use Planning”. Unfortunately, the building is adjacent to a sports center that
prevents the lack of regulation and control (such as setbacks) of the land. It remains insufficient to
meet complementary needs that results to poor planning. Second, is the absence of the “Design
Principles. The design of the building must have better design solution to ensure good design and
construction.

On the month of March, it was initially declared the Covid-19 which results to have a
global pandemic outbreak. Hospitals are overcrowded of patients infected with the virus which
effects to the deficiency of room treatment for COVID 19 which lead to the third problem. With
its unexpected current situation, it shows the building lacks for treatment rooms. Due to the
adjacent structures, the space prevents the expansion of the building. It will eventually need to
relocate to a larger area or place multi-storey spaces. This will comprise basic space planning,
ventilation, more isolated user room facilities, and for health worker.

This research aims at the challenges of achieving public health goals, relocating due to the
difficulty of access/place multi-storey level, implementing social distance and designing
hospitality especially in a post COVID world.
1.2 STATEMENT OF THE PROBLEM
The local government of Merida for the COVID 19 pandemic shows that public health
management are poor in handling the situation. Lack of supplies and quality control. Most
people refuse regular checkups due to finances and a lack of healthcare professionals. Merida
lacks health workers, preventing local access to quality healthcare. Furthermore, these
development aims to provide a solution to the following issues:
• What are the design considerations in a new normal post COVID 19 era?
• How do you conduct a comprehensive, efficient, and well-coordinated plan?
• How can the structure's adaptability and flexibility be improved?
• How to create a sustainable design place that gives environmental, social, and
economic effects into consideration?
• Who are the client and users from this study?

1.3 ARCHITECTURAL GOALS AND OBJECTIVES

1.3.1 GOAL

To develop and design the Infirmary Health Center in Merida, Leyte, with thoughtful
consideration to its functions, appearance, strength, and materials.

1.3.2 OBJECTIVES

1.3.2.1 To design a level 1 hospital infirmary health center and emergency care treatment,
as well as general administrative and ancillary services, are provided.

• Provide a broad contrast between a practice and an intervention for longer-term

sustainability as part of the daily routine
• Develop comprehensive approach that covers all aspects of each health needs.

1.3.2.2 To develop and relocate a new medical facility for a more proper, effective, fast
recovery services for the users.

• Applying sustainable design concepts and theories.

• Providing facilities to accommodate various activity preferences.
 • Examine important concepts, practices, and techniques.

1.3.2.3.1 To make health care more accessible to Meridanons and poor communities’
culture-sensitive institution.
• Engage for quality, safety, performance, and accountability should all be improved.
• Envision the facility development and future-oriented formal analysis and decision-
making process.

1.4 SIGNIFICANCE OF THE STUDY

The study aims the challenges of providing health care to everyone. The following implies some
of the factors that contributed to the study's relevance:

1.4.1 Significance of the study to the patients:

This study will demonstrate how healthcare should treat people based on their age, gender,
social status, and special needs, such as PWDs.

1.4.2 Significance of the study to the healthcare providers:

This research will ensure that health professionals have enough supplies to help patients
recover quickly.

1.4.3 Significance of the study to the field of healthcare architecture:

Because the development is one of the new concepts in a building development, the
research will also be important in the field of architecture. Architecture will be the method through
which societal considerations influence building the design.

1.5 SCOPE AND DELIMITATIONS OF THE STUDY

1.5.1 SCOPE:

The importance of an Infirmary Provincial Hospital and Center will be discussed, as well as its
organizational structure, as well as the people and spaces involved in such growth. It will also
determine the optimum site for the development, as well as the architectural design, planning, and
development plans that will be implemented.

This research will provide the reader with a comprehensive understanding of what a culture
sensitive hospital is like, particularly in the province of Mindoro, and how it might assist the
province's and town's poor medical state.

1.5.2 DELIMITATIONS:

This research will focus on architectural plans, concepts, and ideas, and also space planning skills,
and fundamental structural systems. Environmental systems may vary according on the site's
location; further prospective sites may be investigated.

1.6 ASSUMPTIONS

Merida Health Center has a long history of inefficiency and poor service due to a deficiency of
health personnel. Patients and staff will be unable to provide service and treatment as a result of
this. One of its key issues is the government's proposed budget. There is a lack of a comprehensive
strategy for the community's efficient and caring requirements. Inequity in access to health
facilities and services has resulted in poor health in rural communities. Given the expected level
of demand for health and nutrition services, the provision of these services must be increased and
strengthened in response to the growing provincial population

The challenge of meeting these demands to improve people's well-being will need concerted
efforts by national and local governments, private organizations, non-governmental organizations,
and individuals/communities.
1.7 DEFINITION OF TERMS

1.7.1 CONTEXTUAL DEFINITIONS

Merida Leyte- is also called “Municipality of Merida Leyte” there are over 31,574 population in
this area.

Meridanons- refers to collective inhabitants of Merida province.

Hospital- a location focused primarily to the operation and management of treatment facilities.

Infirmary Health Center- also called as “Small Hospital”. A facility where sick or injured
people are treated.

1.7.2 ABBREVIATIONS

PWD- Persons with Disabilities

(SARS COVID19)- also known as “Severe Acute Respiratory Syndrome Coronavirus

2019”
 CHAPTER 2

1.8 RELATED LITERATURE AND STUDIES

This research study mentioned books and publications that were relevant to the topic's
inquiry. It consists of domestic and foreign research and literature that include information and
facts on the issue under study. Additionally, it clarifies current research and establishes logical
connections between itself and previous work.

REVIEW RELATED LITERATURE

1.9 HEALTHCARE IN TOWN
John Ryan Santos (2019) quoted, "Despite their large numbers, CAHs face significant
challenges that threaten their long-term viability. These difficulties included payment systems,
product quality, financial access, and skilled labor. COVID-19 also introduces additional
problems, including duplicate plans for small areas, a lack of a community healthcare system, and
the inherent unpredictability associated with individuals establishing their care plans. Further
policy interventions will be necessary to address or alleviate the problems in each area during the
next decade to preserve CAHs (Critical Access for Hospitals).
A healthcare project is a compact hospital model with a test site intended to serve as a
template for a network of close hospitals built in rural municipalities throughout the Philippines in
the future. Moreover, he also said that small towns must fund their hospitals, unlike developed
countries, where hospitals are well-funded. It means they must be highly efficient in planning to
provide the critical service capabilities of a tertiary hospital at a cost that is not prohibitive to
investors. Simultaneously, they must be disaster-resilient, as we are one of the world's most
disaster-prone countries.
As specified by (Santos 2021), access to healthcare is essential for maintaining good
conditions, but rural areas encounter various barriers to getting these services. Ideal individuals
should have convenient and confident access to patient healthcare, dental care, behavioral health
care, emergency care, and public health care.
Rural residents frequently encounter barriers to health care that make it challenge to receive
the treatment they require. A timely availability and accessibility of necessary and appropriate
healthcare services for rural residents are required to ensure that they have enough access to care.
Suppose the community has an adequate quantity of healthcare services, further considerations
regarding healthcare. Entry must be considered. Confidence in utilizing services without risking
one's privacy or the ability to receive proper care.

2.0 CHALLENGES FOR RURAL HEALTH CARE

According to (Nortje et al., 2021), rural health care delivery faces various challenges beyond
simple issues such as low population density, geographic isolation, and accessibility. Rural
regions, according to studies, confront a range of structural problems. These problems can make
it much more difficult for remote hospitals to manage essential patients, maintain key supply
reserves, and define particular paths for care. It may leave them unable to consult best practice
publications and identify solutions suited for their scenario. Apart from that, rural regions confront
various topographical challenges, which are worsened by harsh weather. These situations might
compromise patients' safe and timely transfer to tertiary care institutions. It is hard to have a steady
internet connection or even a phone connection. As a result, even essential communication with
and among community members may be challenging.
For months, hospitals and healthcare practitioners have been feverishly striving to 'flatten the
curve.' However, there are legitimate concerns about the likelihood of future pandemic outbreaks.
Numerous nations that struggled to reconcile conflicting demands for price, efficiency, ecology,
comprehensiveness, and continuity of treatment may now face an even more challenging task.
Rural contexts in which problems are handled are distinct from urban contexts. These metrocentric
systems may be ineffective if when residing in a rural area with limited resources. Another benefit
of living in a very rural town is the sense of community. In pastoral health care, ethical decisions
are seldom abstract; they regularly affect relatives, neighbors, coworkers, and patients and their
families. As a result, provider-patient relations can be enhanced by utilizing a decision-making
foundation and a collaborative method when confronted with complex and unexpected scenarios.
Globally, medical systems, hospitals, and health personnel are being challenged with making
ethical judgments in the face of unforeseen conditions during the COVID-19 epidemic. These
problems are worsened by the daily reality of rural communities, where financial, economic, and
personnel restrictions have already influenced the delivery of essential health care services. On the
other hand, in rural areas, strategic and collaborative methods may have the capability to enhance
efforts and outcomes.
 As defined by (Slonim 2020), pandemic crises are massive outbreaks of infectious illness
that can significantly enhance morbidity and death across a vast geographic region while wreaking
havoc on economic and social systems and triggering political instability. In a public health
emergency, changing professional standards and rebalancing ethical considerations to prioritize
community needs above individual needs is appropriate. In times of public health emergency,
changing standards of practice and rebalancing ethical considerations to prioritize community
needs above personal needs is relevant.

CAHs (Critical Access Hospitals) confront significant problems that jeopardize their long-
term existence, notwithstanding their high population density. These difficulties included payment
systems, product quality, financial access, and qualified labour. COVID-19 also introduces
additional problems, including duplicate plans for small areas, a lack of medical healthcare system,
and the inherent unpredictability associated with individuals establishing their care plans. Other
government initiatives will be necessary to address or alleviate each area's problems during the
next decade to sustain CAHs. Several objectives to guarantee that CAHs satisfy the meaning or
purpose of the Fair Tax Act of 1997:
• Rural areas must have access to high-quality healthcare that meets the COVID-19 problems
that continue to evolve.
• CAHs must have access to money, technology, and qualified personnel to perform at an
acceptable degree of excellence.
• These facilities should be no more expensive to operate than the US health system.
• Any future policy modifications or proposals must develop a cost structure that is not
neutral. After all, the present system was untenable before COVID-19 and may be
untenable following COVID-19.

2.1 TELEMEDICINE IMPLEMENTATION

According to (Sedavia et al., 2020), In the context of international pandemic response,
technological innovation has arisen as a new area of concern, particularly in third world nations
such as the Philippines, where technological has not been widely adopted. Telemedicine will assist
employees in meeting the growing in the healthcare industry. Telemedicine is a branch of medicine
that makes use of information and communications technologies to enable a physician situated in
another location to view a patient's data.
With 2.3 billion internet users, Asia Pacific has the world's largest internet user population
in 2019. As of June 2019, the Philippines is rated 12th among nations to the most internet users.
People on social media in the Philippines grew to 76 million. By contrast, the digital demographic
is largely constituted of individuals aged 16 and older. In comparison to the rest of the globe,
Filipinos spend much time online and on social media. The Department of Health (DOH)
conducted a countrywide study on non-communicable illnesses using mobile phone technology
(NCDs). According to the Department of Health's health secretary, the statistics will serve as a
national benchmark for preventative initiatives.
With the occurrence of the problem in the Philippines, this study aims to innovate the existing
telemedicine application in order to assist residents of a highly urbanized community in the
Philippines in gaining convenient access to proper medication and consultation with physicians
regarding their physical health during the COVID-19 pandemic. This will be done using system
design, a quality house, and multiple regression. The study's aim is to accomplish 75percent of
total (75%) of the target, with a primary focus on the developed ratio with the use of telemedicine.
The research will focus on a urbanized town in the Philippines and will make the assumption that
other urbanized areas suffer a similar challenge. Additionally, this study will not target health care
practitioners, as they are not the intended audience.
As stated by (Sanmorino & Gustriyanyah, 2019), this study examines ways to enhance
community health centre services via the use of e-Notification architecture. Regular information
such as vaccination programs and frequency of visits for pregnant women can be delivered by e-
Notification.
When disseminating information simultaneously or personally, utilizing e-Notification can
save time. Using e-Notification, this may be feasible to deliver a high number of notifications
concurrently. The proposed architecture is suitable for rural or isolated locations. This design is
still being developed and has not been verified. However, when compared to other existing ways
of information delivery, the method we proposed is faster.

The Community Health Center (CHC) serves as a focal point for enabling communities,
families, and primary care providers to enhance the quality of the service by providing patients
with relevant, timely, and focused information. The research will increase the percentage of CHC
services provided to patients (particularly pregnancies) through notification services for pregnancy
control plans and family planning and reminder services in various types of vaccinations. The cost
of delivering short messages for notifications or reminders generated by back-end apps is lowered
by utilizing the SMS-Gateway Service. This pull application will deliver SMS messages to
pregnant women and family planning services on a scheduled basis. Additionally, this app will
remind patients, particularly pregnant women, infants/toddlers, and children, to receive
vaccinations to lower the high infant/toddler death rate. By providing timely and tailored
information to patients and families via SMS, the suggested e-Notification architecture can assist
CHC in improving its services. This e-Notification can inform pregnant women or family planning
services automatically. E-Notification can also be used to remind patients, particularly expectant
mothers, newborn babies, and children, to obtain vaccinations to minimize infant/toddler mortality.

2.2 IMPROVISATION ACCESS TO RURAL HEALTH-CARE

According to (Community Health Workers in Rural Settings, 2019), rural regions with
limited access to health care, particularly those lacking customized and culturally competent
treatment, are especially in need of this sort of service. While health care workers (CHWs) have
historically been engaged to serve minority communities, their numbers have risen considerably
in recent years. They currently provide services to a variety of rural, urban, and underprivileged
populations. In rural regions, CHWs seek to improve health outcomes by making care more
accessible.
This subject guide includes materials that define several community‐based models, highlight
excellent community‐based programs, and discuss the difficulties and obstacles inherent in
creating primary healthcare programs. Two critical aims are to increase the value of the healthcare
team and improve the quality of life for poor, underserved, or members of minority populations.
In both rural and urban contexts, CHWs operate as a contact point between customers and service
providers. CHWs provide culturally competent health and prevention learning, referrals to a
variety of health and care services, and guidance in navigating the care system care, promoting for
individuals and groups within the medical system, assessing progress in maintaining medical
illnesses and achieving optimal health, and tracking the performance of individuals and groups
within the medical system.
 As specified by (Module 6: Funding and Sustainability for Rural Community Health Worker
Programs, 2019), rural communities may want to consider various sustainability strategies to help
them support community health workers (CHW) programs. Obtaining long-term sustainability
frequently necessitates a combination of private and public funding sources.

To sustain improvements in population health, one strategy is to develop or identify funding

models that support population health. Local governments in rural areas should consider creating
a financial plan to bill for health promotion/disease prevention services.
Among the essential strategies for achieving sustainability are the following:
• Partnerships must be strengthened to have the most significant impact on rural
communities. Creating collaboration between organizations with similar goals can raise
program visibility and emphasize the importance of health messages.
• Educating program staff to specific proficiency levels ensures that the skills and knowledge
required to improve community health and wellness are available. A train-the-trainer
model ensures that the knowledge and skills gained from training are shared and retained
in communities.
• Diversifying funding sources: To ensure long-term sustainability, programs should be
funded from multiple sources. A project can be financed from revenue or reimbursement,
leveraging existing resources, grants, or fundraising. Some rural programs charge
participants or employers to recoup costs.
• Evaluation findings can help determine which program elements should be maintained and
by whom. Others opt for sustainability plans that reduce operations, program participants,
and services or delegate responsibilities to willing coalition members.
• Communicating effectively can have a long-term impact on health issues by raising
awareness and encouraging people to rethink their actions.
2.3 COVID-19 QUALITY IMPROVEMENT
According to (Bakri 2020). This article discusses the operation of community hospitals,
community health initiatives, personal health actions, and infection - control during the COVID-
19 pandemic. Alongside adjusting activities, the Improvement In quality of Support Center for
Health Promotion within Pandemic requires resource management changes. While each health
centre faces unique challenges depending on the number of cases in the area, the health provider
and the Medical Department must actively support these changes through official sources to adapt
the procedure of services to be offered immediately.

A health centre is a universal coverage facility that engages directly with the community by
providing preventative, curative, and rehabilitative services. Indicators of effectiveness in
managing COVID-19 in the work environment have been devised, and these indicators are
monitored and controlled monthly. Regional and state budgets and other lawful sources are utilized
to support the execution of services during a pandemic, as required by relevant legislation. The
community health centre provides adjustments to other resources development, particularly human
resource management, and adjustments to the efforts or activities to be undertaken and the
financing to be undertaken. Increase of Service Quality Due to the pandemic, actions, activities,
financing, and resource management have been adjusted. While each medical centre has specific
problems based on the amount of COVID 19 patients in their region, services can improve by
adhering to formal and responsible standards given by programs. Due to the changing research
around the COVID-19 pandemic, policy and guidelines may change. The health centre and the
Healthcare Department must constantly monitor this development from official sources to make
necessary adjustments to the service routine. It is critical to increase staff expertise in COVID-19
services and the Priority Programme.
According to (Safaai, 2021. To help manage suspected COVID-19 patients, users created
a binary triage approach based on contamination and functional reorganization. Medical personnel
may more readily handle infection control practices in the emergency room with this approach.
This research examined the efficacy of a new triage system and structural restructuring in response
to the pandemic.
COVID-19-infected individuals with fever and respiratory symptoms are separated from
other patients using a binary triage method. We gathered and evaluated pre-tests and post results
on COVID-19-exposed HCW using descriptive statistics. It is divided into three categories:
crucial, semi-critical, and non-critical—triage criterion for zones before the reorganization. The
study's findings indicate that the number of patients exposed to COVID-19 reduced in the medium
and high-risk categories. The binary triage approach, which was enabled by reorganizing the
emergency department's architecture, shows that it can significantly minimize COVID-19
exposure among health workers. The new system for triaging patients places a premium on the
severity of disease and the presence of infection.
Nonetheless, it continues to adapt to suit the present demands of healthcare systems. The
effectiveness of innovative methods in the Emergency Unit may be crucial in controlling future
illness epidemics. Additionally, these technologies may act as the ultimate line of protection
against COVID-19 virus transmission to healthcare personnel.

Chapter 3

2.4 Introduction

This chapter covers and discusses the methodology used by the researchers to collect the necessary
data and information for the full investigation. It identifies the respondents and subjects of the investigation.
This also demonstrates the data collection methods and instruments utilized; these chapters also address the
sort of research, the research method, and the research location.

2.5 Research Method

The purpose of this study was to get the chance to build the Infirmary healthcare system. The
researcher utilized a descriptive technique and a qualitative strategy to collect the relevant data. Analyzing
the characteristics of qualitative research can assist in comprehending its significance. One of the significant
advantages of qualitative research is that it enables greater flexibility in modifying and refining research
concepts as the study advances. The planned study's quality, data collecting, information management, and
data analysis are all critical aspects in establishing the results' and conclusions' trustworthiness. This chapter
will describe the techniques and methods used to collect the information, how the information will be
evaluated and evaluated and how well the results will be presented. This section will detail the procedures
used to conduct the study and provide it with a sense of meaning.

2.5.1 Delimitations:

Unfortunately, as a result of the pandemic, strict regulations were imposed. Gathering data for many
people may prove difficult as a result of this situation. Online surveys, on the other hand, are the most
effective method of gathering data. These may include ensuring that all 20 respondents in a random
sampling process have an equal opportunity to be included in the data collection method.
2.6 Research Instrument

Due to the pandemic, the data-gathering survey was conducted entirely online. Other instruments,
such as online documents, articles, and books, were used to gather secondary data for analysis. These
findings aided in broadening the scope of the research and establishing the significance of the findings.
Additionally, this provides another point of view on the research being conducted.

2.7 Data Analysis and Presentation

The study made use of first-hand information gathered from a sample of respondents who
responded to survey questions that were sent to them. Direct information comes from survey participants
who have completed a survey prior to the research being carried out. In addition to primary data, secondary
data was used in the study. In qualitative methods, secondary data includes raw data and summaries that
have been published. According to (Saunders et. al, 2003) he stated that secondary data following
information is divided into three main categories: documentary data, survey-based data, and data compiled
from a variety of source

2.8 Validity

For the purpose of determining the validity of the evaluation, the respondents were asked if they
had any suggestions or recommendations as to how to make the survey better. As a result, the researchers
excluded the portion of the study where the difficult terminologies were used and replaced them with
simpler terminologies.

2.9 Ethical Considerations

Given the fact that this study involved human participants and focused on corporate practices,
several issues were addressed. In order to protect the participants' privacy and security, it is necessary to
take these considerations into account. In order to avoid future problems that could have emerged during
the research process, these issues were identified in advance and addressed. Consent, confidentiality, and
data protection were just a few of the important issues that were taken into consideration.
 CHAPTER 4-THEORETICAL BACKGROUND

3.0 Introduction

This chapter discusses the description of the data, the assessment of information, and the
analysis of findings obtained by a questionnaire distributed to the studied area.

3.1 Principle 1: Establish proper space planning for the built environment

Space planning is a complex process that considers a range of aspects. This principle
identifies its principles of space planning, which requires meeting a defined set of criteria in a
prioritized manner.

Matters of Concern:

3.1.1 Collect Information

The client or end-user will have numerous requirements for the design of a building or
space. It is critical to conduct extensive research and consider as many aspects of space use as
possible during the very early stages of design.

3.1.2 Build the Brief

When considering how to create spaces and accommodate humans within them, it's helpful
to consider some universal concepts about how people interact with their environments.

3.1.3Space and Spatial Relationship

Spatial relationships are taken into considerations by linking a shared space, interlocking
spaces, and adjacent spaces. It is also acquiring efficient circulation and fluidity of the building.

3.2 Principle 2: Opportunities for green architecture development as convenient

The development path is generic, lacks originality, falls short of optimal modernity, and
lags significantly behind on all levels of design. In terms of advanced and turning architectural
trends worldwide, such as green architecture, local perspectives and understanding remain
minimal.

Matters of concern:

3.2.1 Vegetations

The region immediately surrounding the structure has been free of vegetation since the
excavation began. Greenery is essential to our natural environment and makes various
contributions to the biosphere; it helps regulate the amount of multiple biogeochemical cycles.
Natural vegetation was scarce on the location. Additionally, planting is essential for achieving
sustainable living.

3.2.2 Challenges

As green technologies provide numerous environmental benefits and a high level of durability
while ensuring sustainable development and assisting in improving building management
efficiency, extensive use of green technologies in buildings is critical.

3.3 Principles 3: Community Services as Foundation

Power, water, and drainage systems are just some of the daily services provided by
the Municipality of Merida Leyte. Local government units (LGUs) determine this based on the
needs of the community daily.

3.3.1 Power Supply Connections

The Leyte Electric Cooperative created a power supply (LEYECO). It is essential daily.

3.3.2 Water Supply Connections

The Leyte Metropolitan Water District developed Water Connection to meet water delivery
demands. Distribution systems must deliver drinkable water supply and fire prevention water to
all users reasonably, at an appropriate pressure, with slight loss and acceptable quality, while being
economically viable.
 Rainwater collection serves various functions, including supplying potable water to
consumers during times of water shortages, recharging groundwater, and reducing runoff and
flooding during wet seasons. It is possible to develop this system utilizing indigenous knowledge,
skills, and resources. Residents who live on rooftops during the rainy season can collect and
process their water. Rainwater collected on the roof is utilized for personal or household purposes.

3.3.2 Drainage System

Since the site is located on an uphill slope, when the rainy season arrives, the water would
rapidly flow downward and move from the site's surface area. As a result, drainage should be
installed for the sake of safety.

3.3.3 Waste Management

It includes all the processes and actions necessary to manage waste from inception to disposal.
It encompasses the waste collection, transportation, treatment, removal, monitoring and regulation
of waste management processes and waste-related laws, technologies, and economic mechanisms.

3.4 Principle 4: Transforming into a Sustainable Path; Regenerative Architecture

Regenerative architecture is the technique of utilizing the natural environment as a media for
and generator of building. It is an architecture that promotes conservation and performance by
reducing a building's influence on the environment.

3.4.1 Integration of System Design

It embodies and explains arguably the essential set of rules in the collection. The system's demands
are not the only criteria and addressing the design process to function inside the system without
separating, dismissing, or neglecting any personnel of the given site's entire system community is
critical.

3.4.2 Landscape Integration

It is divided into three major focus points. According to the first, the landscape's site study and its
natural features and systems serve as the basis and creator of the design. It is a process that converts
on-site data, knowledge, and insight into architectural and landscape form. By following this
procedure, this should be capable of developing a unique design for the site.

3.5 Principle 5: Formation of Socio-Cultural Factors Influence

"Culture" is the primary factor that shapes architectural spaces and is critical to social
sustainability. This principle identifies its critical study culture and its impact on architectural
spaces to comprehend human behavioural patterns.

3.5.1 Culture and Identity

Traditions and customs are two of the mechanisms that result in the emergence of norms that
define culture. This supervision relates to community methods and devices to enable individuals
to adapt to them in the eyes of a group or community.

3.5.2Space Syntax Analysis

Space syntax analysis, which is based on the spatial configuration method, quantifies links
between socialization and the built environment by investigating connections between personal
and community behaviour patterns and the physical structure of the space.

3.6 Principle 6: Using active design as a substitute

Active systems include components that convert solar energy into usable forms such as hot
water or electricity. This principle identifies to give economic impact with less power in a zero-
energy production cost.

3.6.1 Solar Panel

Solar panels harvest renewable energy from the sun and convert it to electricity, used for electrical
power loads.

3.6.2 Wind Energy

The primary benefits include an infinite, free, renewable resource economic value, maintenance
costs, and facility placement. The wind is a limitless, cost-free, renewable energy source.

3.7 Principle 7: Utilizing outdoor lighting for security

Exterior lighting breathes life into facades and outdoor spaces. Whether used for protection,
landscaping, or dramatic effect, exterior lighting can alter your perception and understanding of a
building or pathway. Also, this will help to secure the building, especially at night.

3.7.1 Motion Sensor Lights

Detector lights are powered by surrounding activity, making them perfect for security lighting
and areas of your property with heavy traffic, such as entrance and pathways. The motion sensor's
range and angle are determined by design.

3.7.2 Dusk to Dawn Light

These fixtures are equipped with special photo sensors that enable them to turn on and off
automatically in response to the sun setting and rising. They are a simple way to ensure that your
outdoor lighting is only activated when necessary.

3.8 Principle 8: Effective and Efficient Roadways

It is critical to emphasize the importance of staff driving efficiently, including conserving as

much fuel as possible. Another essential aspect is route planning in advance, to ensure that the
distance is as short and accessible for transport vehicles.

Matters of Concern:

3.8.1 Road Connections

It enables accessibility for users towards the proposed site.

3.8.2 Transport Connection

 To ascertain the amount of vehicular transportation used to reach the establishment. It
includes road connections and pedestrian walkways to ensure user comfort.

3.9 Principle 9: Social Distancing

These measures maintain a minimum of one meter of physical separation between people and
minimize contact with contaminated surfaces while also promoting and sustaining virtual social
connections within families and communities.

Matters of Concern:

3.9.1 One-meter distance

Since it is the time of the pandemic, people should make a one-meter distance to show and
eliminate spreading the virus.

3.9.2 Wear mask

Masks are used in conjunction with a comprehensive strategy of measures to halt

transmission and save lives; mask use alone will not provide an adequate level of protection against
COVID-19.

4.0 Principle 10: Modular Triage Area

They are establishing a separate waiting area for patients suspected of having COVID-19. This
principle identifies areas with a high rate of community transmission, and healthcare facilities
should designate a, well-ventilated place for patients at high risk.

Matters of Concern:

4.0.1 Triage Station

This triage option is intended for small healthcare facilities with limited resources. This
triage option sets the bar for establishing a triage station.
 Conceptual Framework

4.1 Site Location and description:

The site is located at the Sto. Nino Upper Highway in Merida Leyte and a nearby complex
is known as the "Civic Center." The municipality of Merida Leyte owns the 150-square-meter
structure. It is also called as an "Isolation Center," an alternative design for those infected with the
virus. As the economy grows, the government intends to develop a project to establish Merida's
independent health care centre.

4.2 Geographical Location:

Infirmary Hospital

Figure 4.2.1 Identified Site

Source: Google Maps

As shown in the figure 4.2.1, the site is located at the Sto. Nino Upper Highway Merida
Leyte. A few meters away from the Merida proper.
 Figure4.2.2: Existing Road Access

Source: Google Map

4.2.2 Transportation

Transportation from Poblacion Merida Leyte (Merida proper) to the Infirmary Center in a
single ride. Usually, this mode of transportation is referred to as "potpot," but due to the sloping
terrain. Its reasonable price ranges between 15 and 20 pesos, and the best mode of transportation.
 Figure 4.2.3 Average temperature

Source: meteoblue.com

4.2.3 Climate:

The average climate of Merida ranges to 28-30 degrees when it's high while 22-25 degrees
when it is low temperature. The average rainy days per year ranges from 16-27, especially during
June to October of the month.

As showed in figure, the red line shows the highest temperature observed in Merida on an
usual day. While the blue line indicates the daily average temperature. During the summer months
and colder nights, as shown by dashed red & blue liens. It shows the average month's hottest day
and coldest night.
 FIGURE 4.2.4: WIND ROSE

SOURCE: meteoblue.com

4.2.4 Wind Direction

The wind rose for Merida indicates the number of hours per year during the direction of
the wind blows. As shown in the image the wind is blowing from the south-west to the north-east.

4.3 ECONOMIC BACKGROUND:

The primary source of economy in the Municipality of Merida is mainly fishing and
farming. The public market is established because of its many productions of fishes or any sea
creatures to be sold. Also, there are many farmlands to be seen along with the areas in Barangay
Mat-e areas.
 Figure: Land Management Bureau

Source: DILG

According to the Philippine Statistics Authority (PSA), the barangay población has a total
population of 9521 hectares of land. As stated by the Philippine Statistics Authority (PSA), the
economical in 2009 is rapidly growing to 32% annually.

4.4 Demographic Profile

FIGURE: DEMOGRAPHIC PROFILE

SOURCE: WIKIPEDIA

The Municipality of Merida, Leyte, had a population of 31,574 people according to the
2020 census. With a population density of 330 people per square kilometre squared or 850 people
per square mile.
 Conceptual Framework

4.5 Performance Objectives

A Performance objective is a coordinated effort from the beginning of the project and
planning through operations to meet user’s needs and give the psychological needs to people who
will use the space.

To ensure that a building is both functional and psychological demands of its users (both
qualitative and quantitative), it takes a coordinated effort by a multi-disciplined team of specialists
who understand and implement a 'Whole Building' design approach.

Active Design identifies solutions for urban

planning and design that promote
community health.
The built environment should promote
health and wellness for people especially
for the PWD's

promotes healthy living in the built

Universal Design and Health
environment

Beautiful design, including art, music, and

colors, options for social connection, and
spaces that celebrate culture and spirit can
greatly improve mental health.

Figure 1. Universal Design and Health

4.5.1 Universal Design

Universal design and health promote environmental quality, especially for the PWDs
(Person with Disabilities). Moreover, the provision of a beautiful built environment, including art,
music, and colours, and opportunities for social connection and spaces that celebrate culture Spirit
can have a significant positive impact on health.

Determine if requirements and

objectives are met
An integrated design process
weaves together diverse
disciplines.
Develop solutions that provide
Aesthetics various benefits while achieving
the organization's objectives

Focus on a lifecycle design

Figure. 2 Aesthetics

4.5.2 Aesthetics

An integrated design process weaves together the various disciplines that contribute to the
creation of a building. Several steps to keep this dialogue moving logically and the complete and
constructive participation of all design and delivery team members will ensure the best possible
outcomes.
 Cost and value engineering should be
applied throughout the project life
cycle.
environmental regulation to building
design, economic analysis integrates
into decision making.
Consider the aesthetics, historic
Cost-effective preservation, security, safety,
resilience, and sustainability benefits.

Continuously apply cost and value

engineering

Figure 3. Cost-Effective

4.5.3 Cost-Effective

Cost Management is used to balance a project's scope, quality expectations, and budget.
Project goals, building type, and client expectations will all influence the process. Considering the
economic analysis also helps to promote the integration of information into the decision-making
process.
 analyze the building's
components as a whole.
detect, containment,
control, and/or
extinguishment of a fire.
Protect Occupant Safety
Secure/Safe
and Health

Provide security for buiding

occupants and assets

Figure 4. Secure and Safe

4.5.4 Secure and Safe

Building fire prevention systems are designed using an integrated systems approach. This
technique enables architects and engineers to assess the entire structure as a fire protection system.
Inevitable accidents and diseases are caused by a lack of building plans and implementation.
Additionally, good secure building design impedes, detects, delays, and responds to robberies. It
also involves preventative steps to minimize damage and provides durability in case of assault.
 taking to an account for
functional and
psychological needs
satisfaction of the peoples
needs
Ensure appropriate system
Functional/Operational
integration

Meet its performance

objectives

Figure 5. Functional and Operational

4.5.4 Functional and Operational

Understanding a project's functional and physical requirements is critical to its success. A

client or owner must first identify a need, purpose, and desired outcome to develop a project. A
project is functionally successful when it meets its users' emotional, cognitive, and cultural needs
and the technical requirements of the programs it is building.

Programmable is designed for flexibility. A well-designed building comprises building

systems, materials, and technologies that work together as a "whole" system. Meeting performance
objectives requires a sustained effort from inception and planning through turnover and operation.
4.6 Conceptual Design

The clarity that conceptual design provides about what a product can do and what it is
intended to be used for is always the most critical aspect of the invention. It is vital when
developing a product, and if it is not done, the process will run into difficulties later. It aids in the
detailed description of the roles and requirements of various users, allowing the project to be better
understood from the beginning.

leads into an investigation

to modernize past
construction
to be able to know its story
from the past
master planning based its
Historic
towns original plan.

may bring up an array of

other opportunities for
usage and analysis

Figure. 1 Historic

4.6.1 Historic

Historical research of the site and its surrounding context can lead to discovering many
new and exciting avenues to pursue and explore. There is a story behind every area. That story
often leads to an investigation into how old building techniques are updated or how a new housing
development should be master-planned by the town's original plan.
 can be used to the
advantage ofconceptual
development.
to relate to the context of
the site
to evolve its form for
Vernacular
people

a skill transfer that unifies

the population

Figure 2. Vernacular

4.6.2 Vernacular

Buildings must relate to their surroundings. If your site has a moderate to vernacular solid,
based on the research from your site analysis, this can be an advantage during the conceptual
development phase of the project.
 to create an advantage
for the viewers
to define and shape the
building
to be able to know
Views
directly for the users

to quickly establish
where the site is located.

Figure 3. Views

4.6.3 Views

Taking advantage of the views from the site helps to assist in defining and shaping the
building's importance and priority in terms of levels of volume and stress. Key spaces will want to
take advantage of them, and functional areas should be set aside for this purpose as well. Aside
from it, how and where views are revealed and how the building opens should be the central design
view.
 to create its own micro
environment.
to be able to quickly
establish the public and
private areas
Public and Private to differentiate each spaces

DIfferent space, different

use

Figure 4. Public and Private

4.6.4 Public and Private

By performing site analysis, it should quickly determine where the public and private areas
are located. Depending on the type of building and the nature of the context, establishing this
concept early on can be a great project motivator.
 promotes vegetations

uses physical layout

to inform and shape
Physical Features
the proposed building,

uses site elements

Figure 5. Physical Features

4.6.5 Physical Features

Physical characteristics are the components of a site and include, but are not limited to,
water bodies, trees, plants, rock formations, and manufactured buildings. It is critical to identify
and have geographical and social characteristics of an area when designing or remodeling a mental
healthcare facility, enabling the clues to assist ground the patient and provide a feeling of
authenticity.
4.7 SOCIO-ECONOMIC EVALUATION

The socio-economic evaluation should assess the rationale for public intervention and the
most appropriate method for addressing that rationale. Concerning institutional arrangements, the
assessment should place a premium on determining whether the various agents have the proper
incentives to achieve the desired outcomes.

The primary goal of socioeconomic evaluation is to assist in designing and selecting

projects that benefit a country's welfare.

gather data on preferences

provides the distribution of
population
broad understanding of the
Demographic Structure
popluation

develop better
understanding to the public

Figure 1. Demographic Structure

4.7.1 Demographic Structure

The most fundamental demographic characteristic is the size of the population. Regardless
of the challenges inherent in measuring the size population, it is a crucial feature of a community
that significantly impacts its overall dynamics. People behave differently depending on their size.
 includes rates, deat and
migration
to be able to model and
study the size and age of
the population
occupancy of the specific
Population Dynamics
area

estiimation of the density

of population

Figure 2. Population Dynamics

4.7.2 Population Dynamics

The environmental, human population trends are significant, as they facilitate evaluating
the ecological impacts of human activities. Land, water, and energy supplies are all under
increasing strain as the world's population continues to grow.
 capital intensive and
high-cost investment
to support the system
and organziation
Infrastructure Direct access in an
Resources infrastructure

Primary use for the

community

Figure 3. Infrastructure Resources

4.7.3 Infrastructure Resources

Infrastructure Resources defines the communal use of the structure of the residents in cities
or a town. They focus on healthcare infrastructure in supporting equipment, access, information
technology, system and process, and sustainability initiatives.

Infrastructure is a factor that affects achieving the overarching goal of promoting higher
standards of care and well-being for all patients and a positive experience with the health care
system. The healthcare system and its personnel must support the population's effective health
promotion, prevention, and self-care.
 adapt behaviour conducive
to health
determine people's health

Human Health Status prevent variety of ailments

lessen the infection of virus

(COVID 19)

Figure 4. Human Health Status

4.7.4 Human Health Status

Human health status is monitored individually to help promote a healthy lifestyle—

especially in this current situation. Covid-19 has been rapidly spread all over the place. Lack of
healthcare providers hinders the health of the people. Impacts of the poor environment on public
health led to failure to cure the virus.

In addressing issues, several workshop participants stated that more comprehensive and
inclusive approaches to environmental health are needed that consider careful planning and justice
for health workers to obtain suitable forms of treatment and thus a better understanding of these
interconnections.
 Job Security
safety for
healthcare workers
Economic pay and financial
Attributes benefits

Leader support

Figure 5. Economic Attributes

4.7.5 Economic Attributes

The need to measure the social benefit of safety upgrades is growing. Four universal and
two context-specific safety qualities were found, covering health-related and non-health-related
aspects of security and safety.

The next phase will be to grade these qualities and integrate them into multiple case studies,
including different decision-makers, practical financial benefits, healthcare experts, leader
support, patients, and the general public.

4.8 Laws and Ordinances

The rule of law is essential since it guards against arbitrary judgments, ensures justice, and
averts tyranny and oppression. It constrains those in positions of authority. The government must
first exert control over the populace and then be compelled to exercise self-control.
4.9 Comprehensive Land Use Plan

It enables the local authority to communicate with various community sectors about how
it expects to satisfy the requirements of their land resources. Additionally, the Land Use Plan
envisions the local administration for the territory's land resources. These are the laws considered:
R.A 10121 “The National Disaster Risk Reduction and Management Act; R.A 7160 “The Local
Government Code of 1991”; P.D 933 & EO 648 of 1981; R.A 7279 or “The Urban and Housing
Development Act of 1992”; R.A 9279 “The Climate Change Act of 2009”. These laws permit
municipal governments to adopt comprehensive land use plans. Among other laws, these are the
following responsibilities of the LGU for managing and conserving their local resources.;

• C.A 141 (The Public Land Act)

• R.A 9593 (The National Tourism Act of 2009) Tourism development
• P.D 1076 (The Water Code of the Philippines)

Additionally, some regulations influence an LGU's ability to administer land use planning and
management services. These include the following:

• R.A 10066 (National Cultural Heritage Act of 2009)

• P.D 705 (The Revised Forestry Code)
• R.A 7586 (The NIPAs Act)
• R.A 8435 (Agricultural Fisheries Modernization Act)
• R.A 7942 (The Mining Act)
• R.A 8550 (Revised Fisheries Code)
• R.A 9003 (Ecological Solid Waste Management Act)

• Other Planning Guidelines:

• DENR
• DILG
• NEDA
 CLIENT USER PROFILE

5.0 Client

The Municipality of Merida has approved the proposed programs of Merida in 2021, including the
"Upgrading of Isolation Building" at the Upper Highway Merida Leyte. The government aimed for this
project to have immediate access to the facility so the users or patients will not have to travel to another
city to receive treatment. Because the pandemic already has taken place, it is mandatory to discuss plans to
build the structure as soon as possible.

Dra. Jane Grace Solana

Head Municipal Doctor

Dale Villamor Velvet Castillo Rhela Navarrete Perla Peteros Christine Eras
MIDWIFE MIDWIFE MIDWIFE MIDWIFE MIDWIFE

Cleo Judilla Iryl Sanchez Joy Valida Eddmerryl Ucat Famila Duhig
NURSE NURSE NURSE NURSE Nurse

Lalaine Pales
Med-tech

Figure 1: Organization Chart

5.1 Organizational Chart

This chart are the hierarchies containing the list of health workers. These health care practitioners
consist of doctors, nurses, midwifery’s, and medical technologists.
5.2 Vision

The vision of our Community Health Center is to be a model of excellence in collaboration with
our partner organizations. By providing high-quality, accessible medical services that exceeds patient
expectations, we will strive to be the best local hospital in our community.

5.3 Mission

Our mission is to provide comprehensive health care and preventative medical services to the
communities we serve. We are committed to maintaining high standards of service in order to treat patients
regardless of a patient's capacity to afford.

5.4 Objectives

The primary objective was to construct a health care facility on the Upper Highway Merida Leyte
for the community to have its health centre. Additionally, the isolation centre's infrastructure is built to
allow for direct access for COVID-19 patients. The structure demonstrates the integration of Merida's new
healthcare facility and is also designed to create additional job opportunities in the rural community.
Unfortunately, there were no future plans for the structure, as it was recently constructed.

5.5 USER CLIENT

Client users are important to have a better understanding to help look and identify for their
prospects. There are two types of users indicating these following:

• Out-patients

It is also called to as non-hospital care; this term refers to any service or treatment that does not
require hospitalization. Mainly, the out-patients are treated without being admitted to the hospital.

• In-Patient

Inpatient service refers to any service provided after a patient has been formally admitted to the
hospital. The patient can stay longer inside the hospital, depending on their health status.

Cooperation provided to other users (also referred to as health care workers) include those
administered by doctors, nurses, medical technologists, and other healthcare professionals. Additionally,
they lend a helping hand in maintaining secure, safe, and faster actions. Drivers, janitors, staff maintenance,
and a cook are among those employed.