Date of Award


Document Type


Degree Name

Master of Science (MS)


Architecture and Health

Committee Chair/Advisor

David Allison

Committee Member

Byron Edwards

Committee Member

Arelis Moore de Peralta


Primary Health Care Centers in Paraguay are the architectural settings for the first level of access to healthcare in Paraguay, providing health promotion, pre- vention, diagnosis, treatment, and health education. These centers are built based on four standard typologies, of which two consist of permanent health- care facilities and two of satellite or mobile units. Standard designs for these centers typically consist of residential scaled buildings, with spaces linked by a single central circulation corridor and lacking adequate attention to ventilation and daylight.

The public healthcare system in Paraguay is organized around four levels of care, and the complexity and nature of care at each level require different fa- cilities. The first level provides primary care services in small scale facilities designed to serve no more than 5000 people and aim to be the first point of access to public healthcare for the population, hence the importance of access to care throughout the country. Yet, Paraguay presents cultural and geographic particularities, along with infrastructure and investment limitations that chal- lenge access to care that the PHC model pursues. Many communities still lack access to primary healthcare and there remains a need to build new primary care centers or replace existing facilities.

Current design prototypes for Primary Healthcare Centers do not adequately enable the effective and efficient delivery of culturally relevant patient and com- munity centered care. Hence, they do fulfill their intended role in the Healthcare System’s integrated network. This study aims to identify those issues and de- fine which ones can be addressed through architecture.

The primary objective of this thesis is to design a prototype for a Rural Primary Healthcare Center in Paraguay which considers the physical, cultural, and normative context to support the provision of effective and efficient care. It proposes that Primary Healthcare Centers should have a standardized program with a customizable design that can utilize local labor, materials and traditional construction sys- tems that do not require additional training, or extra cost and time expenditure.

Primary Healthcare Centers should also provide spaces to support community health and wellbeing with site design features that support healthful community activities and providing pleasing natural settings for patients, staff and the community.

A literature review, and an architectural review of relevant case studies, helped inform best practices that are organized in eight design guidelines that include climatic and cultural responsiveness, flexibility, and resilience. The guidelines provide guidance in support of designing comfortable, appropriate spaces for the engagement of both patients and staff.

Research into existing documentation on primary healthcare centers in Paraguay and the evidence collected resulted in a proposal for a new prototype program and site selection criteria based on local codes but that also incorporates best practice features observed in similar case studies from Latin America to significantly improve performance and enhance the experience of the patients and staff.

The design proposal in this thesis serves as an example to illustrate how the design guidelines could be utilized toward to the design of a Primary Health care Center in Paraguay. It accommodates clinic, administrative, and support areas and pays special attention to the natural areas surrounding the building, considering the existing vegetation as an essential part of the response to cli-matic conditions. The material and construction systems are carefully chosen based on the guidelines and the cultural and physical context analysis.



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