history of hospital and bangladesh
TRANSCRIPT
Hospital design
Contents• What is Hospital?• Types of Hospital• History of Hospital (Ancient period, Medieval period, Colonial period, Modern period, Contemporary work)• History of Hospital in subcontinent (Gautama Buddha , Caraka, King Asoka, South India, Bengal)• History of Hospital in Bangladesh (Ancient, colonial, pre independent, Bangladesh)• Government policies in Health sector
What is Hospital ?
The word hospital is derived from the Latin adjective Hospitals, which belongs to the noun hopes meaning host or guest. A hospital, in the modern sense of the word, is an institution for health care providing patient treatment by specialized staff and equipment,
and often, but not always providing for longer-term patient stays. Its historical meaning, until relatively recent times, was "a place of hospitality"
Types of Hospital
General Hospital Specialized Hospital Teaching Hospital Clinics
General Hospital
General hospitals are general in the sense that they admit all types of medical and surgical cases.
They concentrate on patients with acute illness needing relatively short-term care.
Faridpur general hospital
Types of Hospital
Specialized HospitalSpecialized hospitals, in contrast, may concentrate on a particular group of patients, such as children, or a disease, such as cancer
Dini-Townsend State Psychiatric Hospital, Reno Nevada
Types of Hospital
Teaching Hospital
A teaching hospital combines assistance to patients with teaching to medical students
Khulna Medical College ,khulna
Types of Hospital
Clinics
A medical facility smaller than a hospital is generally called a clinic
Atomic Energy Hospital ,Chitagong And Rajshahi
Types of Hospital
Ancient period
Modern period
Colonial period
Contemporary work
Medieval period
history of Hospital
Chronological development of hospital
B.C.--500 A.D.
500 –1500
1500 –1750
1750 –1960
1960 –present
Ancient period
The earliest documented institutions aiming to provide cures were Egyptian temples
The first teaching hospitalwas the Acadamey of Gundishapur in the Persian.
“to a very large extent, the credit for the whole hospital system must be given to Persia"
B.C.--500 A.D.
500 –1500
1500 –1750
1750 –1960
1960 –present
Chronological development of hospital
Healer god asclepious , known as AsclepieiaShrine,(about 350 b.c.) patients would enter a dream –like state of induced sleep know as Enkoimesis
View of the Askleipion of Kos, the best preserved instance of an Asklepieion..
Healer-God Asclepius
B.C.--500 A.D.
500 –1500
1500 –1750
1750 –1960
1960 –present
Chronological development of hospital
(437 BC to 367 BC) earliest documentary evidence we have; Mihintale Hospital is the oldest in the world.
King asoka is said to have founded at least eighteen hospitals in 230 B.C.
The romans created valetudinaria for the care of sick slaves, gladiators, and soldiers around 100 B.C., and many were identified by later archeology.
In 325 A.D. urged the Church to provide a hospital in every cathedral town.
B.C.--500 A.D.
500 –1500
1500 –1750
1750 –1960
1960 –present
Chronological development of hospital
Findings
The hospital forms closely resembled the forms of the temple
B.C.--500 A.D.
500 –1500
1500 –1750
1750 –1960
1960 –present
Chronological development of hospital
Medieval period
The first psychiatric hospital was built in Baghdad in 705.
The public hospital in Baghdad was opened during the 8th century.
Islamic World
The Al-Qairawan hospital and mosque, in Tunisia, were built under the Aghlabid rule in 830
B.C.--500 A.D.
500 –1500
1500 –1750
1750 –1960
1960 –present
Chronological development of hospital
Bayezid 2 Complex, turkey
B.C.--500 A.D.
500 –1500
1500 –1750
1750 –1960
1960 –present
Chronological development of hospital
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2
3
5 4
6
20 30 m1050
Educational area hospitalization
Plan of 13th century CE al-Mansuri hospital, Mamluk Cairo,
Al-Mansuri hospital, Mamluk Cairo
B.C.--500 A.D.
500 –1500
1500 –1750
1750 –1960
1960 –present
Chronological development of hospital
Administrator Educational area hospitalization
Medieval period Europe World
Medieval hospitals in Europe followed a similar pattern to the Byzantine
The church at Les Invalides in France
B.C.--500 A.D.
500 –1500
1500 –1750
1750 –1960
1960 –present
Chronological development of hospital
Findings
The rational process of thought were reflected in the plan
Order and clarity became evident
Clear patterns of circulation were delineated and attention was paid to functional groupings
The clarity was lost during the mediaeval Christian period
B.C.--500 A.D.
500 –1500
1500 –1750
1750 –1960
1960 –present
Chronological development of hospital
Colonial period
The oldest was the Immaculate Conception, now the Hospital de Jesús Nazareno in Mexico City, founded in 1524 to care for the poor.
B.C.--500 A.D.
500 –1500
1500 –1750
1750 –1960
1960 –present
Chronological development of hospital
University of Pennsylvania Health System ("Penn Health System"). Founded in 1751
University of Pennsylvania,1751
B.C.--500 A.D.
500 –1500
1500 –1750
1750 –1960
1960 –present
Chronological development of hospital
Findings
The rational process of thought were reflected in the plan
Order and clarity became evident
B.C.--500 A.D.
500 –1500
1500 –1750
1750 –1960
1960 –present
Chronological development of hospital
Modern period
In Europe the medieval concept of Christian care evolved during the sixteenth and seventeenth centuries into a secular one, but it was in the eighteenth century that the modern hospital began to appear
Guy's Hospital was founded in London in 1724 Chronological development of hospital
B.C.--500 A.D.B.C.--500 A.D.
500 –1500
1500 –1750
1750 –1960
1960 –present
Kent, Swanley, Westminster Hospital
Westminster Hospital
B.C.--500 A.D.B.C.--500 A.D.
500 –1500
1500 –1750
1750 –1960
1960 –present
Chronological development of hospital
The Vienna General Hospital is the University medical center of the city of Vienna
The Vienna General Hospital,veinna
B.C.--500 A.D.B.C.--500 A.D.
500 –1500
1500 –1750
1750 –1960
1960 –present
Chronological development of hospital
Chronological development of hospital
Findings
Hospital planning treated on a functional and scientific basic
Patients into small groups and ensuring natural light and ventilationFunctional requirements could be satisfied by achievements in constructions and
mechanical services
Clarity in the plan, patterns of circulation were delineated, functional groupings assembled
Over all greater respect shown for human dignity
B.C.--500 A.D.B.C.--500 A.D.
500 –1500
1500 –1750
1750 –1960
1960 –present
• The hospital from the turn of the century to the present day has seen the architectural forms of the hospital change horizontal to vertical
• The recent concept of progressive patient care
Contemporary work
Chronological development of hospital
B.C.--500 A.D.
500 –1500
1500 –1750
1750 –1960
1960 –present
Institute Saint Pierre Palavas-les-Flots, France architect: Jerome Brunet & Eric Sauner
Chronological development of hospital
B.C.--500 A.D.
500 –1500
1500 –1750
1750 –1960
1960 –present
Chronological development of hospital
Administrator Technical area Educational area hospitalization
B.C.--500 A.D.
500 –1500
1500 –1750
1750 –1960
1960 –present
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B.C.--500 A.D.
500 –1500
1500 –1750
1750 –1960
1960 –present
Chronological development of hospital
Semi-outdoor spaces
Agatharied HospitalMunich, GermanyNickl & Partner Architecten Gmbh
Chronological development of hospital
B.C.--500 A.D.
500 –1500
1500 –1750
1750 –1960
1960 –present
Semi-outdoor spaces
Chronological development of hospital
Administrator Technical area Educational area hospitalization
B.C.--500 A.D.
500 –1500
1500 –1750
1750 –1960
1960 –present
Goutama Budhha , Sri Lanka
Bengal
South India
Caraka, King Asoka,
600 B.C. – 300 B.C.
300 B.C. –100 B.C.
1000 A.D.
1100 A.D.
1960 --
history of Hospital in subcontinent
Chronological development of hospital
1000 A.D.
3000 B.C. Indus Valley Civilization- Use of herbs as healing sources.
Goutama Budhha (563-483 B.C.)
First structured systematic thought about medicine- Golden Age of Ayurveda.Sick room - for formal medical care of the monks.
King Pandukabhaya (437-367 B.C.), Sri Lanka
1st Institution for the care of the sick.Mihintale Hospital is the oldest in the world.
600 B.C. –300 B.C.
300 B.C. –100 B.C.
1100 A.D.
1960 --
history of Hospital in subcontinent
Chronological development of hospital
600 B.C. –300 B.C.
1000 A.D..
Caraka (300 B.C.)
Caraka’s compendium- a text with which classical medicine in India really begins. - a text about constructing hospitals, and how it should be equipped.
King Asoka(304 -232B.C.)
Built 18 hospitals in India, For people and animal.Ayurvedic continued to flourish in this period. Where there were no healing herbs, he ordered that to be bought and planted.
600 B.C. –300 B.C.
300 B.C. –100 B.C.
1100 A.D.
1960 --
history of Hospital in subcontinent
Chronological development of hospital
1000 A.D..
Caraka (300 B.C.) , King Asoka(304 -232B.C.)
Asoka and caraka’s theory together made worlds first organized cosmopolitan system of institutionally based medical provision. in 300-450 A.D. Asoka’s ‘Health Hall’ was founded by excavation- 8 km from modern Patna. The building had- 4 rooms of varying size, with walls of fire baked bricks and a brick floor.
600 B.C. –300 B.C.
300 B.C. –100 B.C.
1100 A.D.
1960 --
history of Hospital in subcontinent
Chronological development of hospital
1000 A.D..
South India (Late 11th century A.D.)
Hospital in South India was provided with 15 beds.
600 B.C. –300 B.C.
1100 A.D.
1960 --
history of Hospital in subcontinent
Chronological development of hospital
1000 A.D..
Bengal (12th century A.D.)
Location for highly developed cultures of medical practice for a millennium.Earliest institutional medical centers in South Asia connected with Buddhist monarchies were well established in Bengal and Bihar.
600 B.C. –300 B.C.
1100 A.D.
1960 --
history of Hospital in subcontinent
Chronological development of hospital
Ancient Bengal
Post Independence
Pre Independence
Colonial Period
1960 --
history of Hospital in Bangladesh
Chronological development of hospital
500 -1500A.D..1757-1947 A.D..
1947-1971 A.D..
1971 A.D.-Present
Ancient Bengal
Ayurvedic was the popular form of treatment.It was developed under the Muslim rulers.
1960 --
history of Hospital in Bangladesh
Chronological development of hospital
500 -1500A.D..
Colonial Period (1757-1947)
-After British colonized India- western form of medicine took roots. Since then it became to be recognized officially.-At the same time, Ayurvedic was popular.-From 19th century delivered health care through the local authorities.-Established dispensaries- then developed to hospitals. For example- Pabna and Serajgong hospital were first established as dispensaries.
1960 --
history of Hospital in Bangladesh
Chronological development of hospital
1757-1947 A.D..
Pre Independence
Facilities for rural poor population- established 1200 dispensaries.By 1971- eight medical colleges and specialized hospitals were established.Example- mental hospital in Pabna, Seato cholera research laboratory and hospital, etc.Established- sub divisional and district hospitals.Private sector started- Islamia Eye Hospital.
1960 --
history of Hospital in Bangladesh
Chronological development of hospital
1947-1971 A.D..
Post Independence
More hospitals were established- like Pongu hashpatal, Shishu hospital, Soharawardi hospital.More specialized hospitals were established- BARDEM, N.I.C.V.D. etc.Development in private sector to prevent people moving abroad for better health care. For example- specialized hospitals and clinics were in the country.More training facilities for health care personnel.New institute for post graduate studies, research and specialization.Support for the development of traditional medicine.
1960 --
history of Hospital in Bangladesh
Chronological development of hospital
1971 A.D.-Present
history of Hospital in Bangldesh
Chronological development of hospital
Name of medical college Hospital
Year of establishment
Colonial Pre Independence
Post Independence
Sir Solimullah 1875 .
Mymensingh(Lytt-on school)
1924 .
Dhaka 1946 .
Ctittagong 1957 .
Rajshahi 1958 .
M.A.G. Osmani 1962 .
history of Hospital in Bangldesh
Chronological development of hospital
Name of medical college Hospital
Year of establishment
Colonial Pre Independence
Post Independence
Sher-E-Bangla 1969 .
Rampur 1970 .
Dinajpur 1991 .
Khulna 1991 .
Comilla 1992 .
Ziaur Rahman, Bogra
1992 .
Armed Forces 1999 .
history of Hospital in Bangldesh
Chronological development of hospital
Name of medical college Hospital
Year of establishment
Colonial Pre Independence
Post Independence
noakhali 2008 .
Coxs bazar 2008 .
Recent Hospitals in Bangladesh
Recent Hospitals in Bangldesh
Chronological development of hospital
Square Hospital West Panthapath, Dhaka.
Type- General Hospital Bed No- 300
Roof top garden
Cabins
Recent Hospitals in Bangldesh
Chronological development of hospital
United Hospital Gulshan -2, Dhaka.
Type- General Hospital Bed No- 450
Main lobby area
Space between cabins Roof top gardens
Government policies in Health sector
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Health care in Bangladesh
• The Ministry of Health and Family Planning was responsible for developing, coordinating, and implementing the national health and mother-and-child health care programs
• Population control also was within the purview of the ministry
• Government efforts toward infrastructure development included the widespread construction of rural hospitals, dispensaries, and clinics for outpatient care
• In the late 1980s, government health care facilities in rural areas consisted of sub district health centers, union-level health and family welfare centers, and rural dispensaries
• A sub district health center in the mid-1980s typically had a thirty-one-bed hospital, an outpatient service, and a home-service unit staffed with field workers
Health care in Bangladesh
• As of 1985 there were 341 functional sub district health centers, 1,275 rural dispensaries (to be converted to union-level health and family welfare centers), and 1,054 union-level health and
family welfare centers. The total number of hospital beds at the sub district level and below was 8,100.
• District hospitals and some infectious-disease and specialized hospitals constituted the second level of referral for health care. In the mid-1980s, there were 14 general hospitals (with capacities
ranging from 100 to 150 beds), 43 general district hospitals (50 beds each), 12tuberculosis hospitals (20 to 120 beds each), and 1 mental hospital (400 beds).
• Besides these, there were thirty-eight urban outpatient clinics, forty-four tuberculosis clinics, and twenty-three school health clinics. Ten medical college hospitals and eight postgraduate
specialized institutes with attached hospitals constituted the third level of health care.
• In the mid-1980s, of the country's 21,637 hospital beds, about 85 percent belonged to the government health services.
• There was only about one hospital bed for every 3,600 people
53
Significant progress in the health outcomes and some of the major gains have been achieved through low-cost solutions
54
Reversing past trends, women now live longer than men.
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CHALLENGES
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Bangladesh’s current challenge is to improve effective service delivery, health sector governance (especially in primary and maternal health services), and increase the
number of trained birth attendants.
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Threats of HIV/AIDS, particularly from injectable drug users, pockets of malaria, kal-azar and filaria and multi-drug resistant TB are also emerging as challenges.
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• Arsenic related diseases• Avian flu
• Childhood disabilities• Mental health problems
• Road-railway-river accidents and• Violence (particularly against women).
59
Meeting the health needs of the fast growing urban poor including the slum dwellers will continue to pose major challenge.
60
• Strategies to handle the large number of informal semi or un-qualified health care providers (village doctors, drug sellers, kobiraj, totka, herbalist, faith healers,
untrained traditional birth attendants etc)
GOVERNMENT POLICIES
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Child Health:
• Expanded Programme on Immunization (EPI) will be further strengthened • Introduction of hepatitis B vaccine throughout the country
• School health programmes will be further strengthened. • The integrated management of childhood illness (IMCI) program will be further expanded.
63
Maternal and Reproductive Health:• The on-going national nutrition programme will continue to cater to the need of adolescents as its
special target groups.
• Comprehensive emergency obstetrical care (EmOC) facilities will be expanded by establishing such facilities in more upazila health complexes.
• More community skilled birth attendants (SBA) will be trained.
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Control of Communicable Diseases:
• The existing programs will be further expanded and strengthened to intensify prevention and control of communicable diseases (CDs)
• Special measures will be initiated for combating tuberculosis, leprosy, malaria, filariasis and kal-azar, which are concentrated in specific pockets of the country.
Control of Non-communicable Diseases:
• Provide services for the control of unhealthy diet and lifestyle related major NCDs like – cardiovascular diseases, cancer, diabetes, mental illness, hypertension, asthma, blindness,
• NCDs will further be expanded and strengthened to increase access of all to health care services.
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Control of Emerging Threats:
• Existing counseling and treatment services for mental health, drug abuse, avian flu, STD and HIV/AIDS, arsenic diseases, injuries, trauma sufferers, women and child victims of violence,
road-railway-river accidents, etc.
• Would be improved and introduced where not available.
• Ongoing emergency preparedness and response program will be further strengthened to manage the disasters like flood, cyclone, tornado, Sidr etc. By 2021
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Urban Health Services: • The existing practice of providing urban primary health care (UPHC) services through contracted
NGOs for the city corporations and selected municipalities under the LG Division will continue to be pursued
• MOHFW will continue to provide Primary Health Care (PHC) services in urban areas not covered by the UPHC project.
• The establishment of an ‘Urban Health Unit’ in each Division would be considered.
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Affordable Health Care Services:
• Existing system of affordable health care services will be further expanded and consolidated ensuring proper safety net for the poor.
• Facilities providing health care outside the public sector (but receiving government fund) will ensure that at least 30 per cent of their all types of services are kept for free treatment
for those who cannot pay.
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Community Clinics:
• The government is committed to reactivate 10,723 community clinics (CCs) which were established during 1996-2001. The MOHFW will run at least 8,000 CCs under government
management.
• The government plans to establish 18,000 CCs in phases to deliver maternal and child health care including family planning services and limited curative care.
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New initiatives in health governance include:• Consolidation of public-private partnership in management of health services;
• Citizens charter for health service delivery;• Better regulation of the non-public health care providers;
• Better monitoring in medical colleges and specialized hospitals for ensuring management efficiency and establishing increased attention to patients;
• Decentralization of health administration; and• Formulation of national health policy.
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Structure, Health care In Bangladesh
Rural Community clinicsNutritionHealth educationStrategy planning for unqualified health care providersExpanded Program on Immunization Ongoing emergency preparedness and response program
Sub urban Community clinicsNutritionHealth educationStrategy planning for unqualified health care providersExpanded Program on Immunization Ongoing emergency preparedness and response program
Urban Community clinicsNutritionHealth educationMedical collegeGeneral HospitalSpecialized health careExpanded Program on ImmunizationOngoing emergency preparedness and response program
Administrative level Health facilities Cadre Level of careNational Level • National and regional training centers
• Model clinicsDG line directors, programmanagers, trainers
Tertiary
District Level • Model clinics• Maternal Child Welfare Clinics (MCWC)• district hospitals (MCH-FP clinics)• regional trainings centers
DGFP, additional Director orMedical Officer, clinicalcontraception
Tertiary
Upazila Level • MCH-FP units• MCWC
Family Planning OfficersMedical Officer-MCH
Secondary
Union Level • Union Health and Family Welfare Centers• Rural dispensaries• MCWC
Family Welfare Visitor, SACMO,Family Welfare Assistant, FamilyPlanning Inspector
Primary
Peripheral Level • Satellite Clinics• Domiciliary Services
Family Welfare Assistant Community/primary
MCWC = Maternal Child Welfare ClinicsMCH-FP = Maternal Child health-Family Planning
DGFP = The Directorate General of Family Planning
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Structure, Health care In Bangladesh
• Child Care
• Maternity Care
• Communicable diseases care and public awareness
• Cheap medical assistance for Non-communicable diseases
• Emergency for epidemic diseases and natural disasters (like SIDR, flood etc.)
• Training facilities for family planning and Nutrition
• Treatment services for mental health, drug abuse, avian flu, STD and HIV/AIDS, arsenic diseases, injuries, trauma sufferers, women and child victims of violence, road-
railway-river accidents
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Thank you