Incorporate public health guidelines into public works, Health PS urges architects

Public Health PS Mary Muthoni. [Courtesy]

Architects have been urged to adhere to the Ministry of Health construction guidelines to reduce deaths attributed to an unhealthy environment.

 According to Principal Secretary, State Department for Public Health and Professional Standards, Mary Muthoni, built environments are a critical tool for public health promotion and primary disease prevention.  

Speaking during the Board of Registration of Architects and Quantity Surveyors (BORAQS) forum, Muthoni reiterated that the structures built, such as homes, schools, hospitals, and public facilities, were the very foundation of the nation's public health.  

“We must acknowledge that human beings spend nearly 90 percent of their time indoors. Because of this reality, our built environment is not merely about structures and aesthetics; it is fundamentally about life, health, safety, and dignity. The choices our architects, quantity surveyors, and engineers make today directly influence the health outcomes of future generations,” she noted.

While urging the architects to focus on ‘preventative Infrastructure,’ the Ps said the World Health Organization data, which indicated that an estimated 12.6 million deaths globally are a result of an unhealthy environment and hence the need to integrate public health into the architectural and public works

 “We see the impacts in our own communities, where congested settlements accelerate the spread of communicable diseases, and inadequate drainage systems contribute to flooding and waterborne illnesses. Furthermore, poorly ventilated classrooms affect our children's learning outcomes, and poorly designed hospitals compromise patient safety,” she noted.

She added, "Evidence consistently demonstrates that public health interventions generate a median return on investment of 14 dollars for every dollar invested. Furthermore, community prevention programs have been shown to save up to 5.6 dollars in future healthcare costs for every dollar spent.”

Muthoni told the professionals that investing in healthier environments, safer housing, sanitation, and resilient infrastructure would create long-term national savings and would not incur expenses.

She underscored the need for professionals to prioritize human-centered designs and ensure that the country’s national infrastructure supports and strengthens human health and well-being rather than merely focusing on utility or visual appeal.  

“We must prioritize natural lighting, proper ventilation, thermal comfort, safety, and acoustics in all our public works.  Accessibility must never be treated as an afterthought. Our transport systems, health facilities, and public spaces must equitably serve all users, including children, women, older persons, and persons living with disabilities,” she said.

 She added that there was a need to evaluate building materials not only for cost efficiency but for their impact on indoor air quality, environmental sustainability, and climate resilience and urged builders to embrace emerging concepts like trauma-informed and neuro-inclusive design.  

“Strengthening our nation's health outcomes requires seamless coordination between public health professionals, architects, engineers, planners, quantity surveyors, and policymakers. I challenge you to move beyond mere compliance and actively integrate health and well-being principles into every stage of project delivery,’ she said.

 Simultaneously, Muthoni said there was a need to address the gaps between the public health and the public works, which she said operated in functional silos.

She noted that while public works is treated as an engineering and economic challenge, public health is treated as a medical challenge, noting that while the National Environment Management Authority (NEMA) enforces Environmental Impact Assessments (EIAs) before construction, there is no equivalent mandate for Health Impact Assessments (HIAs).

 “Building approvals by County Governments often prioritize zoning and structural integrity over public health outcomes (e.g., adequate cross-ventilation, natural lighting, and sanitation infrastructure,” she said.

She said there was a need for the Ministry of Health, in collaboration with the State Department for Public Works and the Council of Governors (CoG), to mandate that architectural approvals explicitly meet promotive and preventive health standards.

 At the same time, Muthoni said the ongoing Affordable Housing Program designs should incorporate public health metrics to address poor drainage, lack of sanitation, and severe congestion, which are largely experienced in slum areas.

“The Board of Registration of Architects and Quantity Surveyors (BORAQS) and the Engineers Board of Kenya (EBK) must enforce strict climate-resilient building codes. Infrastructure must be designed to absorb climate shocks without compromising the sanitation and safety of the surrounding population,” she said.