Adjaye Associates has revealed design for a major initiative, Agenda 111, a project will transform Ghana’s district hospitals in 101 locations in different urban and rural settings across the country.  

Called Agenda 111, the project will incorporate 111 Hospitals, including 101 District Hospitals, 2 Psychiatric Hospitals, 7 Regional Hospitals and the Redevelopment of the Accra Psychiatric Hospital.  

Commissioned by the Hospital Infrastructure Group (HIG) on behalf of the Ghana Government, Adjaye Associates is responsible for the design of the district hospitals. The project has broken ground yesterday at the official sod cutting ceremony in Ghana’s Ashanti Region.

Central Courtyard

The District Hospitals aims to transform Ghana’s medical system by establishing unparalleled access to healthcare facilities throughout the country.  

Guided by the ambition to define a next-generation hospital experience, the design concept merges 21st century technology with a contextual and holistic approach crucial to the delivery of state-of-the art healthcare. 

 Aerial View Multiple Locations

"By approaching the hospital as more than just a place for the provision of medical services, the design scheme aims to unlock the potential of this ambitious initiative by repositioning the hospital as a piece of community infrastructure that embodies sustainability, efficiency, and generously provides green spaces to facilitate wellness and healing," said David Adjaye. 

"Agenda 111 is part of a massive vision for Ghana’s healthcare sector, the realization of which will lead to Ghana becoming a Centre of Medical Excellence and a destination for medical tourism," said President Nana Akufo-Addo. 

Each hospital facility will be designed as a single-story campus including patient reception & processing, administration, pharmacy, labs / diagnostics, OPD, physiotherapy, public health, A&E, surgical ward, pediatric ward, maternity ward, isolation ward and surgery. 

The primary care facilities will be supported by other structures like mortuary, waiting pavilions, security pavilions, residences for families and doctors (separated), laundry, waste management, energy centre, kitchen, central store, and maintenance yard.

Main Canopy Entrance

"Unlocking the centuries old wisdom of the Adinkra symbols, our design sought inspiration from the Denkyem, which symbolizes a crocodile—a creature able to thrive with both air and water that is celebrated for its adaptability and intelligence," said Adjaye associates. 

Each building design will be adapted to over 101 locations in different urban and rural settings across the country, the design scheme will incorporate smart strategies and ecologically responsive systems to able to conform to each unique geographic condition. 

The hospitals, covering a total of 8,500-square-metre area, will be made of prefabricated systems that work conductively with materials to maintain the lowest possible carbon footprint whilst also maximizing the ability to reproduce efficiently and rapidly.

"Departing from the assumed poor industry standards of hospitals where visitors often feel lost on arrival, the form of the building becomes a tool for wayfinding with a defined canopied entrance that guides you into the heart of the building," added Adjaye associates. 

By creating a language of clustered horizontal and vertical bars, Adjaye Associates-designed buildings branch out from a central spine that is activated by a central garden and a series of nature-filled public spaces. 

Patient Ward

Each building will feature a lush landscaping that can be easily identified within the center of the single story campus, as the team says, "the introduction of public gardens departs from the status quo of hospital design where all spaces are entirely enclosed and sterile." 

Instead, the central garden and the ancillary green spaces are punctuated in the plan and provide an overall atmosphere of healing crucial for patients. 

The architects placed the patient ward at the outermost perimeter along the rear of the building to ensure natural light and open-air flow, crucial for health and healing. 

Designed for their specific functionality, the building’s are differentiated through their roof structures: gable or butterfly. For programmes such as the patient wards, the Butterfly Roof is used to maximize the amount of natural light and cross ventilation resulting in less energy consumption for artificial lighting and excessive mechanical cooling.

Public Garden and Circulation

While the patient wards will receive maximized light and airflow, other spaces such as surgery will be a more controlled environment. 

As the architects emphasize, "in these instances, the Gable Roof typology is deployed," and as they say, "this ensures minimum exposure to the natural elements using the roof’s long overhangs to protect against the sun’s rays and provide shade on the building envelope." 

Although there will be differences in the roof structures, both types will effectively harvest rain water and provide an insulated shell to minimize heat gain on the building interiors.

Axonometric drawing

Building Diagrams

East Facing Cross Section

North Elevation

Adjaye Associates will work with Accra-based architecture practice Sutherland & Sutherland Architects on this project, Sutherland & Sutherland Architects will be working as design coordinator. Brix Landscaping will be responsible for landscape design of the project.

Project facts

Architect: Adjaye Associates

Design Coordinator: Sutherland & Sutherland Architects

Biomed: Titan Biomedical Engineering 

Gross building area: 8,500m2  

Contractor: Varies 

Electrical Engineer: Global Engineering & Technology 

Kitchen Consultant: Smollensky’s

Hospital Consultant: Ministry of Health

Landscape: Brix Landscaping

Mechanical Engineer: Global Engineering & Technology

QS: CC&M Consult Ltd.

Signage: Mainline

Structural & Mechanical Engineer: CSEng

Top image: Dusk Aerial View

All images & video courtesy of Adjaye Associates.

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