Hesperian Health Guides

Low-cost ideas to make health center and hospital buildings easier to use

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HealthWiki > A Health Handbook for Women with Disabilities > Chapter 2: Organizing for disability-friendly health care > Low-cost ideas to make health center and hospital buildings easier to use

Buildings can be designed to welcome all people or to keep some people out. It is amazing what a few good pathways, ramps, handrails, staircases with shorter steps, lifts (elevators), larger toilets, or floors that are not slippery can do to make it easier for people to get in and use any building.

Handrails (or ropes)

Handrails or ropes along pathways leading to a building and along the walls inside will help people who are blind, or who have balance problems or difficulty walking, to get in and find their way around.

women with disabilities entering a health center, using a ramp and a roped pathway.
Roped pathways and smooth road surfaces with textured edges make areas around health centers easy to use. Textured edges can help women who are blind or do not see well.


a woman pressing down on a door handle with her arm that has no hand.

A door handle is easier to use than a round door knob. People who cannot easily move their hands can often press down on a handle. Most people who use wheelchairs also find handles easier. And anyone who is carrying something will always find a door handle easier to open.

You can change a door knob into an easy-to-turn door handle by welding a metal plate onto the door knob. Put the handle low enough for easy reach by someone of small stature or someone who uses a wheelchair.

If a door is hard to open, you can use oil, grease, or candle wax on the hinges. Then the door will swing more easily.

Also, doors sometimes do not leave space to move a wheelchair into a room. If the space is small, such as in a toilet, try to make sure the door opens out into the bigger space or room. When a door swings into the smaller room, it can make it hard for someone to move in and out of the room or space. Sometimes, doors can be made to slide if space is limited.

The doorway itself should be wide enough for a person in a wheelchair to pass through. It should leave enough space for her wheelchair and her hands on the wheels.

a woman in a wheelchair unable to enter a latrine with the door opening inward.
a woman in a wheelchair entering a latrine with the door opening outward.
Often you can change the hinges on a door so it opens the other way.

Build ramps

Ramps make it easier for many people to get in and out of buildings and public places such as health centers, schools, and libraries. Ramps not only help wheelchair users, they also help people who have a hard time walking and people with temporary injuries.

a boy pushing a woman in a wheelchair up a ramp that is too steep.
too steep
a woman pushing herself in a wheelchair up a ramp that is not too steep.
This ramp is 4 times as long as it is high. It is too steep for most people to use, except for short distances. Ramps can be between 8 to 12 times as long as they are high. This ramp is 12 times as long as it is high. This slope is easier for people who use wheelchairs.


a box seat with a hole in the center placed over a basin on the floor.

If you use a wheelchair, toilets should have enough space for you to move around and transfer from your chair onto the toilet seat. It is easiest for you to get onto the seat if the toilet is at the same height or a little lower than your wheelchair seat. If there is not a seat (in a squatting toilet or latrine), or if the seat is too low, you can make a simple box seat with hand-holds and an opening. You can also put a bar or a hand-hold on the wall so you do not fall.

Hospital beds

a woman with a crutch trying to get onto a high bed with rolling wheels.

Many people, not just people with disabilities, complain that hospital beds are difficult to get onto. These beds are usually higher off the ground or floor than the beds people sleep in at home. It is easier for health workers to take care of sick people if they do not have to bend down to reach them in a lower bed.

a woman with a crutch getting onto a low bed without wheels.

But when people are sick or disabled, getting onto a high bed can be very difficult. And because the beds usually also have wheels, it can be dangerous, because the bed can start to roll away from the person who is trying to get onto it.

If some beds in a health center have no wheels and are low to the ground, everyone could choose the bed that works best for them.