Clinic of Care in Tanzania
Maternity and community health center
Clinic of Care in Tanzania
Maternity and community health center
By Vedhant Maharaj - University of Johannesburg, Johannesburg, South Africa; Meriem Chabani - New South, Paris, France; Stefan Novakovic - DIALOG Design, Toronto, Canada; Twaha Kyomuhendo - REGENESYS Architects, Kampala, Uganda
Situated on the foothills of Mount Kilimanjaro in northern Tanzania, the village of Nkweshoo is an idyllic rural setting. Framed by lush, vivid greenery and a majestic view of the snow-capped dormant volcano, the village is located at the heart of a region famed for its ecology and rich cultural heritage.
As in many rural communities across Sub-Saharan Africa, however, local healthcare infrastructure struggles to meet the needs of the community. The small medical center and dispensary that serves the village offers a vital yet critically under-resourced amenity. Access to women’s healthcare and childbirth services is hindered by an acute shortage of appropriate (and culturally responsive) space and equipment.
To help address a longstanding community need, a trio of young architectural practitioners are working with community members to expand Nkweshoo’s existing dispensary and maternity facility to improve the quality of care and childbirth services. Funded by the recently launched Holcim Foundation grant program, the Clinic of Care: Tanzania project led by Holcim Foundation Next Generation Ambassadors Meriem Chabani, Twaha Kyomuhendo and Vedhant Maharaj with Stefan Novakovic is undertaken in partnership with Tumbili, a local NGO that has been providing ad hoc financial aid and healthcare volunteers to the Nkweshoo community since 2017.
Improving local healthcare infrastructure
Clinic of Care: Tanzania responds to a long-established community need, expressed through years of advocacy for an expanded healthcare complex. Nkweshoo’s existing dispensary comprises two barrack-like structures that do not provide adequate daylight, ventilation, or sanitation – a reality reflected in local birthing practices. In 2022, 85 women gave birth in the maternity building, while 150 had to be redirected elsewhere. However, the nearest hospital is located in another valley, a considerable journey via a road which may be blocked to traffic depending on the season. Meanwhile, larger urban hubs are several hours away by flight.
Now underway, the project is rooted in a deep understanding of local context and culture. In the spring of 2023, Kyomuhendo and Maharaj conducted a site visit, working closely with community members and healthcare providers to understand needs and priorities, while also undertaking an assessment of the built environment and site context. The dispensary staff identified the need for an additional dedicated childbirth facility, as well as four new rooms for patients in pre- or post-natal observation. Moreover, locals have stressed the importance of a comfortable, dignified setting that embraces the cultural meaning attached to childbirth.
A plan and local partnerships
With a preliminary site plan and project scope now identified, Chabani, Kyomuhendo and Maharaj are partnering with a group of architectural faculties as well as Tumbili to host an upcoming construction workshop and design studio. A first workshop with architecture students from Ardhi University (Tanzania) and École Paris-Malaquais (France) will be held in October 2023. The construction phase is expected to take place in early 2024 and will also include the collaboration of The University of the Witwatersrand (South Africa).
There is immense community support for the project, including from community leaders, politicians, and the local healthcare community.
Clinic of Care

Clinic of Care: Tanzania is one half of the Next Generation Ambassador program, which itself forms a part of the Holcim Foundation’s Next Generation Network. The Clinic of Care initiative also includes a project to restore and adapt Indonesian vernacular housing on the island of Java, creating a rehearsal space and cultural venue for a traditional dance collective. Championing preservation over demolition, the Clinic of Care projects are defined by an environmentally, culturally and economically sensitive approach to design and construction.
Creating leadership opportunities for a new generation of architectural practitioners while embracing community co-design, the Clinic of Care initiative is a reflection of the goals and principles of the Holcim Foundation. In Tanzania and Indonesia alike, the projects advance a holistic understanding of sustainability that addresses embodied and operational carbon in concert with support for thriving local economies, cultural heritage and quality of place.