Abstract
AbstractThe COVID-19 pandemic catalyzed comprehensive revisions to Egypt's Housing and Building Research Center (HBRC) healthcare facility codes. This mixed-methods study systematically compares the HBRC standards from 2015 (pre-pandemic) and 2021 (post-pandemic) across five domains—surge capacity, circulation efficiency, ventilation/infection control, spatial flexibility, and safe healthcare design—triangulating document analysis (Tables 1-5) with stakeholder insights from 25 professionals (architects n=3, administrators n=3, policymakers n=9, healthcare professionals n=10).Key findings indicate a transformative evolution with new guidelines for isolation units and the addition of intermediate care units, emphasized flexibility, optimized variable corridors, mandatory intensive care units (ICU) airlocks, and acuity-adaptable patient rooms. Stakeholder-derived innovations directly shaped specifications: Egypt Healthcare Authority advocated four-zone renal dialysis segregation (positive/negative/grey/isolation); administrators promoted excellence center clustering for outpatient efficiency; The General Authority for Healthcare Accreditation and Regulation (GAHAR) confirmed expanded first aid infrastructure (emergency showers, eyewash stations); Ministry of Health and clinicians emphasized ICU visitor view rooms; architects considered that providing natural lighting as non-mandatory in isolation rooms (ICU/emergency/dialysis) is a critical regression. Stakeholders validated 68% surge gap resolution and 72% circulation improvements, highlighting implementation challenges in resource-constrained settings. Egypt's multisectoral governance model—institutionalizing four-sector collaboration without external funding—offers replicable Global South resilience lessons.Discussion synthesizes HBRC's regionally progressive evolution addressing pre-2021 gaps with international alignment, advocating sustained evaluation, longitudinal validation, private sector inclusion, and technology integration. Novel contribution: This first mixed-methods analysis of HBRC code evolution triangulates document analysis with stakeholder insights (n=25) to reveal Egypt-specific pandemic-resilient healthcare regulatory transformations.