Architecture has the power to address some of the world's most pressing issues, especially in Africa. Drawing from my experiences as a principal at MASS Design Group and one of Rwanda’s first architecture graduates, I have seen how architecture that is rooted in place, heritage, and culture can shape communities and foster sustainable development.
My journey to becoming an architect began with a deep curiosity and a desire to build. As a child, I watched my grandfather, a skilled carpenter, as he assembled pieces of furniture on his workbench, often inviting me to observe his craftsmanship up close. It wasn't until I saw a building by Norman Foster on TV that I realized architecture was a distinct profession. In Rwanda, we didn't even have a word for architecture in our local language, so my initial dream was to become an engineer. Only after discovering a new architecture program at the Kigali Institute of Science and Technology, the first one in the country, did I decide to pursue this path.
My career took a pivotal turn when I joined MASS Design Group, a firm dedicated to using architecture as a tool for social change. This decision aligned perfectly with my vision of making architecture accessible to everyone, particularly those in underserved communities.
Kasungu Maternity Waiting Village
In 2015, I moved to the Kasungu District in central Malawi to oversee the construction of a new Maternity Waiting Village. This project was significant for me, not only as a recent graduate but also as an architect committed to addressing pressing health issues through design. My first night there, I couldn’t sleep, struggling to imagine what else could be done to address maternal mortality, not just in Malawi, but across Africa. Witnessing pregnant mothers enduring harsh weather conditions without shelter profoundly impacted me.
My experience in Malawi stirred a personal resolve to ensure that women had access to dignified spaces for childbirth. At the time, the project's design and implementation sought to answer a crucial question: "How can design help reduce maternal and newborn mortality?" But the challenge is broader than that. Maternal and newborn mortality is not just an issue in Malawi or Africa but a global issue. In the U.S maternal deaths have been increasing since 2000 and two-thirds of these deaths are considered to be preventable. Birth is not a medical intervention; it is a natural human process. To truly understand how design can help reduce the issue of maternal and newborn mortality, we need to apply holistic solutions that honor culture, center patient dignity, and work towards long-term change, rather than simply creating spaces for clinical care. Safe motherhood is a human right.
Creating a Home Away From Home
With the Maternity Waiting Village project in Kasungu, MASS sought to design a space that was not only safe, healthy, and comfortable, but – also centered on community, empowerment, and honoring Malawian culture. Research is a critical component to understand the challenge and the specific needs that our partners are facing in tackling their objectives. Our goal was to design a place where women could receive better care in a supportive environment, still surrounded by loved ones and companions. The facility was located next to the Kasungu District Hospital, where women could receive immediate emergency care not available in their villages.
To create a more inviting maternity waiting home, we modeled the layout of Malawian villages. Family compounds are composed of several small buildings housing branches of immediate families. Instead of recreating one giant sleeping area, we created small buildings or “homes,” each with four beds, providing more intimate spaces for mothers. The smaller room size allowed for improved lighting and ventilation while providing privacy and storage for personal belongings. Large roof overhangs and a double roof help keep living spaces cool.
The Maternity Waiting Village was constructed out of local materials, familiar to staff, expectant mothers, and their companions. The walls were built using compressed stabilized earth blocks (CSEB) made from soil excavated for the foundation. Local pine wood was used for the assembly of the roof structure.
Take Care of the Support Companions
As part of our engagement process, we recognized the importance of providing spaces for companions of women in the labor process. Companions play an invaluable role, caring for birthing mothers before, during, and after labor. To encourage women to travel to the waiting villages, we had to integrate spaces that also support companions, including areas for sleeping, cooking, and laundry. In addition to the intimate four-bed units in each building for expectant mothers, we designed companion sleeping spaces with platform beds that function as benches during the day, and beds at night.
In keeping with the village design, courtyards unite the buildings, creating communal spaces for meals, storytelling, personal care, and relaxation among companions, experienced mothers, and first-time mothers. The courtyards also serve as educational areas for workshops on pre- and postnatal care. Communal design elements, such as kitchens for meal preparation and facilities for toilets, showers, and laundry, are integral to the design.
Designing for Enhanced Care and Scaling Impact
Recently, we applied our experience from Malawi to a new project in rural western Kenya, where we are designing three maternity facilities to improve care quality and outcomes for mothers and newborns. We partnered with Jacaranda Health, a nonprofit organization that works with governments across Sub-Saharan Africa, implementing affordable and scalable solutions that sustainably enhance the quality of care and outcomes in public hospitals, where the majority of underserved mothers and babies receive care.
MASS had just finished a two-year project called Delivering More in collaboration with the Institute for Healthcare Improvement (IHI), a leading innovator in health and health care improvement worldwide. Through this project, we developed a human-centered design toolkit for improving maternal newborn care spaces in low- and middle-income countries.
Leveraging the guidelines, we have been able to apply these innovations to our work with Jacaranda Health, ensuring that our solutions are both effective and culturally relevant. This global collaboration underscores the importance of addressing health care challenges with context-specific, sustainable solutions that can be adapted worldwide.
While Kenyan women may have better access to hospitals closer to their villages compared to those in western Malawi, they still have significant barriers to care. Many rural hospitals in Africa are not equipped to handle emergency obstetric care, premature birth, or neonatal complications. To address this, we are designing maternal newborn units at three hospitals, which will include operating theaters and specialized spaces for the care of small and sick newborns.
Similar to the Maternity Waiting Village, we designed spaces where mothers feel comfortable by creating smaller, more intimate wards that are well-ventilated and offer greater privacy and space for companions. The new facilities will support over 10,000 annual births. Culturally beautiful facilities and investments in maternal and newborn care across Africa increase trust in the power of public health to improve health and save lives. These culturally beautiful facilities and investments in maternal and newborn care increase trust in the power of public health to improve health and save lives.
From Malawi to Kenya: Building Trust and Dignity in Birth and Mother Care
Ten years after opening the Maternity Waiting Village in Malawi, the project has significantly contributed to reducing maternal mortality. The village has hosted thousands of mothers, who delivered numerous healthy babies at the neighboring hospital. As a father of two lovely sons, my commitment to improving maternal and newborn health has only grown. Reflecting on my wife's pregnancy and childbirth experiences, contrasted with those I witnessed in Malawi, has intensified my determination to create dignified spaces for mothers and their babies.
Through projects like the Maternity Waiting Village, and our collaboration with Jacaranda Health in Kenya, we reaffirm a personal commitment to addressing maternal mortality and improving maternal and newborn health outcomes. Designing for dignity in childbirth means finding that balance between clinical care and need, built on the foundations of trust, dignity, and safety. MASS has recently launched a new “Mothers and Children” initiative to expand our impact in this important area of work, partnering with public and private organizations to better understand global trends in pregnancy care, investigating contextual geographic challenges, and dedicating time and resources in the development of guidelines and standards which will formalize equitable health spaces, and advocate for programs at key stages of a child's development.
Kasungu District in central Malawi.
In the rapidly evolving landscape of Rwanda and Africa as a whole, local architects, designers, and engineers play a vital role in shaping meaningful communities. Beyond designing and erecting infrastructure, our mission is to create opportunities for positive change, contributing ideas for sustainable development and shaping a promising future for all. My personal journey in architecture underscores the transformative potential of the field when it transcends blueprints to become a force for positive societal change. Local architects, designers, and engineers play a vital role in shaping meaningful communities and contributing ideas for sustainable development.
Read more about MASS Design Group on: Housing Justice by Design Learning from Native America | The Power of Public Monuments | The Power of Provenance|The Architect's Philanthopist| Learning from Poughkeepsie| A Guide to Rewilding|Advocating for Disability Justice in Design|AIA Firm of the Year.
Keep the conversation going—sign up to our newsletter for exclusive content and updates. Sign up for free.
