Improving South Africa's Healthcare Infrastructure

About IUSS

This website is the repository for documents and tools developed under the Infrastructure Unit System Support - IUSS - project, an initiative of the National Department of Health, under leadership of Dr Massoud Shaker and Mr Ndinannyi Mphaphuli. The purpose of the documents is to provide guidance to improve healthcare infrastructure delivery.


IUSS voluntary standard/ guidance documents have been prepared as national Guidelines, Norms and Standards for the benefit of all South Africans. They are for use by those involved in the procurement, design, management and commissioning of public healthcare infrastructure. Many have been made mandatory via gazette and are clearly marked with this status on the front cover and in footers on each page. IUSS material may also be useful information and reference to private sector healthcare providers.

Use of the guidance does not absolve professional responsibilities of the implementing parties, and it remains incumbent on the relevant authorities and professionals to ensure that these are applied with due diligence, and where appropriate, deviations processes are exercised.

Gazetted guidelines are for public reference information and for application by Provincial Departments of Health in the planning and implementation of public sector health facilities. The gazetted guidelines will be applicable to the planning, design and implementation of all new public-sector building projects (including additions and alterations to existing facilities). Any deviations from the voluntary standards are to be motivated during the Infrastructure Delivery Management Systems (IDMS) gateway approval process. The guidelines should not be seen as necessitating the alteration and upgrading of any existing healthcare facilities.

Development process

The development process initiated in 2010 was to consolidate information from a range of sources including local and international literature, expert opinion, practice and expert group workshop into a first level discussion status document. This was then released for public comment through the project website, as well as national and provincial channels. Feedback and further development was consolidated into a second level development status document which again was released for comment and rigorous technical review. Further feedback was incorporated into proposal status documents and formally submitted to the National Department of Health. Once signed off, the documents were gazetted.

Documents and tools have  been assigned a version number and date. The National Department of Health will establish a Health Infrastructure Norms Advisory Committee, which will be responsible for the periodic review and formal update of documents and tools. Documents and tools should therefore always be retrieved from the website repository or Department web portal (forthcoming) to ensure that the latest version is being used.

Updating is currently limited to quarterly cost models updates only. Feedback is welcome and updates will be posted if these become available.


IUSS Norms and Standards were developed with extensive input from numerous individuals and the contributions are appreciated and noted in individual publications.

 South African Federation of Hospital Engineering