Copyright © Prof. Dr. Mohammad Ali Al-Anbari et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. International Journal of Basic and Applied Sciences, 14 (3) (2025) 185-196 International Journal of Basic and Applied Sciences Website: www.sciencepubco.com/index.php/IJBAS https://doi.org/10.14419/17g08850 Research paper Assessment of Health Buildings in Hilla City According to The International Standard LEEDV4 Prof. Dr. Mohammad Ali Al-Anbari *, Lec. Alaa Hadi Obaid, Lec. Mahmood Chabuk College of Engineering, University of Babylon, Hilla, Iraq *Corresponding author E-mail: prof.dr.maalanbari@uobabylon.edu.iq Received: June 12, 2025, Accepted: July 6, 2025, Published: July 20, 2025 Abstract The sustainability and functional performance of healthcare facilities are paramount for patient well-being and environmental steward- ship. This study presents a pioneering assessment of five major public hospitals in Hilla City, Iraq, against the Leadership in Energy and Environmental Design (LEED) v4 for Building Design and Construction (BD+C) framework. Data was collected through comprehensive on-site audits, document analysis, and direct observation. The results reveal a significant performance disparity: the newly constructed Imam Al-Sadiq Teaching Hospital achieved a Gold rating with a score of 67 out of 110 points, demonstrating strong performance in Wa- ter Efficiency and Indoor Environmental Quality. In stark contrast, the four older hospitals (Babylon Teaching, Al-Hilla Teaching, Al Noor Children's, and Marjan Medical City) all scored below the 40-point threshold, rendering them Uncertified. This failure is primarily attributed to aging infrastructure, defunct energy systems, and a lack of sustainable operational policies. The study diagnoses these criti- cal dysfunctions and underscores the urgent need for systematic rehabilitation. We conclude by recommending the enactment of munici- pal legislation requiring that all new hospital constructions and major renovations in the region adhere to LEED v4 standards to ensure a higher, more sustainable quality of healthcare infrastructure for the future.[1] Keywords: -Health Buildings, Green Rating Systems, LEED Certification, LEEDV4, sustainability 1. Introduction Globally, the healthcare sector is a significant consumer of energy and resources, with hospital buildings operating 24/7 and possessing complex functional requirements. Consequently, the push towards green and sustainable healthcare facilities has become a global prior- ity. Green Building Rating Systems (GBRS) such as BREEAM, Green Globes, and the widely adopted Leadership in Energy and Envi- ronmental Design (LEED) provide frameworks to mitigate the environmental impact of buildings. Studies have shown that LEED-certi- fied hospitals can reduce energy consumption by up to 30% and improve indoor air quality, which is directly linked to better patient re- covery rates and staff productivity [2]. Furthermore, research by Bernardi et al. (2017) highlights that such rating systems are instrumen- tal in guiding project managers toward more sustainable decision-making throughout a building's lifecycle. However, in many developing regions and post-conflict areas like Iraq, public infrastructure, including hospitals, often predates modern sustainability concepts. These facilities frequently suffer from deferred maintenance, inefficient systems, and poor environmental perfor- mance, directly impacting public health and operational budgets [3]. While there is a growing body of literature on sustainable buildings, a significant research gap exists in the systematic evaluation of existing hospital infrastructure in Iraq against these international bench- marks. This study addresses this gap by providing the first comprehensive assessment of the major public hospitals in Hilla City using the rigor- ous LEED v4 framework. The novelty of this research lies in its application of a world-class standard to diagnose specific points of failure in aging healthcare infrastructure within a regional Iraqi context. By quantifying the performance of these buildings, this research provides an evidence-based foundation for targeted rehabilitation and policymaking. The objective is to identify critical dysfunctions and propose a strategic roadmap for improving the safety, efficiency, and environmental performance of these vital community assets.[4] 2. LEED V4 In 2014, the latest version of LEED V.4 was released, which will be mandatory on all green buildings from October 31, 2016. During the development stages of the LEED V4 as a building appraisal system, it has been applied in more than 135 countries worldwide due to the continuous development of the LEED V.4 systems to include all conditions and projects, where for example in LEED V.4, 21 different modifications in the market sectors in Various new and constructed projects, warehouses, hospitals, and schools, as well as segmented buildings [5 ]LEED v4 allows the opportunity for LEED to fit the unique aspects of different projects, which were summarized in Figure (1) [8].