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27 September 2021 | Story Rulanzen Martin | Photo Supplied
From the left; Prof Michelle Engelbrecht (center), Director of the CHSR&D at the UFS, together with colleagues Dr Gladys Kigozi (right) and Prof Christo Heunis, is conducting various social sciences-orientated research projects on health and health systems.

The Centre for Health Systems Research and Development (CHSR&D) in the Faculty of the Humanities at the University of the Free State (UFS) has been at the forefront of research on the societal and human impact of COVID-19. The CHSR&D has investigated the effects of the pandemic on, among others, post-traumatic stress and the coping strategies of nurses, and is currently undertaking a research project looking at vaccine literacy and acceptability in South Africa through an online survey, which has already attracted more than 9 500 respondents.

Prof Michelle Engelbrecht
, Director of the CHSR&D, says it is important not to lose sight of the impact that the pandemic has had on society and individuals. “It has affected all aspects of life, caused economic disruptions, and posed immense challenges to both public and private healthcare, food systems, education, and employment,” she says. For the CHSR&D researchers, it is important to understand the health and socio-economic impacts in order to inform interventions and policy. 

Established in 1993, the CHSR&D stems from a rich tradition of research and training in medical sociology and sociology of health. As a centre, they generate and disseminate research findings and information on health and health systems to promote transformation in policy and practice in the South African healthcare system.

A study on the impact of the pandemic on nurses

In early 2021, the CHSR&D completed a project on the post-traumatic stress and coping strategies of South African nurses during the second wave of the COVID-19 pandemic.  This study was one the first to examine how the pandemic influenced the post-traumatic stress and coping strategies of nurses in the country. It was found that 44% of nurses were experiencing post-traumatic stress disorder (PTSD), which was comparatively higher than their counterparts in other countries. Furthermore, a lack of preparedness to manage COVID-19 patients, poorer health, and avoidance coping mechanisms were associated with increased PTSD in nurses. Nurses voiced a need for emotional support and empathy from their managers. 

Some of the intervention strategies recommended by the nurses included emotional, psychological, and debriefing sessions focusing on positive coping strategies to address stress effectively; positive and open communication between managers and their subordinates; psychological support through the Employee Assistance Programme and occupational health units; and an uninterrupted supply of quality personal protective equipment. The findings of this project were shared with the Free State Department of Health (FSDoH).

Ongoing research projects

As of 1 September 2021, the CHSR&D commenced with a national online survey on COVID-19 vaccine literacy and acceptability. While there are a number of studies looking at the uptake of COVID-19 vaccines, Dr Gladys Kigozi notes that “this study is novel, as there is a lack of information about vaccine literacy, which may be defined as the degree to which people have the capacity to obtain, process, and understand basic health information and services to make appropriate health decisions.”. The anonymous online survey is available through social media and the Moya messaging application.
 
The CHSR&D, together with a team from the FSDoH and the World Health Organisation, are also collaborating on a project looking at the impact of COVID-19 on essential health services, mortality in hospital-admitted patients, and outcomes in patients with a history of tuberculosis. According to Prof Christo Heunis, “The COVID-19 pandemic has become infamous for crippling healthcare systems. Resources and staff are being diverted to test and provide treatment for people with presumed or diagnosed COVID-19, and thus some other healthcare services are being compromised to meet the demands of caring for COVID-19 patients.” It is thus imperative to measure the impact of the pandemic on essential health services and treatment outcomes. 


Interdisciplinary research project focusing on the health and well-being of vulnerable families 

The CHSR&D, together with the UFS Department of Social Work, the School of Nursing, and the Disaster Management Training and Education Centre for Africa (DiMTEC), will commence with a study investigating the impact of COVID-19 on the health and well-being of vulnerable families in the Mangaung Metropolitan area. This project is funded by a UFS interdisciplinary grant.  While the study is limited to the Mangaung Metropolitan area, it has the potential to inform health and social policy in other metropolitan areas in South Africa – particularly with regard to preparedness and management of pandemics such as COVID-19. 

News Archive

Emotional health of vulnerable children needs urgent intervention
2014-02-04



In South Africa, thousands of children under the age of 18 are orphaned as a result of HIV/Aids. Experts are worried that these orphans and vulnerable children will experience serious socio-emotional problems and behaviour disorders, should urgent intervention programmes not be implemented urgently.

A study was undertaken by the Centre for Development Support at the UFS, in conjunction with Stellenbosch University and the Houston University in America. The research found that in the Free State province alone, about 15% of orphans and vulnerable children showed signs of psychiatric disorders. Almost half of the children in the study showed signs of abnormal or maladjusted behavioural functioning.

The research team believes that the South African government and the numerous non-governmental organisations put too much emphasis on the physical needs of orphaned and vulnerable children and that their socio-emotional or mental wellbeing receives very little attention.

The nominal financial grant is a welcome relief for some of the needs of this risk group. Researchers are worried, though, that the lack of reliable and culturally-sensitive diagnostic methods for the early detection of psychiatric disorders may pose a challenge when the children reach puberty.

The current study is focusing on the detection of emotional behavioural problems even before adolescence. Questionnaires were distributed across the Free State at clinics, schools and non-governmental organisations dealing with these children. The questionnaires enabled researchers to establish the children's socio-emotional needs.

"Overcrowding in houses where orphans and vulnerable children often live is directly linked to poor socio-emotional health in children," says Prof Lochner Marais from the Centre for Development Support. "The state institutions offering programmes for orphans and vulnerable children overemphasise the physical and/or financial needs of these children. The programme provides, for example, food for the children, grants for the [foster] parents, assistance with school clothes and ensures clinic visits for the children. Of these, only the supply of food has a direct impact on the improved mental health of children."

The study provides, for the first time, a profile of the state of mind of this group, as well as the emotional impact of HIV/Aids – an "urgent matter" according to Dr Carla Sharp from the University of Houston's Department of Psychology. According to Dr Sharp, much more could be done to assist foster parents in addressing the emotional needs of these children. The early detection of behavioural disorders should be the key in intervention programmes.

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