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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

Media: Sunday Times
2006-05-20

Sunday Times, 4 June 2006

True leadership may mean admitting disunity
 

In this edited extract from the inaugural King Moshoeshoe Memorial Lecture at the University of the Free State, Professor Njabulo S Ndebele explores the leadership challenges facing South Africa

RECENT events have created a sense that we are undergoing a serious crisis of leadership in our new democracy. An increasing number of highly intelligent, sensitive and committed South Africans, across class, racial and cultural spectrums, confess to feeling uncertain and vulnerable as never before since 1994.

When indomitable optimists confess to having a sense of things unhinging, the misery of anxiety spreads. We have the sense that events are spiralling out of control and that no one among the leadership of the country seems to have a definitive handle on things.

There can be nothing more debilitating than a generalised and undefined sense of anxiety in the body politic. It breeds conspiracies and fear.

There is an impression that a very complex society has developed, in the last few years, a rather simple, centralised governance mechanism in the hope that delivery can be better and more quickly driven. The complexity of governance then gets located within a single structure of authority rather than in the devolved structures envisaged in the Constitution, which should interact with one another continuously, and in response to their specific settings, to achieve defined goals. Collapse in a single structure of authority, because there is no robust backup, can be catastrophic.

The autonomy of devolved structures presents itself as an impediment only when visionary cohesion collapses. Where such cohesion is strong, the impediment is only illusory, particularly when it encourages healthy competition, for example, among the provinces, or where a province develops a character that is not necessarily autonomous politically but rather distinctive and a special source of regional pride. Such competition brings vibrancy to the country. It does not necessarily challenge the centre.

Devolved autonomy is vital in the interests of sustainable governance. The failure of various structures to actualise their constitutionally defined roles should not be attributed to the failure of the prescribed governance mechanism. It is too early to say that what we have has not worked. The only viable corrective will be in our ability to be robust in identifying the problems and dealing with them concertedly.

We have never had social cohesion in South Africa — certainly not since the Natives’ Land Act of 1913. What we definitely have had over the decades is a mobilising vision. Could it be that the mobilising vision, mistaken for social cohesion, is cracking under the weight of the reality and extent of social reconstruction, and that the legitimate framework for debating these problems is collapsing? If that is so, are we witnessing a cumulative failure of leadership?

I am making a descriptive rather than an evaluative inquiry. I do not believe that there is any single entity to be blamed. It is simply that we may be a country in search of another line of approach. What will it be?

I would like to suggest two avenues of approach — an inclusive model and a counter-intuitive model of leadership.

In an inclusive approach, leadership is exercised not only by those who have been put in some position of power to steer an organisation or institution. Leadership is what all of us do when we express, sincerely, our deepest feelings and thoughts; when we do our work, whatever it is, with passion and integrity.

Counter-intuitive leadership lies in the ability of leaders to read a problematic situation, assess probable outcomes and then recognise that those outcomes will only compound the problem. Genuine leadership, in this sense, requires going against probability in seeking unexpected outcomes. That’s what happened when we avoided a civil war and ended up with an “unexpected” democracy.

Right now, we may very well hear desperate calls for unity, when the counter-intuitive imperative would be to acknowledge disunity. A declaration of unity where it manifestly does not appear to exist will fail to reassure.

Many within the “broad alliance” might have the view that the mobilising vision of old may have transformed into a strategy of executive steering with a disposition towards an expectation of compliance. No matter how compelling the reasons for that tendency, it may be seen as part of a cumulative process in which popular notions of democratic governance are apparently undermined and devalued; and where public uncertainty in the midst of seeming crisis induces fear which could freeze public thinking at a time when more voices ought to be heard.

Could it be that part of the problem is that we are unable to deal with the notion of opposition? We are horrified that any of us could be seen to have become “the opposition”. The word has been demonised. In reality, it is time we began to anticipate the arrival of a moment when there is no longer a single, overwhelmingly dominant political force as is currently the case. Such is the course of history. The measure of the maturity of the current political environment will be in how it can create conditions that anticipate that moment rather than seek to prevent it. We see here once more the essential creativity of the counter-intuitive imperative.

This is the formidable challenge of a popular post-apartheid political movement. Can it conceptually anticipate a future when it is no longer overwhelmingly in control, in the form in which it is currently, and resist, counter-intuitively, the temptation to prevent such an eventuality? Successfully resisting such an option would enable its current vision and its ultimate legacy to our country to manifest in different articulations, which then contend for social influence. In this way, the vision never really dies; it simply evolves into higher, more complex forms of itself. Consider the metaphor of flying ants replicating the ant community by establishing new ones.

We may certainly experience the meaning of comradeship differently, where we will now have “comrades on the other side”.

Any political movement that imagines itself as a perpetual entity should look at the compelling evidence of history. Few movements have survived those defining moments when they should have been more elastic, and that because they were not, did not live to see the next day.

I believe we may have reached a moment not fundamentally different from the sobering, yet uplifting and vision-making, nation-building realities that led to Kempton Park in the early ’90s. The difference between then and now is that the black majority is not facing white compatriots across the negotiating table. Rather, it is facing itself: perhaps really for the first time since 1994. Could we apply to ourselves the same degree of inventiveness and rigorous negotiation we displayed leading up to the adoption or our Constitution?

This is not a time for repeating old platitudes. It is the time, once more, for vision.

In the total scheme of things, the outcome could be as disastrous as it could be formative and uplifting, setting in place the conditions for a true renaissance that could be sustained for generations to come.

Ndebele is Vice-Chancellor of the University of Cape Town and author of the novel The Cry of Winnie Mandela

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