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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

Mathematical methods used to detect and classify breast cancer masses
2016-08-10

Description: Breast lesions Tags: Breast lesions

Examples of Acho’s breast mass
segmentation identification

Breast cancer is the leading cause of female mortality in developing countries. According to the World Health Organization (WHO), the low survival rates in developing countries are mainly due to the lack of early detection and adequate diagnosis programs.

Seeing the picture more clearly

Susan Acho from the University of the Free State’s Department of Medical Physics, breast cancer research focuses on using mathematical methods to delineate and classify breast masses. Advancements in medical research have led to remarkable progress in breast cancer detection, however, according to Acho, the methods of diagnosis currently available commercially, lack a detailed finesse in accurately identifying the boundaries of breast mass lesions.

Inspiration drawn from pioneer

Drawing inspiration from the Mammography Computer Aided Diagnosis Development and Implementation (CAADI) project, which was the brainchild Prof William Rae, Head of the department of Medical Physics, Acho’s MMedSc thesis titled ‘Segmentation and Quantitative Characterisation of Breast Masses Imaged using Digital Mammography’ investigates classical segmentation algorithms, texture features and classification of breast masses in mammography. It is a rare research topic in South Africa.

 Characterisation of breast masses, involves delineating and analysing the breast mass region on a mammogram in order to determine its shape, margin and texture composition. Computer-aided diagnosis (CAD) program detects the outline of the mass lesion, and uses this information together with its texture features to determine the clinical traits of the mass. CAD programs mark suspicious areas for second look or areas on a mammogram that the radiologist might have overlooked. It can act as an independent double reader of a mammogram in institutions where there is a shortage of trained mammogram readers. 

Light at the end of the tunnel

Breast cancer is one of the most common malignancies among females in South Africa. “The challenge is being able to apply these mathematical methods in the medical field to help find solutions to specific medical problems, and that’s what I hope my research will do,” she says.

By using mathematics, physics and digital imaging to understand breast masses on mammograms, her research bridges the gap between these fields to provide algorithms which are applicable in medical image interpretation.

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