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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

UFS researcher selected as emerging voice
2016-11-03

Description: Andre Janse van Rensburg  Tags: Andre Janse van Rensburg

André Janse van Rensburg, researcher at the
Centre for Health Systems Research and Development
at the University of the Free State, will be spending
almost three weeks in Vancouver, Canada. He will be
attending the Emerging Voices for Global Health programme
and Global Symposium on Health Systems Research.
Photo: Jóhann Thormählen

His research on the implementation of the Integrated School Health Programme (ISHP) in rural South Africa led to André Janse van Rensburg being selected to become part of the Emerging Voices for Global Health (EV4GH) group.

It is a collection of young, promising health policy and systems researchers, decision-makers and other health system professionals. A total of 222 applications from 50 countries were received for this programme, from 3-19 November 2016 in Vancouver, Canada.

The EV4GH is linked to the fourth Global Symposium on Health Systems Research (HSR2016), from 14-18 November 2016. It also taking place in Vancouver and Janse van Rensburg will be taking part, thanks to his research on the ISHP in the Maluti-a-Phofung area. He is a researcher at the Centre for Health Systems Research & Development (CHSR&D) at the University of the Free State (UFS).

The theme of the HSR2016 is Resilient and Responsive Health Systems for a Changing World. It is organised every two years by Health Systems Global to bring together roleplayers involved in health systems and policy research and practice.

Janse van Rensburg also part of Health Systems Global network
The EV4GH goals relate to the strengthening of global health systems and policies, particularly from the Global South (low-to-middle income countries with chronic health system challenges). The initiative involves workshops, presentations, and interactive discussions related to global health problems and solutions.

As an EV4GH alumni, Janse van Rensburg will become part of the Health Systems Global network. Partnering institutions include public health institutes from China, India, South Africa, Belgium, and the UK.

“The EV4GH is for young, promising health
policy and systems researchers, decision-makers
and other health system professionals.”

Research aims to explore implementation of schools health programme
In 2012, the ISHP was introduced in South Africa. This policy forms part of the government's Primary Health Care Re-engineering Programme and is designed to offer a comprehensive and integrated package of health services to all pupils across all educational phases.

Janse van Rensburg, along with Dr Asta Rau, Director of the CHSR&D, aimed to explore and describe implementation of the ISHP. The goals were to assess the capacity and resources available for implementation, identify barriers that hamper implementation, detect enabling factors and successful aspects of implementation and disseminate best practices in, and barriers to, ISPH implementation with recommendations to policymakers, managers and practitioners.

“A lot of people were saying they don’t
have enough resources to adequately
implement the policy as it is supposed to
be implemented.”

Findings of project in Maluti-a-Phofung area
Janse van Rensburg said the ISHP had various strengths. “People were impressed with the integrated nature of the policy and the way people collaborated across disciplines and departments. The school team were found to work very well with the schools and gel well with the educators and principles.”

He said the main weakness of the implementation was resources. “A lot of people were saying they don’t have enough resources to adequately implement the policy as it is supposed to be implemented.

“Another drawback is the referral, because once you identify a problem with a child, the child needs to be referred to a hospital or clinic.” He means once a child gets referred, there is no way of knowing whether the child has been helped and in many cases there is no specialist at the hospital.

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