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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

Childhood obesity should be curbed early
2017-03-15

Description: Child obesity Tags: Child obesity

Serious intervention by parents is required to deal
with childhood obesity. Prof Louise van den Berg and
a group of final-year PhD students worked on a study
about the prevalence of obesity in six-year-olds in
South Africa.
Photo: Supplied

If your child is overweight when they start school at the age of six, unless you do something about it at that point, the indications are they are going to be overweight teenagers and obese adults. This is according to University of the Free State’s Prof Louise van den Berg.

Evidence has shown that overweight children and teenagers have a greater risk of developing lifestyle diseases such as type 2 diabetes, hypertension and cardiovascular disease later in life, and dying prematurely.

Obesity is a global pandemic rapidly spreading among adults and children, in developed and developing countries alike.

Dr Van den Berg worked with Keagan Di Ascenzo, Maryke Ferreira, Monja-Marie Kok, Anneke Lauwrens, all PhD students with the Department of Nutrition and Dietetics, to conduct the study. Their research found that children who are overweight by the time they turn six should be screened for weight problems.

Why six-year-olds?
Children who are overweight between the ages of two and five are five times more likely to be overweight when they are 12. There are two periods in a normal life cycle when the body makes new fat cells. The first is in the uterus and the second is around the age of six. The second phase lasts from the age of six to puberty.

The study assessed the prevalence of obesity in six-year-olds as part of a campaign in South Africa to raise awareness of the problem among parents and educators.

A total of 99 children were chosen from seven schools in Mangaung, the capital city of Free State. The schools were chosen from quintile four and five schools, which when measured by their own resources and economic circumstances, are well resourced and serve largely middle-class and wealthy communities.

The children’s weight, height and waist circumference were measured and used to calculate a body mass index score and waist-to-height ratio. Both these figures are good predictors for future lifestyle disease risks such as type 2 diabetes, hypertension and cardiovascular disease. A person with a good waist-to-height ratio can wrap a piece of string equal to their height around their waist at least twice.

When the children had a higher body mass index, they also had an increased waist to height ratio. The study found one in four children from the schools surveyed were overweight when they started primary school.

Nipping the fat in the bud
Although there are many factors that play a role in preventing childhood obesity, parents’ perceptions of their children’s weight play an important role. A recent study found that more than 50% of parents underestimate the weight of their obese children. These parents remain unaware of the risks their children face and are not motivated to take any action.

At least half of the parents whose children are overweight struggle to recognise their children’s weight problems fearing that they will be labelled or stigmatised. By the time they turn six overweight children should be referred to dieticians and nutritionists who are qualified to guide their parents in getting them to eat well and be more physically active at pre-primary and primary school.

The high prevalence of weight problems among six-year-olds found in this study is an urgent call to healthcare professionals to step up and empower parents, educators and children with the necessary skills for healthy dietary practices and adequate physical activity.

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