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Using implementation science to address quadruple burden of disease in SA

07 November 2024 | Story André Damons | Photo Supplied

Implementation Science Workshop 2024 — Building capacity for the use of implementation science. The Principal Investigators of the project; Dr Phindile Shangase from UFS, left, and Dr Lebogang Mogongoa from the Central University of Technology, with Dr Shalini Ahuja from King’s College London, centre, who facilitated the workshops.

The Division of Public Health at the University of the Free State (UFS) together with the Central University of Technology (CUT), held a successful workshop (first phase) for their project: Capacity building for the use of implementation science in various typologies in low- and middle-income countries for the prevention and/or management of the quadruple burden of disease.

According to the National Institute for Health as well as the World Health Organisation, implementation science supports innovative approaches to identifying, understanding, and overcoming barriers to the adoption, adaptation, integration, scale-up and sustainability of evidence-based interventions, tools, policies, and guidelines. Implementation research therefore pertains to gathering and analysing implementation evidence of effectiveness that determines if the intervention works in real-world circumstances.

The Principal Investigator at UFS is Dr Phindile Shangase from the Division of Public Health, supported by colleagues in the Division, as well as the CUT team, led by Dr Lebogang Mogongoa. The first phase of the project took place from 14-17 October 2024 with the first two days held at UFS.

In this co-funded project, UFS and CUT engage in partnership capacity building for academics and postgraduate students. At the UFS, the project is funded by the Office of the Deputy Vice-Chancellor: Research and Internationalisation and resulted from the CUT and UFS Joint Research Programme Research Grant 9th Call.

Contributing to evidence-based policies and practices

Dr Shangase says the workshops of this project were well attended by academics, researchers, postgraduate and postdoctoral students from different disciplines, and community organisations, including programme managers, as well as clinicians from the Department of Health. Other stakeholders and international students who could not travel for face-to-face interactions attended live on UFS YouTube.

Workshops were facilitated by Dr Shalini Ahuja from King’s College, London, who is an international expert and experienced in this field through engaging in research as well as field facilitation in various low- and middle-income countries.

Says Dr Shangase: “Implementation science is the study of methods and strategies to promote the systematic uptake of research findings. It contributes to evidence-based policies and practices and ensures that they are implemented effectively to achieve their intended outcomes, through the identification of barriers and facilitators to implementation. These strategies can therefore be integrated effectively into routine practice in healthcare, public health, and other fields.

“Reviewed studies indicate that the effectiveness of implementation research is noted in the identification and investigation of factors that address disparities in healthcare delivery and outcomes, including those within the health systems and in the population. In simple terms, the goal of implementation science is to understand how and why some interventions succeed while others fail, and to identify the best ways to integrate research-backed interventions into real-world settings for maximum impact and to ensure they continue to be used and remain effective over time,” says Dr Shangase.

Purpose of project

According to her, in the context of South Africa, implementation science has potential to assist in addressing the quadruple burden of disease which comprise of these colliding epidemics: maternal, newborn and child health; HIV/AIDS and tuberculosis (TB); non-communicable diseases (e.g. cardiovascular diseases, chronic respiratory diseases, cancers, and diabetes); and violence and injury.

The purpose of this project, explains Dr Shangase, is to capacitate academics and postgraduate students at the UFS and CUT as well as community stakeholders with knowledge and skills regarding the processes and factors involved in the successful integration of evidence-based public health improvement interventions into routine practice and policy.

“Implementation science offers a strategic, data-driven approach for South Africa, especially in addressing the country’s unique and complex healthcare challenges. These advantages stem from its focus on translating evidence-based interventions into real-world practice, addressing the quadruple burden of disease and helping overcome systemic obstacles to effective healthcare delivery.

“These advantages make implementation science a vital tool for improving health outcomes and achieving sustainable public health progress in South Africa.”

The next phase of this project is expected to be more innovative and takes place between February and March in 2025 with the inclusion of a multistakeholder team.

News Archive

‘Is the South African university curriculum ‘colonial'?’ asks Prof Jansen

2017-11-24

Description: Jansen readmore Tags: Prof Jonathan Jansen, colonial, university curriculum, western knowledge

From left; Prof Corli Witthuhn, Vice-Rector: Research; former Rector and Vice-
Chancellor of the UFS, Prof Jonathan Jansen; Prof Michael Levitt, and
Prof Francis Petersen at the celebration lecture at the UFS.
Photo: Johan Roux

One of the critical issues that emerged from the South African student protests during 2015 and 2016 was a demand for the decolonisation of university curriculums.

A senior professor at the Stellenbosch University, Prof Jonathan Jansen, said the number of people, including academics, who joined the cause without adequately interrogating the language of this protest, was astonishing. “The role of social scientists is to investigate new ideas … when something is presented to the world as truth.” Prof Jansen was speaking during a celebration lecture at the University of the Free State in Bloemfontein on 15 November 2017.

Large amount of knowledge not African
He said the accusation is correct to a limited degree. “The objection, in essence, is against the centring of Western, and especially European knowledge, in institutional curricula.” There is no doubt that most of what constitutes curriculum knowledge in South African universities, and in universities around the world, derive from the West. “The major theories and theorists, the methodologists and methods are disproportionally situated outside of the developing world,” Prof Jansen said.

The dilemma is, how will South Africa and the continent change the locus of knowledge production, considering the deteriorating state of public universities? “In the absence of vibrant, original, and creative knowledge production systems in Africa and South Africa, where will this African-centred or African-led curriculum theory come from,” Jansen asked. He says the re-centring of a curriculum needs scholars with significant post-doctoral experiences that are rooted in the study of education and endowed with the critical independence of thought. “South Africa's universities are not places where scholars can think. South African universities’ current primary occupation is security and police dogs,” Prof Jansen said.

Collaboration between African and Western scholars
“Despite the challenges, not everything was stuck in the past,” Prof Jansen said. South African scholars now lead major research programmes in the country intellectually. The common thread between these projects is that the content is African in the subjects of study, and the work reflects collaboration with academics in the rest of the world. These research projects attract postgraduate students from the West, and the research increasingly affects curriculum transformations across university departments. There is also an ongoing shift in the locus of authority for knowledge production within leading universities in South Africa. Prof Jansen feels a significant problem that is being ignored in the curriculum debate, is the concern about the knowledge of the future. How does South Africa prepare its young for the opportunities provided by the groundswell of technological innovation? “In other parts of the world, school children are learning coding, artificial intelligence, and automation on a large scale. They are introduced to neuroscience and applied mathematics,” he said.

Prof Jansen said, in contrast, in South Africa the debate focuses on the merits of mathematics literacy, and what to do with dead people’s statues.

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