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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

Miss Deaf SA inspires UFS teachers with her life story

2009-11-26

Pictured from the left, are: K. Botshelo, Vickey Fourie (Miss Deaf SA) and A. Morake.

Vicki Fourie, Miss Deaf SA 2009 and Miss Deaf HESC, recently visited the University of the Free State to motivate aspiring Foundation Phase teachers by sharing her life story with them.

When Vicki was two years old, her parents found out that she couldn’t speak. Two possible explanations were that she had had an ear infection or speech problems. They took her to a specialist and after a brain scan they found out that Vicki had 97% hearing loss in both ears.

Hearing aids were required and Vicki’s father, Pastor Gerhard Fourie from the Christian Revival Church (CRC) enrolled her in a kindergarten school for deaf children, Carel Du Toit in Cape Town.

However, even though Carel Du Toit’s slogan is ‘Where Deaf Children Learn to Speak’, it was because of her mother’s efforts that Vicki is able to communicate effectively with hearing people today.

Bonita Fourie would sit with her child every single day and teach her how to pronounce words phonetically and how to read lips. It is because of that that Vicki is not dependent on sign language at all.

When she was seven years old, her parents enrolled her in an English A.C.E. school. Even though Vicki’s home language is Afrikaans, her parents decided to go against the norm by placing her in an English school (most deaf/hard of hearing people cannot learn a second language). Today Vicki is fluent in both languages.

“I used to think that my hearing aids are just a normal thing you put on, like using glasses for reading,” she said. “I still think that way. People always come up to me and say, ‘It’s amazing how easily you adapt to hearing people. You have no stumbling blocks or holdbacks.’

“To me it’s interesting because my reaction is always this: ‘God gave me this situation, and I have made the best of it. I’ve overcome it, and therefore I can go forward in life’. We were born not to survive, but to thrive. I detest the attitude of, ‘I’m a victim, so the world owes me something’. The world owes nobody anything! We can be victorious over our own circumstances. It is possible. My name’s meaning is testifies to this: “Vicki” comes from the word “Victory”. I was meant to be victorious, and not a victim.”

Vicki, who is now 20, has achieved so much in life. She did ballet, hip-hop, modern dancing, drama (she even went to America for her dramatic monologue and poetry recitation), and she has published over 70 magazine articles, nationally and internationally. Her dreams are to write books one day, become a TV presenter, and motivate and inspire people all over South Africa through public speaking.

When one hears this story, one cannot help but be surprised by her success. It makes you realize that anything is possible when you see the potential in a child, and then do everything in your power to develop it and draw it out. When you believe in the child that you are educating, that child will sense it and blossom like a flower.

“Courage isn’t a gift, it is a decision,” Vicki said. “There will always be things that try to hold you back. The key to working with any child is to be patient, patient, and patient! Teachers play a huge role in equipping children for the future. It is a big responsibility, but it can be done.”

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