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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

“You cannot find Ubuntu in a culture of dominance” – Dr Mamphela Ramphele during second Leah Tutu Gender Symposium

2015-02-28

From the left are: Samantha van Schalkwyk, Zanele Mbeki, Prof Pumla Gobodo-Madikizela and Dr Mamphela Ramphele.
Photo: Johan Roux

Video message from Mrs Leah Tutu

Session 1: Keynote address by Dr Mamphela Ramphele
Ndiyindoda! Yes, you are a man

Session 2: Professor Robert Morrell from the University of Cape Town
South African Gender Studies: Setting the context

Session 3: How can we engage young men to act against violence against women?
Panel discussion by Lisa Vetten (Wits Institute for Social and Economic Research), Despina Learmonth (Psychology Department, University of Cape Town) and Wessel van den Berg (Sonke Gender Justice)

Session 4: Professor Pumla Gobodo-Madikizela
Self-defence as a strategy for women’s resistance: Reflections on the work of Susan Brison

Engaging men to act against gender-based violence in the Southern African context.

This was the theme of the second International Leah Tutu Symposium, hosted by the Gender Initiative of Trauma, Forgiveness and Reconciliation Studies of the University of the Free State (UFS) on Tuesday 24 February 2015.

What does it mean to be man? How can men become active in the fight against gender-based violence? And when does one say: enough is enough? Questions like these set the tone as highly-respected individuals such as Dr Mamphela Ramphele, Prof Rob Morrell, Lisa Vetten and Andy Kawa took to the stage in the Odeion on the Bloemfontein Campus.

Leah Tutu
Unfortunately, Mrs Leah Tutu could not attend this year’s event, but she still managed to send sparks of wit and insight into the auditorium. In her video message, Mrs Tutu referred to the fact that our country has “consigned discriminatory legislation to the rubbish bin of the past”, but we continue to inhabit a divided society.

“We have a constitution and bill of rights that should have sounded the death knell for patriarchy. But women are unsafe across the land,” Mrs Tutu said. “Our freedom cost too much to be left out in the rain,” she urged.

Ndiyindoda! Yes, you are a man
In Dr Ramphele’s keynote address, “Ndiyindoda! Yes, you are a man”, she scrutinised the dominant masculinity model that has supported an alpha-male mentality for millennia. A mentality that celebrates dominance, power and control – where the winner takes it all. How then, can we expect our young boys to embrace the value system of a human rights culture?

“Gender equality is at the heart of our constitutional democratic values. Yet, our society continues to privilege and celebrate the alpha male as a masculinity model,” Dr Ramphele said. This dissonance can only produce conflict and violence.

We encourage our young men to be gentle, communicative, caring people who show their emotions. And when they do, what do we as women do? Do we encourage them?

“Or do we join those who call them wimps, moffies, sissies? How do we respond when they are ridiculed?” Dr Ramphele asked. Are we, as mothers, fathers and grandparents willing to socialise our children to acknowledge a diversity of masculinities as equally valid in our society?

The new man and the new woman of the 21st century need to be liberated from the conflict-ridden dominant masculinity model. They need to be able to shape their identity in line with a value system of human rights as enshrined in our constitution.

Perhaps Dr Ramphele’s message could be summed up by one sentence: You cannot find Ubuntu in a culture of dominance.

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