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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

From peasant to president; from Samora Machel to Cahora Bassa

2015-03-25

Prof Barbara Isaacman and Prof Allen Isaacman
Photo: Renè-Jean van der Berg

When the plane crashed in Mbuzini, the entire country was submerged in a profound grieving.

This is how Prof Allen Isaacman, Regents Professor of History at the University of Minnesota, described the effect President Samora Machel’s death in 1986 had on Mozambique. In a public lecture, Prof Isaacman spoke about the man, Samora Machel, and the influences that shaped Machel’s life. The event, recently hosted by the UFS International Studies Group on the Bloemfontein Campus, was part of the Stanley Trapido Seminar Programme.

Samora Machel: from peasant to president
Born in 1933 into a peasant family, Machel was allowed to advance only to the third grade in school. “And yet,” Prof Isaacman said, “he became a very prominent local peasant intellectual and ultimately one of the most significant critics of Portuguese colonialism and colonial capitalism.” Machel had a great sense of human agency and firmly believed that one is not a mere victim of circumstances. “You were born into a world, but you can change it,” Prof Isaacman explained Machel’s conviction.

From herding cattle in Chokwe, to working as male nurse, Machel went on to become the leader of the Liberation Front of Mozambique (Frelimo) and ultimately the president of his country. To this day, not only does he “capture the imagination of the Mozambican people and South Africans, but is considered one the great leaders of that moment in African history,” Prof Isaacman concluded his lecture.

Displacement, and the Delusion of Development: Cahora Bassa and Its Legacies in Mozambique, 1965–2007
Later in the day, Profs Allen and Barbara Isaacman discussed their book: ‘Displacement, and the Delusion of Development: Cahora Bassa and Its Legacies in Mozambique, 1965–2007’ at the Archives for Contemporary Affairs. As authors of the book, they investigate the history and legacies of one of Africa's largest dams, Cahora Bassa, which was built in Mozambique by the Portuguese in the late 1960s and early 1970s.

The dam was constructed under conditions of war and inaugurated after independence by a government led by Frelimo. The dam has since operated continuously, although, for many years, much of its electricity was not exported or used because armed rebels had destroyed many high voltage power line pillars. Since the end of the armed conflict in 1992, power lines have been rebuilt, and Cahora Bassa has provided electricity again, primarily to South Africa, though increasingly to the national Mozambican grid as well.

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