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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

Lecture focuses on how Marikana widows embody the transformative power of art

2015-08-11

Makopane Thelejane

"When I got the news of my husband is dead, I put my hands above my head, as you see me in this picture. I could not bear the ache in my heart." - Makopane Thelejane

A woman looks down on a canvas covered in thick layers of red, dark shadows falling across her face. A brief moment that captures the silently-devastating aftermath of the Marikana massacre that bled into the lives of 34 widows.

It is this silent trauma that was at the centre of the last instalment of the Vice-Chancellor’s Lecture Series for 2015. “These stories of the Marikana widows are important. It is these stories of silence that live behind the spectacular scenes of the violence,” Prof Pumla Gobodo-Madikizela, Senior Research Professor in Trauma, Forgiveness, and Reconciliation Studies at the University of the Free State (UFS) said at the event.

Panel
The lecture, which took place on Monday 27 July 2015 on the Bloemfontein Campus, took the form of a panel discussing the theme of “Speaking wounds: voices of Marikana widows through art and narrative”. The panel consisted of members from the Khulumani Support Group, including Dr Marjorie Jobson (National Director) and Judy Seidman (Sociologist and Graphic Artist), as well as Nomfundo Walaza, former CEO of the Desmond Tutu Peace Centre.

Betty Lomasontlo Gadlela

"Then this dark time came, a dark cloud over me. It made me to have an aching heart, which took me to hospital, from losing my loved one, my husband, in such a terrible manner. " - Betty Lomasontlo Gadlela

Trauma made visible
In a project initiated by Khulumani, the Marikana widows were encouraged to share their trauma through painting body maps – in which the widows depicted their own bodies immersed in their trauma – and narrating their personal stories. Throughout the workshops, the focus always remained on the women. As Siedman put it, “the power of this process is rooted in the participants. The statements of what the participants experienced is what’s important.”

Initially silenced and isolated, this group of women has now moved “into a space where they have become connected to each, and stand up for each other in the most powerful ways,” Dr Jobson said. “Our work is conceptualised in terms of giving visibility and voice to the people who know what it takes to change this country; to change this struggle.”

The transformative power of art and narrative
During her response, Walaza pointed out “how art and narrative can transform traumatic memory and become integrated in the survivors’ life story.” This gives individuals the opportunity, she said, “to step into a space of mutual listening and dialoguing in which people bond together.”

Co-hosted by Prof Gobodo-Madikizela and the UFS Institute for Reconciliation and Social Justice, the lecture series forms part of a five-year research project funded by the Andrew W. Mellon Foundation.

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