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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

Forgive and forget? Or remember and retaliate?

2015-10-08

Cover of the novel Kamphoer

Fact and fiction came together at the Bloemfontein Campus recently to discuss the traumatic repercussions of the South African War. The event forms part of a three-year project – headed by Prof Pumla Gobodo-Madikizela (University of the Free State Trauma, Forgiveness, and Reconciliation Studies) – which investigates transgenerational trauma in the aftermath of the South African War.

The discussion explored the theme, ‘Working through the Past: Reflections on the novel Kamphoer’.

Together, Emeritus Prof Chris van der Merwe (University of Cape Town) and the author of the novel, Dr Francois Smith (University of the Free State, Department Afrikaans and Dutch, German and French), engaged in a thought-provoking, insightful conversation, tracing themes of trauma and issues of forgiveness presented in Kamphoer. Prof Van der Merwe and Dr Smith demonstrated how both fiction and historical fact can inform our present, and guide us into the future.

Emeritus Prof Chris van der Merwe and Dr Francois Smith
discuss the novel Kamphoer and how the book relates to
current issues of transgenerational trauma.

“On a societal level,” Prof Van der Merwe said, “we need to work through trauma by putting it into words, and putting it into a narrative.” When it comes to historical trauma, should we forgive and forget, though? Or rather remember and retaliate? Neither, proposed Prof Van der Merwe. “What I want to plead for is the difficult challenge: remember and forgive.” But Prof Van der Merwe also pointed out that, although forgiveness blesses both the giver and receiver, it is an ongoing process.

Dr Smith agreed wholeheartedly. “One of the discoveries of my book is that forgiving is a continuous process. It’s not something that gets completed at a particular stage in your life. By the same token, you can’t say that you are ever able to leave the past behind.” These issues of trauma, forgiveness, the past versus the present, remembering and forgetting are all integral questions confronting the main character of the novel, Susan Nel .

They are also questions we, as a nation, are currently confronted with, too.

“At this moment in our society,” Prof Van der Merwe said, “we have enough killers. We have a greater need now for caring nurturers.”

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