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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.

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Letter to students from Prof Jonathan Jansen about student protest action at the UFS

2015-10-21

Dear Students

Student protest action at the University of the Free State

I wish to make clear that the senior leadership of the University of the Free State understands and supports the demands from students and their leaders that higher education be accessible to all students, especially the poor. For the past six years we have done everything in our power to meet that commitment to students who are academically talented, but simply cannot afford to pay; that is why our tuition fees remain among the lowest in the country. Our efforts to raise private funding have enabled thousands more students to study at the UFS than would have been possible on the government subsidy only. Whether it is the Staff Fund contributions (yes, our staff empty their pockets to support student fees) or the No Student Hungry (NSH) bursary programme (yes, we raise funds for food bursaries), we will continue our drive to fund students who cannot afford higher education. Let me repeat, no student with a solid academic record will be denied access to studies simply because they cannot pay.

Now, to the matter at hand. There is a national demand from students for a 0% fee increment for 2016. The Minister’s response, after consultation with stakeholders, was that universities should cap their 2016 fee increases at 6%. Despite this initiative from government, the protests continue on virtually all campuses across South Africa for the ‘no fee’ increase.

Our response, as the UFS leadership, is to continue engaging the SRC as the chosen leadership of our students in trying to negotiate a settlement on the matter. We have worked around the clock to be available to student leaders to find some resolution on 2016 fees. While we understand the demands of students, as university leaders, we can only work with the government subsidy we receive. Any agreement reached, cannot and must not place the university at academic and financial risk in its ability to deliver public higher education to the country - if that happens, everybody loses. Still, no matter what happens in terms of the response from government, the leadership door at the UFS remains open to finding a mutually acceptable solution to all parties in these deliberations.

Students, we are deeply concerned by the violence, intimidation and threats from the small group of protesting students. These dangerous and demeaning behaviours, like disrupting classes and verbally abusing students and staff, undermine the legitimate quest of students for relief concerning tuition fees. Such behaviour is completely unacceptable and the university will take action where required. We must also remember that we have an obligation to all 30 000 students whose right to learn without fear of violence and intimidation must be respected.

In conclusion, over the past few years we have worked hard to build a culture of mutual respect and embrace as we worked through some very difficult challenges on campus. You would have noticed that the university leadership responded quickly and sympathetically to reason and respect in difficult situations of rage and demonstration. A minority of students, with some outsiders, have come onto the campus to break down that culture in which, while we might disagree, we continue to work on the basis of mutual respect. I urge all students that, as we engage of this important problem of enabling greater access to higher education, we continue to remain true to the core values of our Human Project.

Best Regards

Prof Jonathan Jansen
Vice-Chancellor and Rector
University of the Free State

Letter to students from Prof Jonathan Jansen about student protest actions at the UFS (Pdf format)

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