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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

Academic delivers inaugural lecture on South African foreign policy

2007-08-06

In her inaugural lecture Prof. Heidi Hudson from the Department of Political Sciences, focused on the impact that Pan-Africanist sentiments have had on South Africa’s foreign policy. She also put the resulting contradictions and ambiguities into context. At her inaugural lecture were, from the left: Proff. Frederick Fourie (Rector and Vice-Chancellor of the UFS), Heidi Hudson, Engela Pretorius (Vice-Dean: Faculty of The Humanities) and Daan Wessels (Research Associate in the Department of Political Science).
Photo: Stephen Collett

Academic delivers inaugural lecture on South African foreign policy

“We are committed to full participation as an equal partner … opposed to any efforts which might seek to project South Africa as some kind of superpower on our continent. … the people of Africa share a common destiny and must therefore … address their challenges … as a united force...” (Mbeki 1998:198-199).

Prof. Heidi Hudson from the Department of Political Science referred to this statement made by president Mbeki (made at the opening of the OAU Conference of Ministers of Information in 1995) when she delivered her inaugural lecture on the topic: South African foreign policy: The politics of Pan-Africanism and pragmatism.

One of the questions she asked is: “Can the South African state deliver democracy and welfare at home while simultaneously creating a stable, rules-based African community?”

She answers: “South Africa needs to reflect more critically and honestly on the dualism inherent in its ideological assumptions regarding relations with Africa. South Africa will always be expected by some to play a leadership role in Africa. At the moment, South Africa’s desire to be liked is hampering its role as leader of the continent.”

In her lecture she highlighted the ideological underpinnings and manifestations of South Africa’s foreign policy. Throughout she alluded to the risks associated with single-mindedly following an ideologically driven foreign policy. She emphasised that domestic or national interests are the victims in this process.

Prof. Hudson offers three broad options for South Africa to consider:

The Predator – the selfish bully promoting South African economic interest.
Mr Nice Guy – the non-hegemonic partner of the African boys club, multilaterally pursuing a pivotal but not dominant role.
The Hegemon - South Africa driving regional integration according to its values and favouring some African countries over others, and with checks and balances by civil society.

She chooses option three of hegemony. “Politically correct research views hegemony as bad and partnership as good. This is a romanticised notion – the two are not mutually exclusive,” she said.

However, she states that there have to be prerequisites to control the exercise of power. “The promotion of a counter-hegemon, such as Nigeria, is necessary. Nigeria has been more effective in some respects than South Africa in establishing its leadership, particularly in West Africa. Also needed is that government should be checked by civil society to avoid it sinking into authoritarianism. The case of business and labour coming to an agreement over the HIV/Aids issue is a positive example which illustrates that government cannot ignore civil society. But much more needs to be done in this regard. South Africa must also be very careful in how it uses its aid and should focus potential aid and development projects more explicitly in terms of promoting political stability,” she said.

Prof. Hudson said: “It is also questionable whether Mbeki’s Afro-centrism has in fact promoted the interests of ordinary citizens across Africa. Instead, elite interests in some countries have benefited. But ultimately, the single most important cost is the damage done to the moral code and ethical principles on which the South African Constitution and democracy is founded.

“In the end we all lose out. More pragmatism and less ideology in our relations within Africa may just be what are needed,” she said.

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