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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

An education system based on hope is what South Africa needs – Dr Beryl Botman

2016-05-26

Description: Hope revised Tags: Hope revised

Dr Beryl Botman, a postdoctoral research
fellow at the IRSJ, with Dr Willy Nel research associate
at the IRSJ and lecturer at the UFS
Faculty of Education.

HOPE is tangible and concrete construct that should be rooted in the learning and training of teachers,” said Dr Beryl Botman, a postdoctoral research fellow at the Institute for Reconciliation and Social Justice (IRSJ).

She presented her research paper Educators, praxis, and hope: A philosophical analysis of post-apartheid teacher education policy, based on the theoretical ideologies of Paulo Freire’s Pedagogy of the Oppressed. She explores ways in which oppression has been justified, and how it has been overcome through a mutual process between the oppressor and the oppressed, drawing on Paolo Freire’s theories and practices. The presentation was held at the University of the Free State’s (UFS) Faculty of Education, on the Bloemfontein campus on 13 May 2016.

From oppression to hope
Hope should be an educational construct for teacher education in South Africa. Dr Botman asserts that epistemology and ontology should be inseparable, as they are pivotal to an education system that is transformational.

The recent country-wide student protests and demonstrations are an indicant that education institutions need to seek understanding of mechanisms that fuel social conflict. Dr Botman claims that vast social inequalities make the process of democratisation difficult thus hindering transformation. She states that a critical consciousness is important for all South Africans, but more so for educators; it can be used as a tool to understanding the mechanisms of social conflict.

“Self-reflection and self-critique is vital for educators, we need to understand that we do not have all the answers because we ever-evolving beings, working on understanding ourselves and the people around us,” said Dr Botman.

The notion of hope
“I am a farmer. I have no hope for a future that is different from today. This quotation comes from Paulo Freire’s work," said Dr Botman. She said that the South African context and environment is similar. She said that people cannot live for today; one should live for tomorrow if hope is to manifest itself.

South African education environment needs to adopt a progressive consciousness that is future orientated, “You need to be hopeful, if you are radical. You need to be able to envision a new society and a new world,” said Dr Botman.

“You cannot only denounce the present, you need to also announce your hopes for a new society. South Africa needs education systems built on understanding. Although change is difficult, it is necessary for transformation,” Dr Botman added.

What makes hope educational?
“Hope is a vision for a tomorrow that is different, and vital for a transformative education system. To get out of a state of despair, people need to educate their hope. Lately, the issue of white privilege has been brought to the fore. You need to educate your hope, so that you understand the reality of others but, more importantly, of yourself,” said Dr Botman.

Dr Botma added that teacher education needs to adopt a Freirean pedagogy with a strong philosophy based on hope. The agency of teachers can either be hopeful or without hope. It is vital that education promotes hope.

“Teachers need to rely on their existential experience, the experiences of others, and the experiences of the children or students they teach. An understanding of all these experience reinforces the idea that people are life-long learners, always learning and adapting to society’s needs,” said Dr Botman.

Teachers as agents of hope
Dr Botman stated that current South African education policy is directed towards transformation but it does not stipulate means to achieve this objective. Further, she argues that educators need to put greater emphasis on self-knowledge, self-reflection, and self-education. Connecting with teachers, parents, students and the community engages with their self-knowledge and reflection.

Reorientation of teacher education
Dr Botman concluded by mentioning that rethinking ontological and epistemological aspects of education is important, and should be a pivotal point of teacher education. A renewed vision of hope-orientated philosophy and pedagogy needs to be adopted by the education institutions. A praxis, which is an informed action, when a balance between theory and practice is achieved. There is a need for an inclusive exploration of education philosophies and education systems not only European and Western but also African and Eastern as well.

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