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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

Service learning teaching strategy essential for the infusion of graduate attributes

2017-01-02

Dr Pulane Pitso, Director: Institutional Performance
Monitoring within Performance Monitoring and Evaluation
Branch in the Department of the Premier, Free State
Provincial Government (FSPG).
Photo: Rulanzen Martin

“Public service delivery is not only about ‘government’s sector end products’, but is also fundamentally related to the ways in which the citizens can be best served at the point of client interface, as the primary beneficiaries.”

It is against this backdrop that Dr Pulane Pitso’s study explored the role of Higher Education Institutions (HEIs) in infusing the curriculum with graduate attributes for improved service delivery. The study is entitled: Community service learning as a transformative tool for infusing the university curriculum with graduate attributes for improved service delivery.

Citizens the central focus in public-service delivery
Although with the advent of democracy, the South African public service introduced the Batho Pele “people first” initiative which is one of the key transformation-oriented initiatives to ensure that citizens are the central focus in public service delivery. An extant literature indicates that more work by the government still needs to be done in terms of the institutionalisation and implementation thereof.

Notwithstanding that public service is primarily responsible for addressing challenges related to poor service delivery, Dr Pitso moved from a premise that a multifaceted and collaborative approach, underpinned by a concerted effort by all relevant sectors, is more likely to contribute significantly towards improving service delivery. Specific focus was given to sectors primarily mandated to lay foundations through training and development such as HEIs, since the nature and quality of public service largely depends on the nature, quality and relevance of the system of education.

CSL a transformative teaching strategy
The basis for her thesis, emanated from the contention that public service delivery is a dynamic process which cultivates into a citizen-government relationship.

“It is this relationship that makes the implementation of the Batho Pele initiative crucial in ensuring that the social fabric and moral character of government is not compromised, thus the sustainability and facilitation of the emerged relationship,” Dr Pitso says.

The study focuses on the notion of community service learning (CSL) as an increasingly recognised transformative teaching strategy. It transcends lecture halls and utilises communities as educational spaces to provide practical exposure to real-life experiences to students on both learning and serving the communities.

Instilling graduate attributes in students
Dr Pitso’s thesis, which was predominately qualitative in nature, comprised two main stages. The first stage of the study focused on determining the current state of the public service in terms of the implementation of the Batho Pele principles. Whereas with the second stage, the focus was on determining the extent to which the graduate attributes are instilled in students by means of an exit-level CSL module at the UFS.

Dr Pitso’s thesis, which was awarded to her on 30 June 2016, is the product of five years of hard work, commitment and perseverance. She said it would not have been realised if it had not been for the leadership and mentorship of her promoter, Prof Mabel Erasmus, and co-promoter, Prof Victor Teise.

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