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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

Socially inclusive teaching provides solution to Grade 4 literacy challenges

2017-01-23

Mots’elisi Malebese, postdoctoral Fellow of the Faculty
of Education at the University of the Free State (UFS) tackles
Grade 4 literacy challenges.
Photo: Rulanzen Martin

Imagine a teaching approach that inculcates richness of culture and knowledge to individual learners, thus enhancing equity, equality, social justice, freedom, hope and fairness in terms of learning opportunities for all, regardless of learners’ diversity.

This teaching strategy was introduced by Mots’elisi Malebese, postdoctoral Fellow of the Faculty of Education at the University of the Free State (UFS), whose thesis focuses on bringing together different skills, knowledge and expertise in a classroom environment in order to enhance learners’ competence in literacy.

A teaching approach to aid Grade 4 literacy competency
Titled, A Socially Inclusive Teaching Strategy to Respond to Problems of Literacy in a Grade 4 Class, Malebese’s post-doctoral research refers to an approach that improves listening, speaking, reading, writing, technical functioning and critical thinking. Malebese, who obtained her PhD qualification in June this year, says her research confirmed that, currently, Grade 4 is a bottleneck stage, at which learners from a low socio-economic background fall behind in their learning due to the transition from being taught in their home language to English as a medium of instruction.

Malebese, says: “My study, therefore, required practical intervention through participatory action research (PAR) to create conditions that foster space for empowerment.”

PAR indoctrinates a democratic way of living that is equitable, liberating and life-enhancing, by breaking away from traditional teaching methods. It involves forming coalitions with individuals with the least social, cultural and economic power.

Malebese’s thesis was encouraged by previous research that revealed that a lack of readiness for a transitional phase among learners, teachers’ inability to teach literacy efficiently, and poor parental involvement, caused many learners to experience a wide variety of learning barriers.

A co-teaching model was adopted in an effort to create a more socially inclusive classroom. This model involves one teacher providing every learner with the assistance he or she needs to succeed, while another teacher moves around the room and provides assistance to individual learners.

“Learners’ needs are served best by allowing them to demonstrate understanding in a variety of ways, because knowledge is conveyed and accomplished through collaborative work,” Malebese said.

She believes the most important benefit of this model is assuring that learners become teachers of their understanding and experiences through gained knowledge.

Roleplayers get involved using diverse expertise in their field
Teachers, parents and several NGOs played a vital role in Malebese’s study by getting involved in training, sewing and cooking clubs every weekend and during school holidays. English was the medium of teaching and learning in every activity. A lodge, close to the school, offered learners training in mountain biking and hiking. These activities helped learners become tour guides. Storyteller Gcina Mhlophe presented learners with a gift of her latest recorded storytelling CD and books. Every day after school, learners would read, and have drama lessons once a week.

AfriGrow, an organisation that works with communities, the government and the corporate sector to develop sustainable community-driven livelihoods through agricultural and nutrition programmes, provided learners with seedlings, manure and other garden inputs and training on how to start a sustainable food garden. The children were also encouraged to participate in sporting activities like soccer and netball.

“I was aware that I needed a large toolbox of instructional strategies, and had to involve other stakeholders with diverse expertise in their field,” Malebese said.

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