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UFS CHSR&D drives research to advance stronger health systems

21 October 2024 | Story Leonie Bolleurs | Photo Stephen Collett

Centre for Health Systems Research & Development team — For more than three decades, the Centre for Health Systems Research & Development (CHSR&D) has been actively involved in efforts to strengthen health systems and improve health outcomes through its research and community engagement initiatives. Pictured are members of the CHSR&D team. From the left: Prof Gladys Kigozi-Male, Bridget Smit, Dr Ngwi Mulu, and Prof Michelle Engelbrecht. Absent, Prof Christo Heunis.

The Centre for Health Systems Research & Development (CHSR&D) at the University of the Free State (UFS) has played a key role in health systems research in South Africa. Established in 1993, the centre is built on a strong foundation of medical sociology and the sociology of health, addressing some of the most critical challenges in public health. For more than three decades, the centre has been actively involved in efforts to strengthen health systems and improve health outcomes through its research and community engagement initiatives.

The centre’s primary mission is clear: to generate and disseminate scientific knowledge that informs and improves health policies, strategies, and practices at the local, provincial, and national levels. As health systems worldwide continue to grapple with new and emerging challenges, the CHSR&D has positioned itself as a critical resource for evidence-based solutions that drive progress towards improved health outcomes. The centre also provides postgraduate training and capacity building that contributes to expanding expertise in health, health systems, and health-care research and development.

Focus on priority health programmes

According to Prof Michelle Engelbrecht, Director of the centre and an Associate Professor, the CHSR&D’s research portfolio covers a wide range of issues that are critical to the development of a strong health system. “The centre focuses on areas such as public health policy implementation and operational functioning, human resources for health, occupational health, and priority health programmes such as tuberculosis (TB) and HIV prevention and control, sexual and reproductive health, as well as mental health. In response to the recent COVID-19 outbreak, the centre prioritised research to enhance understanding of this global crisis. Notable studies from the past five years include COVID-19 vaccine literacy and acceptability, the psychological well-being of nurses during the second wave of COVID-19, and the impact of COVID-19 on essential health services in the Free State. Additionally, over the past five years, the centre has focused on the increased co-morbidity between TB and mental health, aiming to develop more holistic approaches to TB treatment towards improved TB programme performance.”

One of the CHSR&D's most impactful initiatives is its work in sexual and reproductive health, specifically its programme aimed at including men in the pregnancy and birth process. Historically, men have often been excluded from prenatal, childbirth, and postnatal care, which can negatively affect the health of mothers and babies. The centre is working to change this by advocating for men’s involvement in all stages of the pregnancy and birth process, creating a more supportive environment for expectant mothers and improving family health outcomes. By focusing on developing support systems and resources for men to participate actively in reproductive health, they are also working to shift policies and cultural norms that have traditionally sidelined male involvement in these critical moments.

As the world continues to confront the challenges posed by universal access to health care, South Africa is undertaking the greatest experiment ever in attempting to equalise access to quality health care by treating health care not as a commodity, but as a human right, namely through the implementation of National Health Insurance (NHI). Prof Christo Heunis, also an Associate Professor in the centre, says that the CHSR&D’s work in these areas is more important than ever. “If NHI is to be successful, (public) health systems strengthening is required. Health-related research and development, as well as the capacity to conduct such research and development – to inform health systems strengthening – is the fundamental purpose of CHSR&D.”

Collaboration with communities

Engaging with the community is at the heart of the CHSR&D’s work. The centre has a long history of working with local communities to identify health priorities and develop solutions that are responsive to the needs of those they serve. Prof Gladys Kigozi-Male, an Associate Professor as well, notes that this commitment ensures that the centre's work is not only academically thorough, but also practically relevant and impactful.

The CHSR&D also works closely with key partners and collaborators to expand the reach and impact of its research. “The centre has a longstanding partnership with the Free State Department of Health and is actively involved in the Provincial Health Research Committee. These collaborations allow the centre to contribute to health systems strengthening in meaningful ways, particularly through citizen-centred assessment of public health-care service delivery,” adds Prof Kigozi-Male.

In addition to its local collaborations, the centre partners with international academic institutions such as the University of South Carolina (USA) and Makerere University in Kampala (Uganda). These partnerships enable the CHSR&D to exchange knowledge and best practices with global health experts, further enhancing the quality and impact of its research. Civil society organisations such as Mosamaria Aids Ministry, Sonke Gender Justice, and loveLife also play a critical role in the centre’s work, helping to bridge the gap between research and implementation on the ground.

Quality, reliability, and future goals

"At the Centre for Health Systems Research & Development, we align with the UFS’ Vision 130, which emphasises transformation and an outward approach. We are dedicated to engaging with local and regional communities, pursuing knowledge that addresses the needs and aspirations of the Free State, South Africa, and the broader African continent. Our commitment to maintaining the highest standards of quality and reliability in our research is unwavering. By employing a variety of methodological approaches – quantitative, qualitative, and mixed-methods – we ensure that our research findings are comprehensive and can confidently inform health policies and strategies," notes Prof Engelbrecht.

In conclusion, the CHSR&D remains a critical player in the landscape of public health research and development. Its commitment to high-quality research ensures that it will continue to drive progress in health systems development and improve health outcomes for the foreseeable future. CHSR&D staff are dedicated to providing high-quality postgraduate supervision, undertaking necessary research to strengthen health systems, producing internationally impactful publications, and remaining locally and regionally relevant.

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Premiere of the documentary on King Moshoeshoe - Address by the Rector

2004-10-14

Address by the rector and vice-chancellor of the University of the Free State, prof Frederick Fourie, at the premiere of the documentary on King Moshoeshoe, Wednesday 13 October 2004

It is indeed a privilege to welcome you at this key event in the Centenary celebrations of the University of the Free State.

We are simultaneously celebrating 100 years of scholarship with 10 years of democracy

Today is a very important day with great significance for the University. This Centenary is not merely a celebration of an institution of a certain age. It is a key event in this particular phase of our history, in our transformation as an institution of higher learning, in taking the creation of a high-quality, equitable, non-racial, non-sexist, multicultural and multilingual university seriously.

This is about building something new out of the old, of creating new institutional cultures and values from diverse traditions.

It is about learning together - as an higher education institution - about who we are where we come from – to decide where we are going.

It is about merging the age-old tradition of the university, of the academic gown, with the Basotho blanket, the symbol of community engagement.

Then why is it important that we remember Moshoeshoe, where does he fit into our history?

In the Free State province, where large numbers of Basotho and Afrikaners (and others) now live together, a new post-apartheid society is being built in the 21st century.

The challenge is similar to that faced by Moshoeshoe 150 years ago. As you will see tonight, he did a remarkable thing in forging a new nation out of a fragmented society. He also created a remarkable spirit of reconciliation and a remarkable style of leadership.

Not all people in South Africa know the history of Moshoeshoe. Many Basotho – but not all – are well versed in the history of Moshoeshoe, and his name is honoured in many a street, town and township. Many white people know very little of him, or have a very constrained or even biased view of his role and legacy. In Africa and the world, he his much less known than, for instance, Shaka. (In Lesotho, obviously, he is widely recognised and praised.)

We already benefit from his legacy: the people of the Free State share a tradition of moderation and reconciliation rather than one of aggression and domination.

With Moshoeshoe, together with Afrikaner leaders and reconciliators such as President MT Steyn and Christiaan de Wet, we have much to be thankful for.

Our challenge is take this legacy further: to forge a new society in which different cultural, language and racial groups – Basotho, Afrikaners and others – will all feel truly at home.

Bit by bit, on school grounds, on university campuses, in each town and city, people must shape the values and principles that will mould this new non-racial, multicultural and multilingual society.

A shared sense of history, shared stories and shared heroes are important elements in such a process.

Through this documentary film about King Moshoeshoe, the UFS commits itself to developing a shared appreciation of the history of this country and to the establishment of the Free State Province as a model of reconciliation and nation-building.

Moshoeshoe is also a strong common element, and binding factor, in the relationship between South Africa / the Free State, and its neighbour, Lesotho.

For the University of the Free State this also is an integral part of real transformation – of creating a new unity amidst our diversity.

Transformation has so many aspects: whilst the composition of our student and staff populations have been changing, many other things change at the same time: new curricula, new research, new community service learning projects.

In also includes creation of new values, new (shared) histories, new (shared) heroes.

It includes the incorporation of the Qwaqwa campus, which serves a region where so many of the children of Moshoeshoe live, including her majesty Queen Mopeli.

We see in Moshoeshoe a model of African leadership – of reconciliation and nation-building – that can have a significant impact in South Africa and Africa as a whole.

We also find in the legacy of King Moshoeshoe the possibility of an “founding philosophy”, or “defining philosophy”, for the African renaissance.

To develop this philosophy, we must gain a deeper understanding of what really happened there, of his role, of his leadership.

Therefore the University of the Free State will encourage and support further research into the history, politics and sociology of the Moshoeshoe period, including his leadership style.

We hope to do this in partnership with National University of Lesotho.

The Moshoeshoe documentary is one element of a long-term project of the UFS. The other elements of the project that we are investigating are possible PhD-level research; a possible annual Moshoeshoe memorial lecture on African leadership; and then possible schools projects and other ways and symbols of honouring him.

It is my sincere wish that all communities of the Free State and of South Africa will be able to identify with the central themes of this documentary, and develop a shared appreciation for leaders such as King Moshoeshoe and the legacy of peace, reconciliation and nation-building that they have left us.

Prof. Frederick Fourie
Rector and Vice-Chancellor
University of the Free State
13 October 2004.

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