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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.

News Archive

Census 2011 overshadowed by vuvuzela announcements

2012-11-20

Mike Schüssler, economist
Photo: Hannes Pieterse
15 November 2012

Complete Lecture (MP3)

Census 2011 contains good statistics but these are overshadowed by vuvuzela announcements and a selective approach, economist Mike Schüssler said at a presentation at the UFS.

“Why highlight one inequality and not another success factor? Is Government that negative about itself?” Mr Schüssler, owner of Economist.co.za, asked.

“Why is all the good news such as home ownership, water, lights, cars, cellphones, etc. put on the back burner? For example, we have more rooms than people in our primary residence. Data shows that a third of Africans have a second home. Why are some statistics that are racially based not made available, e.g. orphans? So are “bad” statistics not always presented?”

He highlighted statistics that did not get the necessary attention in the media. One such statistic is that black South Africans earn 46% of all income compared to 39% of whites. The census also showed that black South Africans fully own nearly ten times the amount of houses that whites do. Another statistic is that black South Africans are the only population group to have a younger median age. “This is against worldwide trends and in all likelihood has to do with AIDS. It is killing black South Africans more than other race groups.”

Mr Schüssler also gave insight into education. He said education does count when earnings are taken into account. “I could easily say that the average degree earns nearly five times more than a matric and the average matric earns twice the pay of a grade 11.”

He also mentioned that people lie in surveys. On the expenditure side he said, “People apparently do not admit that they gamble or drink or smoke when asked. They also do not eat out but when looking at industry and sector sales, this is exposed and the CPI is, for example, reweighted. They forget their food expenditure and brag about their cars. They seemingly spend massively on houses but little on maintenance. They spend more than they earn.”

“On income, the lie is that people forget or do not know the difference between gross and net salaries. People forget garnishee orders, loan repayments and certainly do not have an idea what companies pay on their behalf to pensions and medical aid. People want to keep getting social grants so they are more motivated to forget income. People are scared of taxes too so they lower income when asked. They spend more than they earn in many categories.”

On household assets Mr Schüssler said South Africans are asset rich but income poor. Over 8,3 million black African families stay in brick or concrete houses out of a total of 11,2 million total. About 4,9 million black families own their own home fully while only 502 000 whites do (fully paid off or nearly ten times more black families own their own homes fully). Just over 880 000 black South Africans are paying off their homes while 518 000 white families are.

Other interesting statistics are that 13,2 million people work, 22,5 million have bank accounts, 19,6 million have credit records. Thirty percent of households have cars, 90% of households have cellphones and 80% of households have TVs.

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