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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

Dialogue between Science and Society series looks at forgiveness and reconciliation

2013-03-24

Taking part in the discussion on forgiveness and living reconciliation, were from left: Olga Macingwane, a survivor of the Worcester bombing of 1993; Dr Juliet Rogers, a Scholar on Remorse from the University of Melbourne in Australia and Dr Deon Snyman, Chairperson of the Worcester Hope and Reconciliation Process.
Photo: Mandi Bezuidenhout
24 March 2013

How do you, as a mother who lost her only daughter, forgive the man who claimed responsibility for the attack that killed her? How do you forget his crime while travelling with him across the world?

These were some of the questions posed to Jeanette Fourie at a Dialogue between Science and Society series on forgiveness and living reconciliation. Jeanette, whose daughter Lyndi was killed in an attack on the Heidelberg Pub in Cape Town in 1993, was one of three people telling their stories of forgiveness while dealing with traumatic experiences.

Sitting next to Letlapa Mphahlele, the man who owned up to the attack that killed her daughter, Jeanette spoke about their story of forgiveness traveling the world together, spreading the message of forgiveness and conciliation.

"Don't ever think you can forget, because that’s not possible. What you do with the pain is to find peace, and that's what forgiveness does. Forgiveness allows you to stop all the dialogue in your head on why he did it. You don't forget, you confront it and you deal with it."

Letlapa, Director of Operations of Apla, the military wing of the PAC at the time of Lyndi's death, spoke about dealing with the response to his crime. "Sometimes you wish that you were not forgiven, because now you have the great burden of proving that you are worthy of forgiveness."

Also telling her story of forgiveness was Olga Macingwane, a survivor of the Worcester bombing of 1993 in which four people were killed and sixty-seven others injured. Four people were sent to prison. In 2009 Olga met one of the perpetrators, Stefaans Coetzee, and what came out of that meeting, is her story.

"When I met Stefaans I was very angry, but when you sit down with somebody and listen to him or her, you find out what the reasons were that made him or her do something. I can say that I forgave him."

Facilitating the conversation, Prof Pumla Gobodo-Madikizela, Senior Research Professor on Trauma, Forgiveness and Reconciliation, said the seminar was meant to get in touch with the truth that forgiveness is possible.

"Before we had the Truth and Reconciliation Commission (TRC) in South Africa, the experts always said that forgiveness was not possible in these stories of the past. And then the TRC came into life as a response to mass atrocities. For the first time in the history of these traumatic experiences, of political traumas, we witness something that we have never seen. Even us on the TRC, although it was framed as reconciliation, we never imagined there would actually be stories of forgiveness emerging out of that process, and then we witness that this too is possible."

Others who took part in the two-hour-long seminar, were Dr Juliet Rogers, a Scholar on Remorse from the University of Melbourne in Australia and Dr Deon Snyman, Chairperson of the Worcester Hope and Reconciliation Process. They spoke about the dynamics behind the processes of engagement between victims/ survivors and perpetrators.

The Dialogue between Science and Society series was co-hosted by the Institute for Reconciliation and Social Justice.

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