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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

UFS hones focus to nurture world-class research - Business Day

2006-02-10

Sue Blaine
THE University of the Free State plans to concentrate academic study in five areas to strengthen its status as a research institution, the university said yesterday.

The Bloemfontein-based university will focus on areas it classes as development (economics, health, literacy and other human activities) and social transformation — an analysis of how South African society is changing from a philosophical and political viewpoint.

The other three research areas are new technologies, water resources and security, and food production and security.

“It makes sense to concentrate the university’s human resources, infrastructure, financial resources and intellectual expertise,” said university rector and vice-chancellor Prof Frederick Fourie.

The move introduces a style of research that matches international trends.

Universities in Canada, Britain and Australia are setting up their research departments in this way.

In SA, the universities of Stellenbosch, the Witwatersrand, Cape Town and KwaZulu-Natal have embarked on similar strategies.

Fourie gave the example of his alma mater, the US’s Harvard University, whose Nanoscale Science and Engineering Centre is an example of “clustering” on a larger scale.

The centre is a collaboration with Harvard, the Massachusetts Institute of Technology, the University of California, Santa Barbara, the Museum of Science, Boston, and universities in the Netherlands, Switzerland and Japan.

Fourie said the modern research world was so diverse and complex that no university could cover all bases so it was better to establish areas of expertise that made it different from its peer institutions.

Having scientists and researchers work in teams meant certain issues could be researched and developed in a multidisciplinary manner. “I think it’s the only way in which any university can excel. This will help SA become world class in selected areas,” Fourie said.

It is in chemistry that the cluster model has already had its most visible results, with a slice of the university’s on-campus pharmacological testing company Farmovs, established in the 1980s, sold to the US’s Parexel International.

The company is one of the largest biopharmaceutical outsourcing organisations in the world, providing knowledge-based contract research, medical marketing and consulting services to the global pharmaceutical, biotechnology and medical device industries, according to Biospace, an internet-based company providing resources and information to the life science industry.

President Thabo Mbeki, in his state of the nation address last Friday, committed government to allocating more resources to research, development and innovation, and increasing the pool of young researchers in SA.

He said government would “continue to engage the leadership of our tertiary institutions focused on working with them to meet the nation’s expectations with regard to teaching and research”.

The university used to be home to several A-rated scientists, who are considered by a peer review, conducted by the National Research Foundation, to be world leaders in their fields, but had lost them to other institutions. Fourie hopes to lure them back, and with them postgraduate students and funding for their work.

“At universities where you get a star researcher they tend to attract people and funding; if they leave they take that with them,” he said.

Fourie said R50m would be spent on the project, with some already spent last year and the last disbursements to be made next year.

There is R10m in seed money to gather experts and improve equipment and infrastructure, and R17m has been invested in chemistry equipment and staff.

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