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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

CR Swart Memorial Lecture: Mr Cecil le Fleur

2006-08-08

Khoe and San call for government to speed up policy dialogue with indigenous communities

Mr Cecil le Fleur, leader of the National Khoe-San Consultative Conference and member of the executive management of the National Khoe-San Council, has called for a national policy on indigenous peoples to protect the human rights and special needs of indigenous people in South Africa.

Mr Le Fleur delivered the 38th CR Swart Memorial Lecture on the Khoe and San at the University of the Free State (UFS). He commended the UFS for its serious approach to the Khoe and San and for initiating initiatives such as a research project on the Griqua in which various aspects linked to language, -culture, -history, - leadership, their role in the South African community (past and present) and the conservation of their historical cultural heritages will be covered.

“The policy dialogue with indigenous communities initiated by government in 1999 and supported by the International Labour Organisation (ILO), has been exceedingly slow, owing to political and bureaucratic problems,” said Mr Le Fleur.

According to Mr Le Fleur the slow pace is also impacting negatively on the United Nations’ efforts to expand the international standards and mechanisms for human rights so as to include the special needs of indigenous peoples.

“The successful adoption of a South African policy would probably have a major impact on the human rights culture of Africa and, more specifically, on the UN system,” he said.

“South Africa has a powerful moral authority internationally and is willing to use this authority in multilateral forums. At this stage, however, South Africa’s Department of Foreign Affairs (DFA) may not take an official position on UN instruments and declarations pertaining to indigenous issues, until the Cabinet has resolved its own domestic policy position,” he said.

According to Mr le Fleur it therefore came as a great surprise when the DFA brought out a positive vote in the UN for the adoption of the "Draft Declaration on the Rights of indigenous Peoples" in June this year, even before the completion of the policy process.

Policy consolidation in South Africa is the primary key to creating a new policy climate in Africa in order to protect the rights of indigenous peoples. “The existing constitution of the Republic of South Africa is one of the most liberal on the continent, and embraces the concept of redress of past discrimination. It already includes a clause (Section 6) making provision for the protection of language rights for Khoe and San peoples - the fist peoples of southern Africa,” he said.

“If South Africa can effectively integrate this ‘third generation’ of collective rights within an existing democratic constitution, this will send a clear message to Africa and the world that indigenous rights are a necessary component of human and civil rights in modern democracies,” he said.

Mr Le Fleur proposed an institutional framework based on set principles that would satisfy the needs and aspirations of the Griqua and other first indigenous peoples in South Africa. “The proposed framework was based on the notion of vulnerability as a result of colonialism and apartheid, which stripped us of our indigenous identity, cultural identity and pride as people. This injustice can hardly be addressed within the existing mechanisms provided by the current text of the Constitution,” he said.

Mr Le Fleur also proposed that the principles of unique first-nation status, as recognised in international law, should be applied in the construction of the framework of the constitutional accommodation for the Khoe and San.

Mr Le Fleur further proposed that the Khoe and San’s indigenous status in constitutional terms must be separate from the constitutional acknowledgement of their status as a cultural community, as envisaged in sections 185 and 186 of the Constitution of 1996.

According to Mr Le Fleur, the suggested mechanism should make provision for structures such as:

A statutory representative council for First Indigenous Peoples of South Africa at a national level;
a separate Joint Standing Committee on Indigenous and Traditional Affairs, in both the National Assembly and the National Council of Provinces on which the Khoe and San can be represented;
a representative structure for the Khoe and San in the legislature of each relevant province; and
ex officio membership in the relevant structures of local government.

Media release
Issued by: Lacea Loader
Media Representative
Tel: (051) 401-2584
Cell: 083 645 2454
E-mail: loaderl.stg@mail.uovs.ac.za
24 August 2006

- Full lecture
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