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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

Research on cactus pear grabs attention of food, cosmetic and medical industry

2015-02-18

Cactus pear
Photo: Charl Devenish

The dedicated research and development programme at the UFS on spineless cactus pear (Opuntia ficus-indica) – also known as prickly pear – has grown steadily in both vision and dimension during the past 15 years. Formal cactus pear research at the UFS started with the formation of the Prickly Pear Working Group (PPWG) in June 2002. It has since gone from strength to strength with several MSc dissertations and a PhD thesis as well as popular and scientific publications flowing from this initiative.

According to Prof Wijnand Swart from the Department of Plant Sciences, the UFS is today recognised as a leading institution in the world conducting multi-disciplinary research on spineless cactus pear.

Cactus pear for animal feed

Increasing demands on already scarce water resources in South Africa require alternative sources of animal feed – specifically crops that are more efficient users of water. One alternative with the potential for widespread production is spineless cactus pear. It is 1.14 x more efficient in its use of water than Old man saltbush, 2.8 x more efficient than wheat, 3.75 x more efficient than lucerne and 7.5 x more efficient than rangeland vegetation.

“Studies on the use of sun-dried cactus pear cladodes suggest that it has the potential to provide some 25% of the basic feed resources required by South Africa’s commercial ruminant feed manufacturing sector,” says Prof HO de Waal of the Department of Animal, Wildlife and Grassland Sciences at the UFS.

Until recently, research has focused extensively on the use of cactus pear as drought fodder. However, this is now beginning to shift, with growing interest in the intensive production of spineless cactus pear for other types of animal feed. One example is the spineless cactus pear fruit, produced seasonal, yielding large quantities of fruit in a relatively short period of a few months in summer. Unless kept in cold storage, the fruit cannot be stored for a long period. Therefore, a procedure was developed to combine large volumes of mashed cactus pear fruit with dry hay and straw and preserve it for longer periods as high moisture livestock feed, kuilmoes – a high water content livestock feed similar to silage.

Cactus pear and Pineapple juice
Photo: Charl Devenish

Cactus pear for human consumption

“In addition to its use as a livestock feed, cactus pear is increasingly being cultivated for human consumption. Although the plant can be consumed fresh as a juice or vegetable, significant value can be added through processing. This potential is considerable: the plant can be pickled; preserved as a jam or marmalade; or dried and milled to produce baking flour. It can also serve as a replacement of egg and fat in mayonnaise,” said Dr Maryna de Wit from the Department of Microbial, Biochemical and Food Biotechnology.

The extraction of mucilage from fresh cladodes can form a gelling, emulsifier, and fat-replacing agent commonly found in food products such as mayonnaise and candy. During an information session to the media Dr De Wit and her team conducted a food demonstration to showcase the use of the cladodes in a juice, chicken stir-fry, biscuits and a salad.

The extrusion of cactus pear seed oil provides a further lucrative niche product to the array of uses. These include high-value organic oil for the cosmetic sector, such as soap, hair gel and sun screens.

The cladodes and the fruit also have medicinal uses. It has anti-viral, anti-inflammatory, pain killing and anti-diabetic agents. It is also high in fibre and can lower cholesterol. The fruit also prevents proliferation of cells and suppresses tumour growth and can even help to reduce a hangover.

In South Africa the outdated perception of cactus pears as thorny, alien invaders, is rapidly disappearing. Instead, farmers now recognise that cactus pear can play a vital role as a high yielding, water-efficient, multi-use crop, said Prof de Waal and the members of the Cactus Pear Team.

Facebook photo gallery
Dagbreek interview with Dr Maryna de Wit

Research on cactus pear (read the full story)

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