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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

“You cannot find Ubuntu in a culture of dominance” – Dr Mamphela Ramphele during second Leah Tutu Gender Symposium

2015-02-28

From the left are: Samantha van Schalkwyk, Zanele Mbeki, Prof Pumla Gobodo-Madikizela and Dr Mamphela Ramphele.
Photo: Johan Roux

Video message from Mrs Leah Tutu

Session 1: Keynote address by Dr Mamphela Ramphele
Ndiyindoda! Yes, you are a man

Session 2: Professor Robert Morrell from the University of Cape Town
South African Gender Studies: Setting the context

Session 3: How can we engage young men to act against violence against women?
Panel discussion by Lisa Vetten (Wits Institute for Social and Economic Research), Despina Learmonth (Psychology Department, University of Cape Town) and Wessel van den Berg (Sonke Gender Justice)

Session 4: Professor Pumla Gobodo-Madikizela
Self-defence as a strategy for women’s resistance: Reflections on the work of Susan Brison

Engaging men to act against gender-based violence in the Southern African context.

This was the theme of the second International Leah Tutu Symposium, hosted by the Gender Initiative of Trauma, Forgiveness and Reconciliation Studies of the University of the Free State (UFS) on Tuesday 24 February 2015.

What does it mean to be man? How can men become active in the fight against gender-based violence? And when does one say: enough is enough? Questions like these set the tone as highly-respected individuals such as Dr Mamphela Ramphele, Prof Rob Morrell, Lisa Vetten and Andy Kawa took to the stage in the Odeion on the Bloemfontein Campus.

Leah Tutu
Unfortunately, Mrs Leah Tutu could not attend this year’s event, but she still managed to send sparks of wit and insight into the auditorium. In her video message, Mrs Tutu referred to the fact that our country has “consigned discriminatory legislation to the rubbish bin of the past”, but we continue to inhabit a divided society.

“We have a constitution and bill of rights that should have sounded the death knell for patriarchy. But women are unsafe across the land,” Mrs Tutu said. “Our freedom cost too much to be left out in the rain,” she urged.

Ndiyindoda! Yes, you are a man
In Dr Ramphele’s keynote address, “Ndiyindoda! Yes, you are a man”, she scrutinised the dominant masculinity model that has supported an alpha-male mentality for millennia. A mentality that celebrates dominance, power and control – where the winner takes it all. How then, can we expect our young boys to embrace the value system of a human rights culture?

“Gender equality is at the heart of our constitutional democratic values. Yet, our society continues to privilege and celebrate the alpha male as a masculinity model,” Dr Ramphele said. This dissonance can only produce conflict and violence.

We encourage our young men to be gentle, communicative, caring people who show their emotions. And when they do, what do we as women do? Do we encourage them?

“Or do we join those who call them wimps, moffies, sissies? How do we respond when they are ridiculed?” Dr Ramphele asked. Are we, as mothers, fathers and grandparents willing to socialise our children to acknowledge a diversity of masculinities as equally valid in our society?

The new man and the new woman of the 21st century need to be liberated from the conflict-ridden dominant masculinity model. They need to be able to shape their identity in line with a value system of human rights as enshrined in our constitution.

Perhaps Dr Ramphele’s message could be summed up by one sentence: You cannot find Ubuntu in a culture of dominance.

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