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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

Situation on the Bloemfontein Campus, and letter to parents
2016-02-28

Letter to parents from Prof Jonathan Jansen, Vice-Chancellor and Rector of the UFS 

 

Statement by Prof Jonathan Jansen, Vice-Chancellor and Rector of the University of the Free State (UFS) about the situation on the Bloemfontein Campus


1.    As all of you know, last night we witnessed a really tragic event at Xerox Shimla Park on the Bloemfontein Campus on the occasion of the Varsity Cup rugby match between NMMU (FNB Madibaz) and UFS (FNB Shimlas).
2.    The game started at 18:30 and about 17 minutes into the match, a group of protestors sitting on the north-eastern side of the stadium decided to invade the pitch and disrupt the game in progress.
3.    After a short while, some of the spectators also invaded the field, chasing and brutally beating those protestors whom they caught.
4.    As a university leadership we condemn in the strongest terms possible the vicious attack on the protestors. Nobody, repeat nobody, has the right to take the law into their own hands. While the protests were illegal and disruptive, it did not harm to the physical well-being of the spectators.
5.    The reaction from the group of spectators, however, not only opened old wounds, it trampled, literally and figuratively, on the dignity and humanity of other human beings. This we condemn in no uncertain terms, and no stone will be left unturned to find those who acted so violently on what should have been a beautiful occasion that also brought families and young children together to enjoy an evening of sport.
6.    I cannot over-emphasise our level of disgust and dismay at the behaviour of the spectators. It is NOT what the University of the Free State (UFS) is about and we are working around the clock to gather evidence on the basis of which we will pursue both charges and, in the case of students, also disciplinary action on campus.
7.    At the same time, the invasion of the pitch is also completely unacceptable and we will seek evidence on the basis of which we will act against those who decided to disrupt an official university event.
8.    Clashes between students occurred afterwards on campus and members of the Public Order Policing had to disperse some of them. The situation was stabilised in the early hours of the morning.
9.    Disruption continued this morning (23 February 2016) when students damaged some university buildings, a statue, and broke windows. Additional reinforcements from the South African Police Service were brought in to stabilise the campus. Additional security has also been deployed.


Broader picture
10.    We are very aware of the national crisis on university campuses and the instability currently underway. While the UFS has been largely peaceful, we have not been spared this turmoil, as last night’s events showed.
11.    We are also conscious of the fact that even as we speak, various political formations are vying for position inside the turmoil in this important election year. In fact, part of the difficulty of resolving competing demands is that they come from different political quarters, and change all the time.
12.    We are therefore learning from reliable sources that the Varsity Cup competition is, in fact, a target of national protests in front of a television audience.
13.    And we are aware of the fact that these protests are not only led by students but also by people from outside who have no association with the university. Just as the violent spectators involved on Monday night also included people from outside the university.

The demands

14.    My team has worked around the clock to try to meet the demands of contract workers demanding to be in-sourced. In fact, this weekend past, senior colleagues sat with worker leaders in the township to try to find ways of meeting their demands. We were hoping that such an agreement would be finalised by Monday afternoon (22 February 2016), but on the same Monday morning workers and students were arrested after moving onto Nelson Mandela Avenue, after which the South African Police Service (SAPS) took over as the matter became a public safety concern outside the hands of the university. Since then, it was difficult to return the workers to settle on a possible agreement.
15.    The fact is that the UFS has been in constant negotiation with contract workers to provide our colleagues with a decent wage and certain benefits. In fact, towards the end of last year we raised the minimum wage from R2 500 to R5 000. We were in fact hoping that the continued negotiations would improve that level of compensation even as we looked at a possible plan for insourcing in the future. We made it clear that if we could insource immediately, we would, but that the financial risk to the university was so great that it threatened the jobs of all our staff. Those negotiations were going well, until recently, when without notice the workers broke away and decided to protest on and around campus.
16.    While these negotiations were going on, the Student Representative Council (SRC) on Monday 22 February 2016 also decided to protest. While the vast majority of our 32 000 students were in classes and determined to get an education, a very small group led by the SRC President decided to protest; some invaded the UFS Sasol Library and the computer centre, and with the President eventually made their way to Xerox Shimla Park on which route they confronted the police, interrupted traffic and in fact injured some of our security staff as well as police officials.
17.    The university is definitely proceeding to collect evidence on these illegal and violent acts and will also act firmly against students involved in these protests.

Summary
18.    The events of Monday night represent a major setback for the transformation process at the UFS. While we have made major progress in recent years—from residence integration to a more inclusive language policy to a core curriculum to very successful ‘leadership for change’ interventions for student leaders—we still have a long way to go.
19.    One violent incident on a rugby field and we again see the long road ahead yet to be travelled. As I have often said before, you cannot deeply transform a century-old university and its community overnight. We acknowledge the progress but also the still long and difficult path ahead. We will not give up.
20.    We have 32 000 students on our campuses; the overwhelming majority of them are decent and committed to building bridges over old divides as we have seen over and over again. So many of our students, black and white, have become close and even intimate friends working hard to make this a better campus and ours a better community and country. Like all of us, they are gutted by what they saw on Monday, but the hundreds of messages I received from parents, students, and alumni this past 20 hours or so said one thing—keep on keeping on. And we will.

 

The Big Read: An assault on transformation (Times Live kolom deur Prof Jonathan Jansen: 25 Februarie 2016)

 

 

 


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