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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

Emma Sadleir talks about social media etiquette
2016-05-18

Description: Emma Sadlier Tags: Emma Sadlier

Emma Sadleir
Photo: Supplied

“We have all become celebrities, we have become social figures because of our power to publish information. We have all become brands, and we need to protect our brand. Digital content is sometimes dangerous content,” said Sadleir.

On 11 May 2016, the University of the Free State, in collaboration with the Postgraduate School, hosted, Emma Sadleir, a leading social media expert, in the Equitas Auditorium on the Bloemfontein Campus. She is an admitted advocate, specialising in social media law.  Dr Henriette van den Berg, Director of the Postgraduate School, described Sadleir’s presentation as a privilege for all the staff and students who attended.

Sadleir said that there are two important rules that staff and students of an institution should try to follow. The first is not to bring the name of the institution into disrepute; and the second is not to breach the goodwill of the institution or, in other words, not to bite the hand that feeds you.

“The common law, even if there is no policy, is that anything that brings the company into disrepute can lead to disciplinary consequences up to termination,” said Sadleir.

Sadleir focused on hate speech and free speech, stating that free speech is a right that is entrenched in the constitution, but, like every other right, it has limitations. She mentioned Penny Sparrow, Matt Theunissen, Velaphi Khumalo, and Judge Mabel Jansen, all of whom have been lambasted by the public over their racist posts on social media. Sadleir stressed that, even on social media, content has to be within the confines of the law, and people must remember our rights are not absolute. We have a lot of freedoms, but no one cannot disseminate hate speech.

“Would you publish whatever you thinking on a billboard, close to a busy highway with your name, picture and employers details or the institution you studying at? If you have no grounds to justify the comment, do not post it,” warned Sadlier.  

According to the South African Bill of Rights, everyone has the right to privacy, but an expectation of privacy has to be enforced. She said people over-document their lives on social media, decreasing your right to privacy drastically. “It is like CCTV footage of your life. It is simple, the more you take care of your privacy, the more you have,” said Sadleir.

Sadleir said it was important for Facebook users to have privacy settings where they can review posts where they are tagged. According to Sadleir, managing your reputation is not only limited to what you post about yourself but also managing what others post about you.

She cited a 2013 case in the Pretoria High Court in which a new wife wrote a scandalous Facebook post about her husband’s ex-wife, tagging the husband in the post. The courts found both the new wife and the husband guilty of defamation.

“If you have been tagged in something but have not been online and seen the content, you are then an innocent disseminator. The moment you are aware of the post you are liable for the content,” said Sadleir.

“It takes 20 years to build a reputation and five minutes to ruin it. If you think about that, you'll do things differently,” Sadleir said, concluding her presentation with the quotation from Warren Buffet.

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