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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

An education system based on hope is what South Africa needs – Dr Beryl Botman

2016-05-26

Description: Hope revised Tags: Hope revised

Dr Beryl Botman, a postdoctoral research
fellow at the IRSJ, with Dr Willy Nel research associate
at the IRSJ and lecturer at the UFS
Faculty of Education.

HOPE is tangible and concrete construct that should be rooted in the learning and training of teachers,” said Dr Beryl Botman, a postdoctoral research fellow at the Institute for Reconciliation and Social Justice (IRSJ).

She presented her research paper Educators, praxis, and hope: A philosophical analysis of post-apartheid teacher education policy, based on the theoretical ideologies of Paulo Freire’s Pedagogy of the Oppressed. She explores ways in which oppression has been justified, and how it has been overcome through a mutual process between the oppressor and the oppressed, drawing on Paolo Freire’s theories and practices. The presentation was held at the University of the Free State’s (UFS) Faculty of Education, on the Bloemfontein campus on 13 May 2016.

From oppression to hope
Hope should be an educational construct for teacher education in South Africa. Dr Botman asserts that epistemology and ontology should be inseparable, as they are pivotal to an education system that is transformational.

The recent country-wide student protests and demonstrations are an indicant that education institutions need to seek understanding of mechanisms that fuel social conflict. Dr Botman claims that vast social inequalities make the process of democratisation difficult thus hindering transformation. She states that a critical consciousness is important for all South Africans, but more so for educators; it can be used as a tool to understanding the mechanisms of social conflict.

“Self-reflection and self-critique is vital for educators, we need to understand that we do not have all the answers because we ever-evolving beings, working on understanding ourselves and the people around us,” said Dr Botman.

The notion of hope
“I am a farmer. I have no hope for a future that is different from today. This quotation comes from Paulo Freire’s work," said Dr Botman. She said that the South African context and environment is similar. She said that people cannot live for today; one should live for tomorrow if hope is to manifest itself.

South African education environment needs to adopt a progressive consciousness that is future orientated, “You need to be hopeful, if you are radical. You need to be able to envision a new society and a new world,” said Dr Botman.

“You cannot only denounce the present, you need to also announce your hopes for a new society. South Africa needs education systems built on understanding. Although change is difficult, it is necessary for transformation,” Dr Botman added.

What makes hope educational?
“Hope is a vision for a tomorrow that is different, and vital for a transformative education system. To get out of a state of despair, people need to educate their hope. Lately, the issue of white privilege has been brought to the fore. You need to educate your hope, so that you understand the reality of others but, more importantly, of yourself,” said Dr Botman.

Dr Botma added that teacher education needs to adopt a Freirean pedagogy with a strong philosophy based on hope. The agency of teachers can either be hopeful or without hope. It is vital that education promotes hope.

“Teachers need to rely on their existential experience, the experiences of others, and the experiences of the children or students they teach. An understanding of all these experience reinforces the idea that people are life-long learners, always learning and adapting to society’s needs,” said Dr Botman.

Teachers as agents of hope
Dr Botman stated that current South African education policy is directed towards transformation but it does not stipulate means to achieve this objective. Further, she argues that educators need to put greater emphasis on self-knowledge, self-reflection, and self-education. Connecting with teachers, parents, students and the community engages with their self-knowledge and reflection.

Reorientation of teacher education
Dr Botman concluded by mentioning that rethinking ontological and epistemological aspects of education is important, and should be a pivotal point of teacher education. A renewed vision of hope-orientated philosophy and pedagogy needs to be adopted by the education institutions. A praxis, which is an informed action, when a balance between theory and practice is achieved. There is a need for an inclusive exploration of education philosophies and education systems not only European and Western but also African and Eastern as well.

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