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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

UFS alumnus receives PhD in Statistics from the University of Oxford
2016-06-03

Description: DW Bester  Tags: DW Bester

In May of this year, DW Bester obtained
a DPhil in Statistics at the University of
Oxford.
Photo: Supplied

On 14 May this year, Dr DW Bester received a DPhil in Statistics from the University of Oxford. The entire ceremony, which was held in the Sheldonian Theatre in Oxford, was conducted in Latin, as has been the case for the past 800 years.

Dr Bester completed his undergraduate studies and his honours degree at the University of the Free State (UFS). “At first, I was only planning to study for a master’s degree, but was privileged to get an opportunity to do a PhD as well. I didn’t think twice!” he says.

Studies at the University of Oxford


Universities in England do not require a master’s degree for PhD studies. With the help of Prof Max Finkelstein from the UFS Department of Mathematical Statistics and Actuarial Science, Dr Bester registered for the DPhil programme in Statistics directly after his honours studies.

“The title of my thesis was: Joint survival models: A Bayesian investigation of longitudinal volatility. It dealt with a problem in the medical field to determine the cause of stroke risk: is it the absolute level of blood pressure, or the volatility thereof? The analysis of this question led to interesting models which needed advanced application techniques. I had to study these techniques and write programmes for their application.

Although Dr Bester is working currently as the technical head of a company that calculates insurance for power stations, satellites, rockets, and cyber risks, he would like to continue working with his Oxford supervisor in future to make the techniques they have developed more accessible for researchers outside of the field of statistics.
 
“Studying at Oxford requires hard work, perseverance, and a lot of luck. Luck plays a big role, since there are no guarantees that hard work will ensure you a spot in one of the top universities.

Regarding his studies at Oxford, Dr Bester thinks back on his exposure to the GNU/Linux operating system, and free software. “I have seen how valuable this is for analyses in practice. I also had the privilege of meeting the father of free software, Richard Stallman,” Dr Bester says.

2011 Rhodes Scholar

He was elected as Rhodes Scholar in 2011. According to Dr Bester, who has been interested in Mathematics since high school, the Rhodes scholarship was something of a fluke. He applied for the Rhodes scholarship on the recommendation of Prof Robert Schall of the Department of Mathematical Statistics and Actuarial Science.

Role of the UFS in his successes


In addition to the continued support from the team of passionate professors and lecturers at the UFS, the actuarial degree at the UFS is fraught with statistics. Emphasis is also placed on Bayesian statistics. This was crucial to his studies at Oxford. According to Dr Bester, this topic is emphasised strongly in the international statistics community.

Dr Bester regards the work done by two of his lecturers, Michael von Maltitz and Sean van der Merwe, among his highlights at the UFS. Since our first year, they have created an atmosphere of camaraderie among the students. “I think this contributed to the success of everybody. They also make an effort to present topics outside of the syllabus regularly,” says Bester.

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