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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

Service learning teaching strategy essential for the infusion of graduate attributes

2017-01-02

Dr Pulane Pitso, Director: Institutional Performance
Monitoring within Performance Monitoring and Evaluation
Branch in the Department of the Premier, Free State
Provincial Government (FSPG).
Photo: Rulanzen Martin

“Public service delivery is not only about ‘government’s sector end products’, but is also fundamentally related to the ways in which the citizens can be best served at the point of client interface, as the primary beneficiaries.”

It is against this backdrop that Dr Pulane Pitso’s study explored the role of Higher Education Institutions (HEIs) in infusing the curriculum with graduate attributes for improved service delivery. The study is entitled: Community service learning as a transformative tool for infusing the university curriculum with graduate attributes for improved service delivery.

Citizens the central focus in public-service delivery
Although with the advent of democracy, the South African public service introduced the Batho Pele “people first” initiative which is one of the key transformation-oriented initiatives to ensure that citizens are the central focus in public service delivery. An extant literature indicates that more work by the government still needs to be done in terms of the institutionalisation and implementation thereof.

Notwithstanding that public service is primarily responsible for addressing challenges related to poor service delivery, Dr Pitso moved from a premise that a multifaceted and collaborative approach, underpinned by a concerted effort by all relevant sectors, is more likely to contribute significantly towards improving service delivery. Specific focus was given to sectors primarily mandated to lay foundations through training and development such as HEIs, since the nature and quality of public service largely depends on the nature, quality and relevance of the system of education.

CSL a transformative teaching strategy
The basis for her thesis, emanated from the contention that public service delivery is a dynamic process which cultivates into a citizen-government relationship.

“It is this relationship that makes the implementation of the Batho Pele initiative crucial in ensuring that the social fabric and moral character of government is not compromised, thus the sustainability and facilitation of the emerged relationship,” Dr Pitso says.

The study focuses on the notion of community service learning (CSL) as an increasingly recognised transformative teaching strategy. It transcends lecture halls and utilises communities as educational spaces to provide practical exposure to real-life experiences to students on both learning and serving the communities.

Instilling graduate attributes in students
Dr Pitso’s thesis, which was predominately qualitative in nature, comprised two main stages. The first stage of the study focused on determining the current state of the public service in terms of the implementation of the Batho Pele principles. Whereas with the second stage, the focus was on determining the extent to which the graduate attributes are instilled in students by means of an exit-level CSL module at the UFS.

Dr Pitso’s thesis, which was awarded to her on 30 June 2016, is the product of five years of hard work, commitment and perseverance. She said it would not have been realised if it had not been for the leadership and mentorship of her promoter, Prof Mabel Erasmus, and co-promoter, Prof Victor Teise.

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