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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

Socially inclusive teaching provides solution to Grade 4 literacy challenges

2017-01-23

Mots’elisi Malebese, postdoctoral Fellow of the Faculty
of Education at the University of the Free State (UFS) tackles
Grade 4 literacy challenges.
Photo: Rulanzen Martin

Imagine a teaching approach that inculcates richness of culture and knowledge to individual learners, thus enhancing equity, equality, social justice, freedom, hope and fairness in terms of learning opportunities for all, regardless of learners’ diversity.

This teaching strategy was introduced by Mots’elisi Malebese, postdoctoral Fellow of the Faculty of Education at the University of the Free State (UFS), whose thesis focuses on bringing together different skills, knowledge and expertise in a classroom environment in order to enhance learners’ competence in literacy.

A teaching approach to aid Grade 4 literacy competency
Titled, A Socially Inclusive Teaching Strategy to Respond to Problems of Literacy in a Grade 4 Class, Malebese’s post-doctoral research refers to an approach that improves listening, speaking, reading, writing, technical functioning and critical thinking. Malebese, who obtained her PhD qualification in June this year, says her research confirmed that, currently, Grade 4 is a bottleneck stage, at which learners from a low socio-economic background fall behind in their learning due to the transition from being taught in their home language to English as a medium of instruction.

Malebese, says: “My study, therefore, required practical intervention through participatory action research (PAR) to create conditions that foster space for empowerment.”

PAR indoctrinates a democratic way of living that is equitable, liberating and life-enhancing, by breaking away from traditional teaching methods. It involves forming coalitions with individuals with the least social, cultural and economic power.

Malebese’s thesis was encouraged by previous research that revealed that a lack of readiness for a transitional phase among learners, teachers’ inability to teach literacy efficiently, and poor parental involvement, caused many learners to experience a wide variety of learning barriers.

A co-teaching model was adopted in an effort to create a more socially inclusive classroom. This model involves one teacher providing every learner with the assistance he or she needs to succeed, while another teacher moves around the room and provides assistance to individual learners.

“Learners’ needs are served best by allowing them to demonstrate understanding in a variety of ways, because knowledge is conveyed and accomplished through collaborative work,” Malebese said.

She believes the most important benefit of this model is assuring that learners become teachers of their understanding and experiences through gained knowledge.

Roleplayers get involved using diverse expertise in their field
Teachers, parents and several NGOs played a vital role in Malebese’s study by getting involved in training, sewing and cooking clubs every weekend and during school holidays. English was the medium of teaching and learning in every activity. A lodge, close to the school, offered learners training in mountain biking and hiking. These activities helped learners become tour guides. Storyteller Gcina Mhlophe presented learners with a gift of her latest recorded storytelling CD and books. Every day after school, learners would read, and have drama lessons once a week.

AfriGrow, an organisation that works with communities, the government and the corporate sector to develop sustainable community-driven livelihoods through agricultural and nutrition programmes, provided learners with seedlings, manure and other garden inputs and training on how to start a sustainable food garden. The children were also encouraged to participate in sporting activities like soccer and netball.

“I was aware that I needed a large toolbox of instructional strategies, and had to involve other stakeholders with diverse expertise in their field,” Malebese said.

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