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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

Childhood obesity should be curbed early

2017-03-15

Description: Child obesity Tags: Child obesity

Serious intervention by parents is required to deal
with childhood obesity. Prof Louise van den Berg and
a group of final-year PhD students worked on a study
about the prevalence of obesity in six-year-olds in
South Africa.
Photo: Supplied

If your child is overweight when they start school at the age of six, unless you do something about it at that point, the indications are they are going to be overweight teenagers and obese adults. This is according to University of the Free State’s Prof Louise van den Berg.

Evidence has shown that overweight children and teenagers have a greater risk of developing lifestyle diseases such as type 2 diabetes, hypertension and cardiovascular disease later in life, and dying prematurely.

Obesity is a global pandemic rapidly spreading among adults and children, in developed and developing countries alike.

Dr Van den Berg worked with Keagan Di Ascenzo, Maryke Ferreira, Monja-Marie Kok, Anneke Lauwrens, all PhD students with the Department of Nutrition and Dietetics, to conduct the study. Their research found that children who are overweight by the time they turn six should be screened for weight problems.

Why six-year-olds?
Children who are overweight between the ages of two and five are five times more likely to be overweight when they are 12. There are two periods in a normal life cycle when the body makes new fat cells. The first is in the uterus and the second is around the age of six. The second phase lasts from the age of six to puberty.

The study assessed the prevalence of obesity in six-year-olds as part of a campaign in South Africa to raise awareness of the problem among parents and educators.

A total of 99 children were chosen from seven schools in Mangaung, the capital city of Free State. The schools were chosen from quintile four and five schools, which when measured by their own resources and economic circumstances, are well resourced and serve largely middle-class and wealthy communities.

The children’s weight, height and waist circumference were measured and used to calculate a body mass index score and waist-to-height ratio. Both these figures are good predictors for future lifestyle disease risks such as type 2 diabetes, hypertension and cardiovascular disease. A person with a good waist-to-height ratio can wrap a piece of string equal to their height around their waist at least twice.

When the children had a higher body mass index, they also had an increased waist to height ratio. The study found one in four children from the schools surveyed were overweight when they started primary school.

Nipping the fat in the bud
Although there are many factors that play a role in preventing childhood obesity, parents’ perceptions of their children’s weight play an important role. A recent study found that more than 50% of parents underestimate the weight of their obese children. These parents remain unaware of the risks their children face and are not motivated to take any action.

At least half of the parents whose children are overweight struggle to recognise their children’s weight problems fearing that they will be labelled or stigmatised. By the time they turn six overweight children should be referred to dieticians and nutritionists who are qualified to guide their parents in getting them to eat well and be more physically active at pre-primary and primary school.

The high prevalence of weight problems among six-year-olds found in this study is an urgent call to healthcare professionals to step up and empower parents, educators and children with the necessary skills for healthy dietary practices and adequate physical activity.

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