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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

Power shortage: Measures to be implemented immediately
2008-01-31

1. In order to avoid the further implementation of power sharing, electricity companies countrywide are requiring, in addition to measures announced for domestic consumers, that major power consumers save a certain percentage of power.

2. Die UFS is one of the 100 largest clients of Centlec, the local electricity distribution company. During a meeting last Thursday evening with the 100 largest clients, it was indicated that the UFS had to deliver a saving of 10%. The details are as follows:

  • Provision is made to a certain extent for an increase in electricity consumption. The calculation is done as follows: maximum consumption for 2007+6%-10%.
  • This entails a saving during peak times, as well as a saving regarding the total number of units consumed.
  • The saving is calculated on a monthly basis.
  • Saving measures must be implemented immediately (from 7 March). If electricity-saving goals are not attained, power sharing will be resumed from 10 March.

3. The UFS has been controlling its peak demand by means of an energy control system for many years. The geysers of residences and certain central air-conditioning systems were linked to the control system in order to shift energy consumption to non-peak times.

4. In order to attain the goal of 10%, it is necessary to implement further energy control systems and additional measures – which requires time and money. Attention will have to be given, inter alia, to the following:

  • The 1000+ portable air-conditioning units on the campus (huge power guzzlers) must be connected to energy control appliances and systems.
  • All the filament bulbs must be replaced.

7. The UFS will be conducting high-level talks with Centlec later this week with a view to:

  • conveying the unique needs of the UFS in detail;
  • stating the impact of building and refurbishing projects that are currently in the implementation and planning phases;
  • requesting understanding for the fact that the UFS does not have the capacity to immediately deliver the 10% saving.
     

It is evident from discussions thus far that Centlec is sympathetic and wants to help, but also that immediate action and co-operation are expected from the UFS. During the meeting, the UFS must also report back on steps already taken (since 7 March) in this regard.

8. The installation of the emergency power units for the large lecture-hall complexes and a few other critical areas, which has already been approved, is continuing. About R3m is being spent on this. Additional emergency power needs reported to Physical Resources via line managers are currently being investigated with a view to obtaining a cost estimate and subsequently determining priorities in consultation with line managers.

It is recommended that:

a) All line managers, staff members and students be requested to give their full co-operation with regard to saving electricity in every possible way, and that current operational arrangements be amended if possible with a view to promoting power saving. 

Staff, students and other users of campus facilities be requested to see to it that lights and air conditioning (individual units) in unused areas are switched off.

b) The following measures drawn up in co-operation with electrical engineers come into effect immediately:

Arrangements to be made by Physical Resources staff:
(Additional capacity to be able to complete everything within a reasonable period of time will have to be found and funded. This aspect will be taken up with the line managers concerned):

  • The geysers of all office buildings will be switched off at the distribution board. Staff are requested to use a kettle for washing dishes, and are warned not to switch appliances on again themselves.
  • In all office buildings where 12V and 15W downlighters and uplighters remain switched on for decorative purposes and do not serve as primary illumination, the light switches will be disconnected.
  • Lighting in cloakrooms will be checked, and illumination levels will be reduced if possible.
  • All light armatures must be replaced by CFL types.
  • All lights on the grounds will be checked to ensure minimum power consumption.
  • The upper limit of all central cooling systems currently regulated via the energy control system must be set to 24 degrees.

Arrangements to be made by Kovsie Sport:

  • Sport activities requiring sports field illumination must be scheduled after 20:00 in the evening (the lights may not be on between 18:00 and 20:00.)
  • Sports field illumination must be managed so that such lights are not switched on unnecessarily.
     

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