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01 April 2025 | Story Andre Damons | Photo Supplied
Health care
Those who took part in the community engagements are: From left Dr Kamo Mothibi from the UFS, Irene Mokgadi from CUT, Dr Mosebi Thejane (UFS), Ahlume Nkumbesi (UFS), Dr Lebogang Mogongoa (CUT), Minnie Mbokazi (UFS), Dr Happy Phage (CUT), Dr Phindile Shangase (UFS) and Teboho Mhlanga from the Free State Department of Health. Seated in from are Meshack Mothupi, driver from CUT, and Sipho Zulu (UFS).

The Division of Public Health at the University of the Free State (UFS) together with the Central University of Technology (CUT), and the Free State Department of Health’s Disability Unit, held community engagements recently by visiting rehabilitation services in Bloemfontein. 

These engagements were part of the co-funded project: Capacity building for the use of implementation science in various typologies in low- and middle-income countries for the prevention and/or management of the quadruple burden of disease. This was phase two in this project with the last phase including a symposium that is expected to take place on 1 April on the UFS Bloemfontein Campus.

Qhomane Mhlanga, a representative from the Free State Department of Health who is actively involved in this project, and her team, identified rehabilitation services for a case study. They also identified stakeholders to be visited during this community engagement in order to gather information on their engagement with Mangaung University of the Free State Community Partnership Programme (MUCPP). The team also visited stakeholders at the Phelang Disability Home, Carel du Toit Special School, and the Department of Education (Inclusive Education). 

 

Research to improve health care service

Dr Phindile Shangase from the Division of Public Health, and Principal Investigator at UFS, says the purpose of community visits was to engage service providers on the implementation strategies. This includes analysing alignment of implementation strategies with the policy (National Rehabilitation Policy 2000, Free State Rehabilitation Policy Guidelines, Framework and Strategy for Disability and Rehabilitation Service in South Africa 2015-2020) as well as identifying facilitators and barriers to implementation.

“It is the intention of the Division of Public Health, UFS to continue collaborations with stakeholders in implementation science research to improve health care service delivery and outcomes. The Division of Public Health also intends to add postgraduate research studies on implementation science in the near future.

“The visit to the clinic sought to establish the services provided by the rehabilitation unit, the referral system, and how the unit collaborates with external stakeholders to enhance the service. We gained knowledge of categories of healthcare professionals in rehabilitation services, e.g., occupational therapists, physiotherapists, speech and language therapists, audiologists, orthotists and prosthetists, rehabilitation doctors, optometrists, community rehabilitation workers. Some of these professionals are not available in the facilities visited,” says Dr Shangase. 

It was identified that, she continues, early hearing screening services for children are not available at healthcare facilities. Early hearing screening helps identify hearing defects which could be managed early to avoid complications that lead to hampered education and poor quality of life.


Outcome of engagements

Before the community outreach began, the UFS/CUT team, in collaboration with the Department of Health, convened to discuss strategies for navigating the Implementation Science project. The meeting focused on identifying key stakeholders and developing approaches essential for the project's success, drawing insights from the Department of Health's Mangaung Metro implementation science case study. 

The team identified five primary approaches for the project: Health, Education, Livelihood, Social, and Empowerment. Additionally, the discussion highlighted both the barriers and enablers related to each approach, which are crucial for ensuring effective project implementation and sustainable outcomes. Free State rehabilitation policy guidelines document was also applied to evaluate the case study.

According to Dr Shangase, the outreach will help with drafting of an intervention plan to address policy implementation gaps identified. The information gathered will assist in commissioning further research to improve health outcomes. “The intention is to collaborate with the Department of Health to work on past research outputs, presented during research day conferences, for implementation in healthcare facilities. Newly identified research areas will also prompt projects in healthcare facilities, led by the academic partners, UFS, Division of Public Health as well as the Department of Health Sciences, CUT.”

News Archive

Media: Sunday Times
2006-05-20

Sunday Times, 4 June 2006

True leadership may mean admitting disunity
 

In this edited extract from the inaugural King Moshoeshoe Memorial Lecture at the University of the Free State, Professor Njabulo S Ndebele explores the leadership challenges facing South Africa

RECENT events have created a sense that we are undergoing a serious crisis of leadership in our new democracy. An increasing number of highly intelligent, sensitive and committed South Africans, across class, racial and cultural spectrums, confess to feeling uncertain and vulnerable as never before since 1994.

When indomitable optimists confess to having a sense of things unhinging, the misery of anxiety spreads. We have the sense that events are spiralling out of control and that no one among the leadership of the country seems to have a definitive handle on things.

There can be nothing more debilitating than a generalised and undefined sense of anxiety in the body politic. It breeds conspiracies and fear.

There is an impression that a very complex society has developed, in the last few years, a rather simple, centralised governance mechanism in the hope that delivery can be better and more quickly driven. The complexity of governance then gets located within a single structure of authority rather than in the devolved structures envisaged in the Constitution, which should interact with one another continuously, and in response to their specific settings, to achieve defined goals. Collapse in a single structure of authority, because there is no robust backup, can be catastrophic.

The autonomy of devolved structures presents itself as an impediment only when visionary cohesion collapses. Where such cohesion is strong, the impediment is only illusory, particularly when it encourages healthy competition, for example, among the provinces, or where a province develops a character that is not necessarily autonomous politically but rather distinctive and a special source of regional pride. Such competition brings vibrancy to the country. It does not necessarily challenge the centre.

Devolved autonomy is vital in the interests of sustainable governance. The failure of various structures to actualise their constitutionally defined roles should not be attributed to the failure of the prescribed governance mechanism. It is too early to say that what we have has not worked. The only viable corrective will be in our ability to be robust in identifying the problems and dealing with them concertedly.

We have never had social cohesion in South Africa — certainly not since the Natives’ Land Act of 1913. What we definitely have had over the decades is a mobilising vision. Could it be that the mobilising vision, mistaken for social cohesion, is cracking under the weight of the reality and extent of social reconstruction, and that the legitimate framework for debating these problems is collapsing? If that is so, are we witnessing a cumulative failure of leadership?

I am making a descriptive rather than an evaluative inquiry. I do not believe that there is any single entity to be blamed. It is simply that we may be a country in search of another line of approach. What will it be?

I would like to suggest two avenues of approach — an inclusive model and a counter-intuitive model of leadership.

In an inclusive approach, leadership is exercised not only by those who have been put in some position of power to steer an organisation or institution. Leadership is what all of us do when we express, sincerely, our deepest feelings and thoughts; when we do our work, whatever it is, with passion and integrity.

Counter-intuitive leadership lies in the ability of leaders to read a problematic situation, assess probable outcomes and then recognise that those outcomes will only compound the problem. Genuine leadership, in this sense, requires going against probability in seeking unexpected outcomes. That’s what happened when we avoided a civil war and ended up with an “unexpected” democracy.

Right now, we may very well hear desperate calls for unity, when the counter-intuitive imperative would be to acknowledge disunity. A declaration of unity where it manifestly does not appear to exist will fail to reassure.

Many within the “broad alliance” might have the view that the mobilising vision of old may have transformed into a strategy of executive steering with a disposition towards an expectation of compliance. No matter how compelling the reasons for that tendency, it may be seen as part of a cumulative process in which popular notions of democratic governance are apparently undermined and devalued; and where public uncertainty in the midst of seeming crisis induces fear which could freeze public thinking at a time when more voices ought to be heard.

Could it be that part of the problem is that we are unable to deal with the notion of opposition? We are horrified that any of us could be seen to have become “the opposition”. The word has been demonised. In reality, it is time we began to anticipate the arrival of a moment when there is no longer a single, overwhelmingly dominant political force as is currently the case. Such is the course of history. The measure of the maturity of the current political environment will be in how it can create conditions that anticipate that moment rather than seek to prevent it. We see here once more the essential creativity of the counter-intuitive imperative.

This is the formidable challenge of a popular post-apartheid political movement. Can it conceptually anticipate a future when it is no longer overwhelmingly in control, in the form in which it is currently, and resist, counter-intuitively, the temptation to prevent such an eventuality? Successfully resisting such an option would enable its current vision and its ultimate legacy to our country to manifest in different articulations, which then contend for social influence. In this way, the vision never really dies; it simply evolves into higher, more complex forms of itself. Consider the metaphor of flying ants replicating the ant community by establishing new ones.

We may certainly experience the meaning of comradeship differently, where we will now have “comrades on the other side”.

Any political movement that imagines itself as a perpetual entity should look at the compelling evidence of history. Few movements have survived those defining moments when they should have been more elastic, and that because they were not, did not live to see the next day.

I believe we may have reached a moment not fundamentally different from the sobering, yet uplifting and vision-making, nation-building realities that led to Kempton Park in the early ’90s. The difference between then and now is that the black majority is not facing white compatriots across the negotiating table. Rather, it is facing itself: perhaps really for the first time since 1994. Could we apply to ourselves the same degree of inventiveness and rigorous negotiation we displayed leading up to the adoption or our Constitution?

This is not a time for repeating old platitudes. It is the time, once more, for vision.

In the total scheme of things, the outcome could be as disastrous as it could be formative and uplifting, setting in place the conditions for a true renaissance that could be sustained for generations to come.

Ndebele is Vice-Chancellor of the University of Cape Town and author of the novel The Cry of Winnie Mandela

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