The Research Programme, as one of four synergistic clusters at HST, specialises in undertaking high priority health systems strengthening research centred on providing appropriate, practical solutions to important and immediate strategic challenges in multi-sectoral settings.
Vision and mission
The Research Programme's vision is for a healthy population served by an effective and equitable health system, strengthened by an appropriate research process orientated to the needs of the most vulnerable. To achieve this, the mission of the Research Cluster is to undertake essential national health research within HST's synergistic multi-cluster approach aimed at supporting the national health system and strengthening the functioning of health districts throughout South and southern Africa.
What our strengths are in dealing with the region's challenges
Faced with the challenges of the Southern African region struggling to cope with a quadruple disease burden and health systems under pressure to improve their efficiencies in resource constrained situations, the special value that the Research Programme adds to the general health research environment, is a capability for commissioning or undertaking relevant, high priority, multi-disciplinary, operational and applied research in a rapid, flexible, cost-effective, cooperative, innovative and principled way.
The main aim
The main aim of the Research Programme/Cluster is to conduct relevant, focused health research and develop essential national health research capacity as part of Health Systems Trust's integrated, multi-cluster approach, based on the principles of primary health care to strengthen functional health districts within sound national health systems in southern Africa.
Current emphasis
The current emphasis is placed on continuing to broaden HST's research role as a responsive research agency within the region. This is achieved through knowledge management activities, establishing new partnerships and diversifying the range of donor and other stakeholder relationships with the intention to focus on sustainability, sound governance and increasingly valuable outputs.
The special niche that HST Research Cluster aims to fill encompasses:
Supporting the process of Essential National Health Research which entails establishing and working within a framework of national health research priorities;
Innovating in the area of health research knowledge management to produce evidence to strengthen the health system encouraging the more effective use of information;
Building capacity and engagement of stakeholders within the National Health Research Committee, the Provincial Health Research Committees, District Health Planning process as well as academic and research institutions, especially those previously disadvantaged;
Influencing policy and practice in health systems strengthening (research translation) - appropriate dissemination relating to research;
Undertaking selected high priority research that fills major gaps.
How we are organised
Research in the RP is grouped into four main units:
Health Priority Programme Studies and Knowledge Management;
Health Service and Community Studies;
Gender, Reproduction, Behaviour and Vulnerable Group Studies;
Socio-Economic Determinants of Disease Studies.
In addition to the four units there is one cross-cutting area
Research Training and Capacity Building.
Current projects
The following are the key current research studies either recently completed or currently being undertaken
Priority Health Programmes and Knowledge Management
Study
Aims and objectives
Refinement of the SA National Health Research Database as a web-based research tool
Maintain an up-to-date database of existing and ongoing health research in South Africa
Continue to define trends in health research and gaps for the National Health Research Directorate and National Health Research Committee
Establish a tool for Provincial Health Research Committees to track provincial research
Providing support to National and Provincial Health Research Committees in providing effective coordination of health research and help to build appropriate health research capacity
Assist National and Provincial Health Research Committees to determine health research priorities
Audit committees to obtain up-to-date information on capacity and needs
Assist in developing a database to track research in the province concerned
Identify training needs and suitable training where the required
Data Verification of TB recording system with a view to informing improvements to the electronic TB register
Undertake two participatory district level data verification studies per quarter as well as one operational research study per quarter
document on weaknesses in the logical design of the ETR
An investigation of the burden of TB disease in children less than 15 years old.
Review data in the ETR, to quantify the burden of TB of all types in children, classified according to type (new or retreatment), site (pulmonary or extra-pulmonary) and drug susceptibility (susceptible, multi- or extremely drug resistant), and if possible, establish the prevalence and/or incidence of these.
Review of clinic-based records to establish the outcomes of children with TB.
An investigation into the practice and management of MDR TB suspects
Undertake a qualitative study, based on interviews with nurses at clinics in selected districts.
Describe how patients who do not smear convert at 2 months are managed, with specific reference to drug treatment and education received
Explore the infection control practices the patients put in place at their homes.
An assessment of the provision of HIV voluntary counselling and testing (VCT) for patients with TB.
Quantify the uptake of VCT by TB patients, in relation to the manner in which VCT is provided using data generated from clinics supported by TASC TB,
Assess the extent of standardisation of the provision of VCT by qualitative interviews with staff at selected clinics supported by TASC TB.
Evaluation of the TASC TB programme
Assess the extent to which the TASC TB programme has achieved its defined objectives
Gauteng Children's Hospital study
To provide information necessary to support the feasibility of establishing a children's hospital
Assessing impact of automation in workplace
To assess the extent to which automation at Sebokeng Hospital has improved efficiency
Strengthening the evidence base for interventions on mother and child survival in 18 priority districts
Impact of the child support grant on maternal and child in relation to the millennium development goals health
Rapid appraisal of community IMCI
EPI coverage per district
Cold chain capacity
What is the capacity for introducing new vaccines for Pneumonia and Diarrhoea?
Skills audit in relation to MCH
HAART for women
Baby friendliness of facilities and hospitals
Baseline survey of nutritional status including growth monitoring
Improving flow of information to and from laboratories (NHLS)
Assess the impact that the provision of social grants has made to MCH
Strengthen model of compensation mechanisms for occupationally-acquired disease
Develop an experimental model of compensating silicosis victims using the provisions of the ODMWA Act
Undertake a series of qualitative case studies to explore how the availability of compensation changes the lives and health status of victims
Assess impact of training service providers such as doctors and nurses
Health Service and Community Studies
Study
Aims and objectives
Strengthening research capacity at local level by engaging in the District Health Planning process (in collaboration with HSTs DSCD cluster)
Introducing a research module for the District Health Planning (DHP) process
indentifying district health research priorities
building capacity to undertake local health research
Review and update assessment of health research capacity building, especially among emerging research agencies, assisting in building health research capacity
Study agencies undertaking health research in South Africa and develop a profile of each making estimates of research capacity to update study undertaken in 2004
Study of work force capacity ( to undertake service-oriented research, especially in relation to priority professions such as nursing) - also includes a specific audit of biostatisticians and focus on understanding the work of academic complexes and historically disadvantaged academic institutions
The functioning of clinic committees, hospital and community advisory boards
To audit clinic committees, hospital boards and community advisory boards around the country
Community based information system for tracking progress especially in relation to managing chronic illness using CHWs
Developing an innovative system to track and manage chronic disease in the community
Investigate integrated disease management (HAST), plus chronic and other diseases management including Mental Health within the paradigm of a PHC approach
Gauteng NPO study
Assess the extent that CBO's are supporting health services and being supported in delivering community based prevention and care;
recommend areas for building capacity.
Audit of HCBC organisations
To audit the work of organizations providing home and community based care nationally
Gender, Reproduction, Behaviour and Vulnerable Group Studies
Study
Aims and objectives
Gendered perspective on progress towards maternal and child health-related millennium development goals
Reviewing Women and Children's Health interventions including contraception, child growth, PMTCT and other related services such as nutrition, prevention of cancer
Develop a gendered (Women's and Men's) perspective
Both HIV+ and HIV- perspective on sexual infections including HPV, contraception, ante-natal care, labour, postnatal care, nutrition, immunization of HIV positive children, feeding and PMTCT (s), where people feel comfortable to go for VCT and use of private facilities eg. men and GPs
To assess the potential and barriers to achieving a district scale masculinity and male circumcision project in Umkanyakude District
Assessing HIV and TB adherence support mechanisms and developing approaches to improve on treatment adherence
Compare the experience of providers and users of approaches to maintaining adherence among patients with TB and HIV
Document best practice in cohort case management
Investigating also, adverse effects and best practice case management
Dual stigma - TB/HIV
To investigate the way in which stigma relating to HIV and TB interact with each other and become barriers to obtaining effective support
Asenze Child Disability study
To assess disability among children in the Valley of a Thousand Hills
Mapping traditional healing terminology and development of knowledge management links
Investigate feasibility of developing a map including potentially a dictionary/lexicon of traditional healing terminology
Linking information sources on traditional healing to National Health Research Database
Socio-Economic Determinants Of Disease
Study
Aims and objectives
The Role of Incentives in Improving TB Outcomes
To assess the impact on TB outcomes on providing vouchers as adherence incentives
Costing of TB services
To provide a model of the financial model of the way that TB is costed
Quality of MDR TB services
Undertake a qualitative study to investigate the perceptions of the quality of services provided at referral facilities for patients with MDR TB, from a patient and health care provider perspective.
Research Training and Capacity Building
Study
Aims and objectives
Commission research for the South African Health Review, in association with HealthLink Cluster and edit Policy into Practice Reviews
Produce reviews that together provide comprehensive coverage of a range of areas that range to the theme of rural health care
Provide an emerging researcher the opportunity of partnering with a more skilled researcher in undertaking a review
Intern capacity development and emerging researchers
Provide learning opportunities for graduates with a bachelor or honours degree to gain experience in health research
Developing a CME research training agenda
Work with PHASA to develop a post-graduate continuing education programme focused on practical skills
Develop a SAQA accredited training programme for health research field work supervisors
To develop an accredited training programme for fieldwork supervisors which provides a basic understanding of how to undertake research and manage data collection