Programme Director,
MECs
Traditional Leaders and Healers
HOD of the Department of Health Dr David Motau
The Vice-Rector research of the University of the Free State Professor Corli Witthuhn
The Vice-Chancellor and Principal of Central University of Technology
National Health Research Committee (NHRD) secretariat Mr Mpho Kgasi
Guest speaker Professor Charles Hongoro
Executive Managers and all officials of the Department of Health at all levels
University management here present and partners
Programme director, during the year 2012 the department hosted on the premises of this same University a successful research day with the theme Evidence based research. In this regard we highlighted three critically important research categories which in our view then resonated well with this theme. The relevant categories were Evaluation Research, Intervention Research and Priority Research.
Evaluation research
The objective of evaluation research is to identify the social determinants of health impacting on life expectancy due to high mortality and morbidity in particular. Without a sound understanding of a community’s cultural psyche, many health workers find that programmes fail despite their best efforts and advanced technologies. To avoid such pitfalls, health workers must conduct research to understand the cultural perceptions of disease in the communities they serve in an effort to develop and implement culturally-sound healthcare services. The areas of concern include, chronic illness prevention, cure, care and treatment as well as self-management regimes, together with evaluations of major causes and risk factors implicated in chronic conditions, injury, social and emotional well-being.
Without continued progress in health research, we would not be able to continuously advance our knowledge of the causes, treatments, and cures of diseases, as well as understanding the factors that cause higher mortality and morbidity. Medical research studies are done to learn about and to improve current treatments. We all benefit from the new knowledge that is gained in the form of new drugs, vaccines, medical devices (such as pacemakers) and surgeries.
Health research should not only generate knowledge; more importantly, it should lead to action. In particular, research outcomes must guide policy and programme development as well as assisting in the designing of the delivery of health services. Healthcare interventions should be evidence-based and grounded on solid research findings. In such instances, research is essential in order to assist in predication of negative outcomes and ultimately ensures the successful implementation of health programmes. Furthermore, community-defined research is important especially in the area of prevention and health promotion with PHC re-engineering programme forming the basis of a strong primary care as we move towards universal health coverage.
Health and medical research aimed at strengthening the links between evidence and policy are paramount and this increases the role of scientific inquiry in all facets of policy making leading to evidence based planning resulting in equitable and efficient use of resources. Practitioners in the research fraternity need to also embark on research translation activities such as design of health promotion messages, particularly information about genetics, cardiovascular disease, kidney disease, diabetes and high blood pressure in an effort to reduce the HIV modified quadruple burden of disease.
In addition research is needed to improve the understanding of the factors that affect secondary and tertiary health care access in all settings. These efforts will establish research relationships which value indigenous knowledge, identify the health infrastructure requirements and needed interventions.
Intervention research
The objective of intervention research is to apply evidence from research in health care and health service delivery. For example, comprehensive strategies for alcohol harm reduction sensitive to local community infrastructure issues. Intervention research will ideally combine social health and clinical health research and I believe in this common goal.
Priority-driven research
The objective of priority-driven research is to determine the factors that strengthen health system in terms of infrastructure needs; this include identification of resource gaps and establishing a strategic framework for improving the health of the Free State community through effective Public health research resulting in formulating guidelines. These guidelines are important as they form the bases of advising the provincial department of health and the community on matters relating to and the improvement of health, the prevention, diagnosis, and treatment of disease, the provision of health care and health care service delivery.
The priority areas of health research are studies that inform policy on mother and child health issues, social and emotional well-being, higher death rates and lower life expectancy, antenatal care, access to prevention and combating HIV and AIDS and TB diseases. Research that informs strategies in combating chronic illnesses related to poverty, inadequate nutrition and chronic illness such as diabetes and high blood pressure. Priority research needed is the research that breaks through the barriers to positive social participation caused by poverty and psychosocial stress. To address health problems research will be required to have an action-orientated purpose and/or be linked to the community-capacity building goals of existing primary health care service delivery. Finally, priority-driven research provides a needed platform that directs the efforts of universal health coverage with due consideration of the geographical distribution of disease in relation to health care equity and access.
Programme director, allow me to thank you all for making time to attend this important occasion, It is indeed an occasion that directly resonates with one of the significant priorities of our Ten Point Plant which is Strengthening Research and Development. Undertaking more research studies and surveys is critically important in that it will help us policy and decision makers to generate key reliable information for health planning, service delivery and monitoring. Research is the central plank of virtually all other priorities of the Ten Point Plan.
Correctly, the theme for this year is Research towards Universal health coverage for the entire Free State population and South Africa at large. This theme in an instructive platform which enjoins us to the critically important programme for the department and government as whole which is the National Health Insurance System (NHI) and it has just been deliberated on by the Guest Speaker. The NHI is aimed at supporting an equitable distribution of health care services to the entire population. The national treasury Fiscal review of 2011 indicated that South Africa spent a total of R248.6 billion on health which is approximately 8.3% of the GDP, and the distribution of this expenditure is about R120.8 billion (48.5%) for private sector, which covers 16.2 % of the population and 122.4 billion (49.2%) in public sector which is made up of 84% of the population. It is this skewed picture of expenditure on health care services that needs to be addressed. However, intensive research is needed to guide the required health systems reforms including appropriate designs and implementation directions necessary for achieving a more efficient and equitable health system in South Africa.
As we strive to give practical effect to the NHI we remain guided by the government’s theme, A Long and Healthy Life for All South Africans. We therefore need to commission more research work in order to establish the outcomes and impact of the implementation of our key programmes. In this regard, fortifying our existing partnerships with the University of the Free State, Central University of Technology and other partners will remain key to our programme of action.
Programme director, this event today is indeed a step in a right direction! I am particularly pleased that the theme for this year’s research day resonates with our efforts to pilot the NHI in the province in Thabo Mofutsanyana District. The topics to be covered today include
- Health systems strengthening,
- Clinical and Laboratory medicine,
- Occupational health,
- Tuberculosis and HIV&AIDS,
- Training and Human resources, and
- Community health workers.
These topics are a reflection of many of the priorities in the Ten Point Plan and also the four important outcomes of the National Service Delivery Agreement regime, namely;
- Increasing Life Expectancy
- Decreasing Maternal and Child mortality
- Combating HIV and AIDS and decreasing the burden of disease from Tuberculosis and,
- Strengthening Health system Effectiveness
Programme director, it is therefore my well-considered view that today we will seriously look at the research papers and presentations made by individuals and organisations with a view of reaping maximum benefits out of them. In this way, I believe, we shall have earnestly started the long but necessary process of making research a tool for development and service delivery.
Importantly to note, is that clinical research is a building block of any effective healthcare system. Yet, the number of PhD students has decreased since 2006/2007. In addition there is little turnover whereby younger researchers replace the older generation of researchers. According to Professor Mayozi, researchers under the age of 30 conduct less than 1% of all medical research. He maintained that this was a serious impediment to the pursuit of clinical research. This event must therefore propel us all into taking bold and courageous action of colossal proportions in making research a real tool to garner interest and common good for all our people. For us research must not be a mere academic exercise. It must help us to be more innovative and identify new practical methods to achieve equitable, efficiency and effectiveness in health care service delivery and, more importantly, to improve health care access, that is. giving effect to universal health coverage for the long suffering people of our province.
Programme director, during June 2013 we launched the Provincial Health Information Systems Committee (PHISC) which must guide the development of provincial policies and regulations to govern information at Provincial and Local level. It therefore follows that there has to be a dynamic and complimentary relationship between the two committees i.e. the Provincial Health Research Committee and the Provincial Health Information Systems Committee. Rigorous research has to provide data to guide policy development by the Information Committee.
I wish to take this opportunity to congratulate all those appointed into the Provincial Health Research Committee (PHRC) and wish you all great success. The Committee is working tirelessly and steadfastly in identifying health research priorities together with procedures and mechanism for authorisation of research as well as guidelines for feedback to the Department, concerned directorates, programmes, managers and, importantly, frontline service providers. Once the priorities have been subjected to a wider discussion, the Committee will encourage, support and facilitate research in the priority areas specifically while not discouraging necessary research with different foci – we are also cognisant of academic freedom and the principles of academia! Having the priorities, procedures and mechanisms fully in place will also assist the Committee to determine its needs in preparation for the next financial year. This Committee is well represented with academics, service delivery and private researchers. In support of the PHRC’s process of research approvals, the National Health Research Committee (NHRC) has developed a National Health Research Data base (NHRD) to facilitate the approvals in the provinces. I believe this information will be shared with our research community today.
Having outlined some of the important research imperatives relevant to this event today it is also critically important that I turn to the principles upon which our approach and quest in providing quality health care is predicated upon. In the ANC Ready to Govern document, 1992 we asserted that the provision of equitable health care should be guided by the aspiration of our people as enshrined in the Freedom Charter and the principles which reflect the Primary Health Care Approach adopted by the World Health Organisation and the United Nation’s Children Fund at Alma Ata in 1978. The tenet or basis of PHC is essentially community development. I believe that some of you have already begun to witness the impact of our PHC re-engineering efforts in the province. We must continue to maintain the principle of community participation espoused by PHC. The PHC approach is key to ensuring that our people indeed do access health care as a basic human right. This unalienable right is enshrined in our Constitution.
The challenges we face as a province and country regarding the task of decreasing maternal and child mortality are well documented. It is therefore important that the health service must continue to give priority to children and mothers guided by research findings. Other sectors that also require our undivided attention include the elderly, the mentally ill, workers, the unemployed, the disabled – in a word, the marginalised.
Programme director, ours is a journey of hope and resilience.
In the recent past many aspects of our health policies have been tested more than ever before. These include amongst others the HIV and AIDS, NHI and the critically important issue of health financing. Our HCT campaign managed to achieve the set targets and we will continue to strengthen our efforts to defeat the scourge of HIV and AIDS. We will also continue to double our efforts towards smooth implementation of the NHI pilot again guided by research findings. The response from the quintile 1 and 2 school principals and GP’s during the recent visit by the Minister of Health is particularly encouraging. During the budget vote speech we committed to ensuring that a financial recovery plan is implemented within the first 100 days of my term. I believe that we are indeed on course regarding this matter. Lessons learned from this will help us make a better case for health financing in the province.
We are on course; let’s accelerate the pace of delivery!!
I would like to conclude by thank the Provincial Health Research Committee and all our partners for working tirelessly in an effort to make this Research Day a success
