Health policy and systems research: needs, challenges and opportunities in South Africa – a university perspective

The last two decades have seen growing international recognition of the need to strengthen health systems in order to deliver already available, cost-effective health interventions. This chapter describes the parallel global growth of the field of Health Policy and Systems Research (HPSR) and outlines what this field of research is and what it is not. The chapter also clarifies how HPSR can contribute to strengthening health systems. The particular relevance of HPSR in SA is discussed, given the range of health system transformation initiatives in place. Drawing both on an HPSR capacity assessment conducted in three universities and discussions with a wider group of researchers and health system managers, the chapter also considers the existing assets for and challenges facing the development of the field in South Africa. It closes with suggested strategies and priorities for developing and building capacity in this field nationally.CHEPSAAWeb of Scienc

Assessment of capacity for health policy and systems research and analysis in seven African universities: results from the CHEPSAA project

The importance of health policy and systems research and analysis (HPSR+A) is widely recognized. Universities are central to strengthening and sustaining the HPSR+A capacity as they teach the next generation of decision-makers and health professionals. However, little is known about the capacity of universities, specifically, to develop the field. In this article, we report results of capacity self- assessments by seven universities within five African countries, conducted through the Consortium for Health Policy and Systems Analysis in Africa (CHEPSAA). The capacity assessments focused on both capacity ‘assets’ and ‘needs’, and covered the wider context, as well as organizational and individual capacity levels. Six thematic areas of capacity were examined: leadership and governance, organizations’ resources, scope of HPSR+A teaching and research, communication, networking and getting research into policy and practice (GRIPP), demand for HPRS+A and resource environment. The self-assessments by each university used combinations of document reviews, semi-structured interviews and staff surveys, followed by comparative analysis. A framework approach, guided by the six thematic areas, was used to analyse data. We found that HPSR+A is an international priority, and an existing activity in Africa, though still neglected field with challenges including its reliance on unpredictable international funding. All universities have capacity assets, such as ongoing HPSR+A teaching and research. There are, however, varying levels of assets (such as differences in staff numbers, group sizes and amount of HPSR+A teaching and research), which, combined with different capacity needs at all three levels (such as individual training, improvement in systems for quality assurance and fostering demand for HPSR+A work), can shape a future agenda for HPSR+A capacity strengthening. Capacity assets and needs at different levels appear related. Possible integrated strategies for strengthening universities’ capacity include: refining HPSR+A vision, mainstreaming the subject into under- and post-graduate teaching, developing emerging leaders and aligning HPSR+A capacity strengthening within the wider organizational development.Web of Scienc

Evaluating tannery wastewater treatment performance based on physicochemical and microbiological characteristics: An Ethiopian case study

Tanneries are an important industrial sector in Ethiopia; consequently, gaps in wastewater treatment process performance need to be identified as the country increases its emphasis on compliance. A case study was conducted to evaluate physicochemical and microbial water quality at a tannery near Addis Ababa. The treatment process was designed for the following: sulfide oxidation; biological oxygen demand reduction; and chromium removal. While some of Ethiopia’s standards for industrial wastewater treatment were met through treatment, effluent COD, sulfide, total nitrogen, and total chromium guidelines were not. 16S rRNA gene analysis was used to evaluate the microbial community composition across the treatment train. The results show that common ruminant phyla were dominant throughout, with Firmicutes and Bacteroidetes comprising 77% to 82% relative abundance. The Firmicutes Clostridium increased consistently in relative abundance with treatment, comprising 39% to 61% of the total bacterial community in the effluent. Improved treatment is needed to meet environmental and public health goals.Practitioner PointsCase Study of tannery wastewater treatment in Ethiopia shows ineffective treatment of chemical pollutants.Microbiological pollutants from tannery wastewater systems can introduce agents of importance to public healthThe microbiological composition of tannery influent, mixed liquor and effluent contains mostly four bacterial phyla lead by Firmicutes.Most pathogenic bacterial genera found in the tannery wastewater treatment system became a decreasing percentage of the total population.Clostridium comprises up to 61% of the effluent bacterial population and deserves further evaluation to better understand the consequences of its dominance.Chemical and microbiological characteristics across a tannery wastewater treatment system in EthiopiaPeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/167775/1/wer1364.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/167775/2/wer1364_am.pd