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Health Policy and Systems

  • About Us

       

                                                          

    Head of Division:  Professor Lucy Gilson BA(Hons) Oxford MA East Anglia PhD London
     

    Welcome to the Health Policy and Systems Division
     

    The Health Policy and Systems Division is particularly interested in better understanding the dynamics of health policy change and health system development, with particular concern for issues of governance and stewardship, the dynamics of policy implementation, and the role of the health system in enabling health equity and public value. We have a particular, but not exclusive, focus on South Africa and Africa.

    We conduct innovative research, support postgraduate capacity development in the field and wider networking.

    We are an intentionally interdisciplinary group, drawing on a range of social science perspectives, but with specific expertise in health policy analysis and the application of systems thinking to the health sector.

    Our research focusses on health systems as a whole - rather than particular health services, condition-specific programmes or health problems. Health system concerns address the complex range of factors that underpin service delivery (such as human resource development and management, financing and resource allocation, information systems, supply chain management and overarching models of care). Understanding how these factors interact and influence health system performance is an essential starting point for thinking about how to change and strengthen the system. We also examine health policy processes and consider how to strengthen them. (please see research page for further details)

    The Division hosts and supervises students at PhD, Masters and Diploma level. We convene the Masters in Public Health, Health Systems Track – and the MPH courses: Introduction to Health Systems (HIS), Health Policy and Planning (HPP) and Introduction to Health Policy and Systems Research (IHSRE) . We also convene the post graduate Diploma in Health Leadership, otherwise known as the Oliver Tambo Fellowship programme. The Diploma is the longest running health management training programme in South Africa, and is a flagship programme in the Faculty of Health Sciences.

    We also welcome prospective PhD students in four main areas of work, whilst being open to other ideas: Policy change and health systems development (with particular interests in policy implementation and health system governance); leadership and leadership development within the health system; health system resilience and responsiveness; and community systems in interaction with the health system.

    Finally, the Division has a strong focus on networking and collaborates with other organisations and individuals engaged in developing the field of health policy and systems research. These networking activities include close collaboration in research and teaching with South African public health leaders and managers, partnership with the School of Public Health at the University of the Western Cape and Division of Health Systems and Public Health at Stellenbosch University in research and teaching and a range of African and international collaborations. 

     

    Contact Information:

    Health Policy and Systems Division
    School of Public Health and Family Medicine
    Faculty of Health Sciences
    University of Cape Town
    OBSERVATORY
    7925
    South Africa
     

    Tel: +27 21 406 6272
    Fax:+27 21 406 6459
    Email: Lucy Gilson

  • Undergraduate Teaching

    At this time there are no undergraduate courses currently offered by the HPS Division.

  • Postgraduate Teaching

    Master of Public Health specialising in Health Systems

    The Health Systems Track is intended for those candidates who have an interest in seeking to change, managing within, or researching the health system. The focus is the health system as a whole - rather than particular health services, or condition specific programmes or health problems. Health system concerns address the complex range of factors that underpin service delivery (such as human resource development and management, financing and resource allocation, information systems, supply chain management and overarching models of care). Understanding how these factors interact and influence health system performance is an essential starting point for thinking about how to change and strengthen the system. Also important, is understanding the politics of policy change, the factors influencing whether health system reforms and wider health interventions are developed and implemented in ways that support achievement of their goals. The compulsory courses provide grounding in the multi-disciplinary perspectives relevant to understanding and working at the level of the overarching health system.

    Track Convenor:  Assoc Prof Jill Olivier

     


    Class of 2019

    Introduction to Health Systems (PPH7093F)

    This course aims to provide an introduction to the core elements of any health system, understanding health systems as complex systems comprised of components, actors and inter-relationship. It provides a platform of understanding relevant to health systems analysis, action and research. By the end of this course students are expected to be able to show understanding of the dynamic and complex nature of health systems; discuss health systems as social constructions, influenced by and influencing the agents within them; apply these understandings to assessment different health system; apply relevant analytical skills and an understanding of complex systems in order to develop ideas about action to strengthen health systems; develop personal communication, teamwork and leadership skills; and demonstrate understanding of and openness to different perspectives on the nature of health systems.

     

    Co-Convenors: Prof Lucy Gilson & Assoc Prof Jill Olivier
     

    Health Systems Research and Evaluation (PPH7094S)

    This course is an introduction to health systems research and evaluation methods. It seeks to open up the “black box” of the health system, and the contemporary approaches to studying it, with the view to encouraging students to consider future research in this field. By the end of the course participants are expected to be able to:  identify researchable HPS issues; formulate substantively relevant HPS research questions; be familiar with the range of research purposes, questions and strategies used within HPSR; identify appropriate research strategies and study designs for HPSR; show awareness of critical issues in, and approaches to, ensuring rigour in HPSR; be aware of critical ethical issues for HPSR; be able to source and critically appraise HPSR materials; appreciate the value of multiple perspectives (positional and disciplinary) in conducting HPSR; have some understanding of how the complex and socially constructed nature of health policy and health systems is addressed in HPSR methodology; plan activities that support the use of research evidence for and in decision‐making; recognise that personal skills, such as reflexivity, listening and facilitation, are critical to being an HPS researcher.

     

    Co-Convenors: Assoc Prof Jill Olivier & Prof Lucy Gilson
     

    Health Policy and Planning (PPH7041S)

    This course introduces participants both to the field of policy analysis and to critical issues in health policy. Policy analysis focuses on understanding the political and social forces that influence why and how policies are (or, sometimes, are not) initiated, formulated, negotiated, communicated, implemented and evaluated, drawing on political science and public administration perspectives. This includes action to prevent policy decisions being taken. This approach to policy analysis understands policy as a process, and in this approach the term ‘policy’ to encompass more than the documents, legislation and guidelines often seen as the end point of ‘policy development’. Instead, policy is seen as including the expectations and understandings that policy actors, including beneficiaries and those responsible for implementation, have about the meanings of those documents and how they translate them into their daily practices. So, policies are reflected in the formal, deliberate decisions to do things differently, as well as in the failure to take action or to change and in the routines and practices that are experienced as the reality of health systems.

    Course convenor: Prof Lucy Gilson
     

    Post Graduate Diploma in Health Leadership (Oliver Tambo Fellowship Programme)

    The PG Dip in Health Management is one of the longest existing health management courses the country, and is the central element of the Oliver Tambo Fellowship programme. The programme has a large network of alumni of over 250 graduates spread across the country, the majority of whom are in senior and middle management positions in the public health sector. The Diploma thus contributes significantly to the strengthening of health management and leadership in the South African Health System.
     

    As part of our constant efforts to maintain high standards and the relevance of our teaching, the Diploma has recently been refreshed in order to bring new teaching and learning modalities to bear on the development of health leadership and management capacity. In particular,work-place based learning and support is now a stronger central element of the refreshed programme curriculum.  Team-based training is encouraged. The target audience of the refreshed Diploma extends to participants from all sectors who seek to create public value.

    Intake for 2021 is 01 April 2020. For more detailed information on the Diploma, please visit the Postgraduate Diploma in Health Leadership web page.

    OTF Programme celebrates 25 years

    Convenor:  Assoc Prof Maylene Shung-King

  • Service Support and Engagement

    Health Policy and Systems research is deeply rooted in real-work problems and contexts – and as such is deeply embedded and engaged in real communities and health systems – in South Africa, Africa more generally as well as internationally.
     

    We strongly encourage the engagement of health systems actors and practitioners in our teaching and our research. For example, by involving health systems actors directly and deliberately in research and policy engagement – and through mechanisms such as seminars, journal clubs and practitioner sabbaticals.
     

    See the Research page for examples of specific projects.

  • Research

    Current Research and Capacity Development Projects 

    Strengthening health system responsiveness to citizen feedback in South Africa and Kenya

    Responsiveness to citizen rights, needs, expectations and values is understood to be an essential quality of health systems. For some time, health system responsiveness has been regarded as both an intrinsic goal and pressing priority for health systems, and the term is commonly used both as an indicator of HS performance in formal assessment frameworks, and colloquially as an HS value and social good. However the citizens in LMICs experience a range of problems with weak health systems that display poor responsiveness. A three-year study will be conducted in South Africa and Kenya – asking the question: “What policies and mechanisms (formal and informal) work for receiving and responding to citizen feedback on health systems in South Africa and Kenya? How can health systems responsiveness be strengthened towards the development of learning, equitable health systems?” The collaborative study will run from 2018 to 2021, and is funded by the MRC (Jointly Funded Initiatives). The main collaborative partners are from UCT (HPS Division), UWC SOPH, KEMRI (Kenya), and local health system partners - the Western Cape Government, Department of Health and County Departments of Health, Kilifi and Mombasa Counties in Kenya.

    Health Policy Analysis Fellowship programme

    This two year programme is supporting a group of eleven PhD researchers, registered in a range of LMIC universities, focused on analysis of policy process issues.  The programme seeks to assist these fellows in sharpening and deepening the focus of their research, building a network among the fellows and also engaging with their supervisors, to support PhD supervision in this field as well. The programme activities include two workshops, some mentoring support around and between the workshops and nine of the fellows are receiving bursary support as well. The overall aim is to develop the pool of those involved in HPA research in LMICs.

    Development of a Health Policy Analysis Reader

    This Reader will present a set of specially selected conceptual, empirical and methodological papers relevant to understanding and researching policy processes and the politics of policy change. The reader will present the papers in ‘sections’ and each section will include a brief initial written piece providing an overview of the focus of the subject of section, and relevant theory, explaining and justifying the papers selected and providing references to other resource materials.

    Engagement between the system and non-state providers in Ghana

    Researchers from the HPSD were awarded a three year grant by the Alliance for Health Policy and Systems Research in the World Health Organisation (AHPSR-WHO), to conduct a historical case study of the evolution of the relationship between the non-state (faith-based) providers and the public health system in Ghana. This project will run from 2015-2018, and is conducted in partnership with colleagues from the University of Ghana, Ghana Health Service (GHS), and the Christian Health Association of Ghana (CHAG).

    Assessing large-scale health systems intervention practice

    A team from UCT are engaged in evaluative research and research support for the Doris Duke Charitable Foundation – focusing on implementation practice in large-scale health systems strengthening interventions. In the first phase (2014-2016), we worked closely with colleagues in Mozambique and Zambia to add a qualitative and process evaluation of the health systems strengthening interventions, focused on health planning and management and primary level quality of care, respectively, they have introduced.

    Partnership for Health Leadership and Management (PAHLM)

    The HPSD is also involved in a partnership with the School of Public Health at the University of the Western Cape, the Division of Community Health Sciences at the University of Stellenbosch and the Western Cape Department of Health to develop a strategy to strengthen health leadership throughout all levels of the health system of the Western Cape Department of Health. Initial phases of work supported the development of the Western Cape Leadership Development Strategy and Leadership Competency Framework. In the longer-term, the partnership seeks to contribute to the vision and goals of the Provincial Strategy of Health Care 2030, by nurturing and developing a cadre of leaders at all levels of the health system who hold stewardship of Health care 2030.

    Collaborative for Health Systems Analysis and Innovation (CHESAI)

    CHESAI is a collaborative of health policy and systems researchers based in the Western Cape, South Africa—with a focus on strengthening the health policy and systems research field through conceptual and methodological development, as well as interdisciplinary and multi‐sectoral engagement. CHESAI aims to contribute to expanding and strengthening the health policy and systems knowledge base in Africa: building an intellectual hub for HPSR in Cape Town South Africa; creating spaces for practice‐research engagement; supporting African HSPR capacity development; sharing and disseminating HPSR conceptual and methodological innovations. The main partners are The University of Cape Town and The University of the Western Cape, Schools of Public Health. The first phase of CHESAI (2012-2015) was supported by a grant from the International Development Research Centre, Canada. Please visit www.chesai.org

    Resilient and Responsive Health Systems (RESYST)

    Resilient and Responsive Health Systems (RESYST) is a Consortium that is undertaking health policy and systems research (with a focus on financing, health workers and governance) in a set of African and Asian settings, including India, Kenya, Nigeria, South Africa, Thailand, Tanzania and Vietnam. Funded by DfID, the consortium began in 2011 and will run until 2018. The Health Policy and Systems Division has a particular focus on the governance agenda within the RESYST programme of work.

    District Innovation, Action and Learning for Health System Development (DIALHS)

    District and sub-district managers in the South African health system are charged with building, strengthening and managing health systems that implement national policy frameworks. At the same time they need to remain responsive to local needs and contexts, involve multiple actors in decision-making and inspire and motivate staff to be creative in delivering services in resource-constrained settings. This is a complex undertaking, and managers are often hamstrung by the constraints of existing systems while they themselves are not sufficiently well-equipped to navigate between high need, limited resources and inherent system complexity. The District Innovation, Action and Learning for Health System Development (DIALHS) project – initially funded by The Atlantic Philanthropies – engages with these challenges at the implementation level in the sub-district of Mitchell’s Plain in Cape Town, in a partnership between the Schools of Public Health at UCT and UWC, as well as the health departments of the City of Cape Town and the provincial government of the Western Cape.

    International Religious Health Assets Programme (IRHAP)

    IRHAP is an international collaborative network working on the interface of religion and public health, seeking to gather and develop systematic evidence to align and enhance the work of religious health leaders, public policy decision-makers and other health workers in their collaborative efforts to meet the challenge of disease such as HIV/AIDS, strengthen health and community systems, and to promote sustainable health, especially for those who live in poverty or under marginal conditions. The hub of the IRHAP collaborative is currently based at UCT within the Division of Health Policy and Systems – and a number of related research projects are run from there. www.irhap.uct.ac.za

    Ongoing PhD Projects

    Thulani Masilela

    How And Why Are Different Forms of Evidence used in Policy-Making in the South African Health Sector?  A Case Study of the National Core Standards for Health Establishments, the Primary Health Care Re-engineering policy, the Prevention-of-Mother-To-Child Transmission of HIV (PMTCT) Policy for South Africa, and the National Drug Policy.

    Marsha Orgill

    Strengthening district management as a key lever in health system strengthening: bottom up innovation in two district health systems in South Africa

    Dickson Okello

    The Leadership Trinity: Examining the Interplay Between Organisational Context, Leadership Practices and Leadership Effectiveness in the Health Sector - A Case Study of District Hospitals in the Western Cape Province, South Africa.

    Eleanor Whyle

    The social value(s) of health systems: Using health policy analysis of health system reform to explore the potential for socially responsive health systems

    Leanne Brady

    Everyday violence and everyday resilience in the South African Health System: A case study of Emergency Medical Services (EMS) in the Western Cape.

    Aaron Mulaki

    The Tyranny of ethnicity: An examination of ethnic influence in health sector resource allocation decision making and implications for horizontal equity in Kenya’s devolved system of governance.

    Joseph Dodoo

    How central level policy actors sustain (or not sustain) public policy reform initiative in Ghana

    Bavhna Patel

    To explore the contribution of a leadership development program on the implementation of improvement projects at a South African central hospital.

    Completed Projects with continued activities

    Whole System Change in South Africa (WholeSystSA)

    Understanding the experience of health system transformation in the Western Cape province.  What public health system performance improvements has the Western Cape province achieved over the last 20 years, and what has enabled or constrained such improvements?  The WholeSystSA grant supported formative research to describe and understand the Western Cape experience of whole system evelopment, contributing to the small global pool of such analyses. It confirmed that large-scale health system transformation entails the multiple health system dimensions and levels and occurs over long time periods, as well as the particular importance of political and distributed leadership in effective implementation of health system change. The project also  generated ideas that are feeding into discussion of relevant monitoring and evaluation activities of health system development in the Western Cape. WholeSystSA was a joint project between the Western Cape Department of Health, the University of Cape Town, and the University of the Western Cape, funded by the UK’s Health Systems Research Initiative (a funding consortium made up of the Wellcome Trust, ESRC, MRC and UKAID).

    The SHICASA (Strengthening School HIV-related Health Services Implementation for Children and Adolescents in South Africa) Project

    The HPSD has been subcontracted by the Medical Research Council, in conjunction with other partners, to work on a 5-year CDC funded project on strengthen the implementation of the Integrated School Health Policy in a NHI pilot district in South Africa. While the work is focused in one district, the innovations and lessons that will emanate out of the research is expected to have applicability to school health services across the country as a whole. The project is a 5-year collaboration and is expected to develop practical school-based intervention models, within the parameters of the National Integrated School Health Programme (ISHP). The proposed models of intervention would be evidence-based, using a combination of evidence sources, and the implementation of the models rigorously evaluated, before making recommendations for wider application. The project focuses on key components of the ISHP, with the aim of providing lessons that could strengthen implementation of the many and varied components of the ISHP.

    Access, Trust and Information: Catholic health providers in Cameroon, Ghana and Malawi

    A research study that ran during 2013 and 2014, looking at improved access to maternal health services in three African countries – in particular looking at the complex policy context that non-profit Catholic health providers negotiate in provision of maternal health and family planning services in three African countries. This project was supported by CORDAID – the Catholic Organisation for Relief and Development.

    Collaboration between civil society and the South African health system

    A collaborative research study from 2013 to 2014 which was undertaken for the Hospice and Palliative Care Association of South Africa (HPCA) – relating to the Health System Strengthening through Strategic Partnerships (HESP) project. HESP was a pilot project jointly funded by PEPFAR, USAID and the Anglo American Chairman’s Fund – aimed at innovating new mechanisms and approaches for strengthening community systems and local partnerships around health and welfare. This research sought to understand this project, and its lessons for collaborative practice in the South African health system.

    Universal coverage in Tanzania and South Africa: monitoring and evaluating progress (UNITAS)

    The UNITAS project focuses on monitoring and evaluating policy formulation and implementation processes aimed at achieving universal health coverage in South Africa and Tanzania. The project undertakes monitoring mainly at the district level, with some monitoring and evaluation at the national level. It aims to support implementation processes and will establish an ‘early warning system’ of implementation difficulties. The project runs from 2011 to 2016 and is funded by the European Union. It is a collaborative project with partners from the London School of Hygiene and Tropical Medicine, Ifakara Health Institute (in Tanzania), Institute of Tropical Medicine Antwerp (in Belgium), Centre for Health Policy, University of Witwatersrand and the Africa Centre in South Africa.

    Consortium for Health Policy & Systems Analysis in Africa (CHEPSAA)

    The Consortium for Health Policy and Systems Analysis in Africa was established as an African-European network that supported capacity development in the field health policy and systems analysis. Activities included curriculum development, staff development and engagement with policy makers in national and regional levels, as well as building a network among the organisational partners. CHEPSAA built on earlier activities funded by the Ford Foundation. It brought together 11 organisational partners from South Africa, Tanzania, Ghana, Kenya, Nigeria, UK, Sweden and Switzerland in the period 2011 to 2014, funded by the European Commission. The official grant-period of CHEPSAA has ended, but the African colleagues have agreed that key activities continue, including the focus on HPS Teaching and Learning, and the networking encouraged through the CHEPSAA website www.hpsa-africa.org

    Completed PhDs (download at www.open.uct.ac.za)

    • The role of gender in patient-provider trust for tuberculosis treatment (Veloshnee Govender)


    Completed MPH Projects (download at www.open.uct.ac.za)

    • Exploring knowledge translation mechanisms in the Western Cape provincial health system (Amanda Edwards)
    • The role of faith-based health providers in the South African health system: a historical case study on their nationalization and privatization (Dineo Maitsa)
    • Community in health systems strengthening: A Systematic Review (Chelsea Lee)
    • Health workers’ experiences of the implementation of Gene Xpert MTB/RIF diagnostic for TB in primary care settings in South Africa (Lance Louskieter)
    • Mapping and tracking the complexity of the financial flows within non-state non-profit (faith-based) health providers in Kenya (Lucy Kingangi)
    • Towards universal health coverage: mapping the development of the faith-based non-profit sector in the Ghanaian health system (Annabel Grieve)
    • Primary health care interventions in Finland: a systematic review (Sanna Malinen)
    • How has the C2AIR2 club initiative spread in primary health care facilities included in the first phase of the initiative? (Edzani Mphaphuli)
    • Training clinic health committees: a vehicle for improving community participation in health (Nkandu Chikonde)
    • Exploring the complex policy formulation process of the draft Control of Marketing of Alcoholic Beverages Bill in South Africa (Adam Bertscher)
    • Stakeholder analysis: drawing methodological lessons from review of relevant literature  (Ruth Henwood)
    • The current situation of children’s nursing training in South Africa (Uchenna Chukwe)
    • The presence and adaptive capacities of faith-based health providers in the Ecuadorian health system (Angelica Ullauri)
    • Gender analysis: sub-Saharan African nurses’ migration experiences – a systematic review  (Constancia Mavodza)
    • Partnerships that support health systems resilience over time: a study of non-state, faith-based health providers in Africa (Jolly Ann Maulit)
    • A logic model for the implementation of electronic medical records in Southern Africa: A systematic review (Liezel Van Deventer)
    • Improving health care provider – health committee working relationships for responsive, people-centred health systems (Gimmene Zwama)
    • Strengthening health systems for chronic care: intersection of communicable and non-communicable diseases services in South Africa (Rangarirai Muzite)
    • Influence of organisational culture on the implementation of health sector reforms in low and middle income countries: a qualitative interpretive review (Rahab Mbau)
    • The representation and practice of interdisciplinarity in health policy and systems research: a systematic review (Kim MacQuilkam)
    • Attitudes and perceptions of healthcare workers in health facilities with regards to the ‘intention to use’ of the road to health booklet (Nanziwe Khumalo)
    • Modelling the new intermediate care system for the WC and quantifying future capacity requirements based on the proposed policy/system changes (Nicola  Wilson)
    • Leveraging community participation through health committees to achieve health rights: the role of power  (Marion Hasson Bloch)
    • Community participation and the right to health for people with disability: A qualitative study into Health Committees’ understanding and practise of their governance role in relation to disability  (Theodore Abrahams)
    • Historical case study of the McCord Hospital model of integrated PMTCT care  (Janet Giddy)
    • Health systems factors that impact on access to maternal services for women with disabilities in Sub-Saharan Africa: a systematic review (Doreen Mheta)
    • Civil society’s role in health system monitoring and strengthening: Evidence from Khayelitsha (Jessica Barker)
    • An organisational typology of public-private engagement for health in Southern Africa: A systematic review (Eleanor Whyle)
    • A case study of the drivers and barriers of implementation of the Baby Friendly Hospital Initiative (BFHI) within a rural sub-district in South Africa (Katherine Brittin)
    • Health system’s barriers hindering the implementation of public-private partnership policy in the health sector at the district level: a case study of partnership for improved reproductive and child health services provision in Bagamoyo district Tanzania (Denice Kamugumya)
    • Public private partnership in the Cameroonian health system: a case study of staff secondment into the Maroua–Mokolo Diocese (Jacob Kuh)
    • Exploring experiences of HIV Counsellors towards the HIV counselling and testing policy in Zambia’s public urban health centers (Remmy Shawa)
    • Factors that affect uptake of community-based health insurance in low and middle-income countries: a systematic review (Esther Adebayo)
    • Trust and motivation in the health sector: a systematic review (Dickson Okello)
    • The National Health Insurance (NHI) in South Africa – scaling up health care provision: The consumers´ perspectives (Edda Weimann)
    • Barriers to Implementation of tuberculosis infection control amongst South African health care workers (Oluwatoyin Adeleke)
  • Links

  • Staff

    Lucy Gilson, Professor and Head of Division

     

    Email:  Lucy.Gilson@uct.ac.za

    Phone:  021 406 6272

    Twitter:  @Lucy_Gilson

    Publications


    Lucy’s research broadly focusses on how to strengthen health systems to offer better public value, with particular concern for health equity. She has a track record of research around: health policy implementation; decentralisation, district health systems and primary health care; user fees and financing issues; and leadership and management. As she has a particular interest in understanding health system actors’ decision-making, her work also considers how trust and power relations shape health system dynamics and complexity.

    Lucy’s teaching focusses on health policy, health leadership, health systems and health policy and systems research. She is also involved in a wider range of capacity development activities within the field of Health Policy and Systems Research.

    Jill Olivier, Associate Professor

     

    Email:  Jill.Olivier@uct.ac.za

    Phone:  021 406 6489

    Publications

     

     


    Assoc Prof Jill Olivier is a South African and UCT alumni, graduating with a PHD from the Humanities Faculty – after which she worked in varied sectors, including as a consultant at the World Bank in Washington DC, before returning to SA and UCT. She splits her time between teaching and research. On the teaching front she runs courses on Health Systems and Health Systems Research; convenes two tracks of the Masters in Public Health programme (the Health Systems and General Tracks); and has a passion for mentoring students through their degree journey, supervising masters and PHD students.

    On the research front she is committed to Southern and engaged scholarship – and has experience as a researcher and research manager in countries across Africa, the Asia-Pacific region and the Americas – holding a South African National Research Foundation B-rating. She is currently the Principal Investigator of several large multi-country grants, including a grant from the WHO (on non-state providers in Ghana), and another from the UK MRC (on health system responsiveness in SA and Kenya). She calls herself an interdisciplinary researcher, and brings her social science and humanities expertise to public health, and health policy and systems research (HPSR). She has a particular interest in scholarship in areas of ‘intersection’ (between sectors, between system and communities, and between disciplines). Her current work focuses on topics such as non-profit non-state health providers; intersectionality; health systems resilience and responsiveness; community system strengthening; health system histories; and communication and cultures within health systems.   

    Maylene Shung King, Associate Professor

     

     

    Email:  Maylene.Shungking@uct.ac.za

    Phone: 021 406 6580

    Publications

     

     

    A/Prof Maylene Shung King is a medical doctor, with further training in public health. Her special interest is the child health and her recent child health policy and research focus has been on school health and the furtherance of the National Integrated School Health Programme goals. She is also integrally involved in a partnership to develop leadership capacity in the Western Cape province.

    Maylene is the convenor of the Oliver Tambo Fellowship programme, a Postgraduate Diploma in Health Management; the Leadership Module of the Postgraduate Diploma in Community Paediatrics and Child Health; and she teaches on the Health Policy and Planning module of the Master in Public Health programme.

    Marsha Orgill, Senior Researcher

     

    Email:  ms.orgill@uct.ac.za

    Phone:  021 650 3859

    Publications

     

    Marsha Orgill is a Senior Research Officer in the Health Policy and Systems Division in the School of Public Health and family Medicine, UCT. Her primary research focus is in the area of Health Policy Analysis, this includes working in multidisciplinary teams to understand complex global and local policy making processes, including the formulation of policies and their subsequent implementation in the health system. Implementation research interests include the diffusion of innovations in complex health systems from a health policy and systems research perspective focusing on how different actors interact in the implementation process to contribute to policy outcomes, with a specific focus on managers and leaders in the district health system. Key methodological interests include case study research, theory driven evaluation and qualitative methods. Marsha co-convenes and lectures on the teaching module ‘Health Policy and Planning’ (HPP) in the Master of Public Health (MPH) teaching programme in the SOPHFM. Over the past eight years she has been part of an international team developing open access teaching resources to build the field of Health Policy and systems Research (HPSR) locally and globally. Resources available here

    Gadija Khan, Research Officer

    Emailgadija.khan@uct.ac.za

    Phone:  021 650 7904

    Honorary Professors

    Irene Agyepong
    Uta Lehmann
    Helen Schneider

    Honorary Senior Lecturers

    Karen Daniels
    Gina Teddy
    Melvin Moodley
    Dintle Molosiwa

    Honorary Lecturers

    Jacques Hendricks
    Mohammed Osman

    Honorary Research Fellow

    Rene English

    Administrative Staff

    Name Description Email Telephone No
    Precious Nobongoza Administrative Assistant (021) 650 7904
  • Publications

    • Journal articles

    • Books and chapters in books

    • Reports and working papers

  • Journal articles

    2018

    Agyepong, I. A., Lehmann, U., Rutembemberwa, E., Babich, S. M., Frimpong, E., Kwamie, A., ... & Gilson, L. (2018). Strategic leadership capacity building for Sub-Saharan African health systems and public health governance: a multi-country assessment of essential competencies and optimal design for a Pan African DrPHHealth Policy and Planning33(suppl_2), ii35-ii49.

    Barasa, E., Mbau, R., & Gilson, L. (2018). What is resilience and how can it be nurtured? A systematic review of empirical literature on organizational resilienceInternational Journal of Health Policy and Management7(6), 491-503.

    Bertscher, A., London, L., & Orgill, M. (2018). Unpacking policy formulation and industry influence: the case of the draft control of marketing of alcoholic beverages bill in South AfricaHealth Policy and Planning.

    Cleary, S., Erasmus, E., Gilson, L., Michel, C., Gremu, A., Sherr, K., & Olivier, J. (2018). The everyday practice of supporting health system development: learning from how an externally-led intervention was implemented in MozambiqueHealth Policy and Planning.

    Doherty, J., Gilson, L., & Shung-King, M. (2018). Achievements and challenges in developing health leadership in South Africa: the experience of the Oliver Tambo Fellowship Programme 2008–2014Health Policy and Planning33(suppl_2), ii50-ii64.

    Gilson, L., & Agyepong, I. A. (2018). Strengthening health system leadership for better governance: what does it take? Health Policy and Planning33(suppl_2), ii1-ii4.

    Hoosen, N., Davids, E. L., Vries, P. J., & Shung-King, M. (2018). The Strengths and Difficulties Questionnaire (SDQ) in Africa: a scoping review of its application and validationChild and Adolescent Psychiatry and Mental Health12(1), 6.

    Mbau, R., & Gilson, L. (2018). Influence of organisational culture on the implementation of health sector reforms in low-and middle-income countries: a qualitative interpretive reviewGlobal Health Action11(1), 1462579.

     

    2017

    Barasa, E. W., Cloete, K., & Gilson, L. (2017). From bouncing back, to nurturing emergence: reframing the concept of resilience in health systems strengtheningHealth Policy and Planning32(suppl_3), iii91-iii94.

    Dimmock, F., Olivier, J., & Wodon, Q. (2017). Network development for non-state health providers: African Christian Health AssociationsDevelopment in Practice27(5), 580-598.

    Erasmus, E., Gilson, L., Govender, V., & Nkosi, M. (2017). Organisational culture and trust as influences over the implementation of equity-oriented policy in two South African case study hospitals. International Journal for Equity in Health16(1), 164.

    Gilson, L., Barasa, E., Nxumalo, N., Cleary, S., Goudge, J., Molyneux, S., ... & Lehmann, U. (2017). Everyday resilience in district health systems: emerging insights from the front lines in Kenya and South Africa. BMJ Global Health2(2), e000224.

    Gilson, L., Lehmann, U., & Schneider, H. (2017). Practicing governance towards equity in health systems: LMIC perspectives and experience.

    Gilson, L., Pienaar, D., Brady, L., Hawkridge, A., Naledi, T., Vallabhjee, K., & Schneider, H. (2017). Development of the health system in the Western Cape: experiences since 1994. In South African Health Review 2017, edited by A Padarath. Durban: Health Systems Trust: 59-69.

    Olivier, J. (2017). Guest editor conclusion: research agenda-setting for faith and health in development–where to now? Development in Practice27(5), 775-781.

    Scott, V., & Gilson, L. (2017). Exploring how different modes of governance act across health system levels to influence primary healthcare facility managers’ use of information in decision-making: experience from Cape Town, South Africa. International Journal for Equity in Health16(1), 159.

    Shroff, Z. C., Javadi, D., Gilson, L., Kang, R., & Ghaffar, A. (2017). Institutional capacity to generate and use evidence in LMICs: current state and opportunities for HPSR. Health Research Policy and Systems15(1), 94.

    Tsofa, B., Goodman, C., Gilson, L., & Molyneux, S. (2017). Devolution and its effects on health workforce and commodities management–Early implementation experiences in Kilifi County, Kenya. International Journal for Equity in Health16(1), 169.

    Tsofa, B., Molyneux, S., Gilson, L., & Goodman, C. (2017). How does decentralisation affect health sector planning and financial management? a case study of early effects of devolution in Kilifi County, Kenya. International Journal for Equity in Health16(1), 151.

    Ullauri, A., & Olivier, J. (2017). The historical contribution of faith-based health providers in the Ecuadorian health system: an overview of the evidenceDevelopment in Practice27(5), 670-683.

    Whyle, E., & Olivier, J. (2017). Models of engagement between the state and the faith sector in sub-Saharan Africa–a systematic reviewDevelopment in Practice27(5), 684-697.

     

    2016

    Cutts, T., Olivier, J., Lazarus, S., Taliep, N., Cochrane, J. R., Seedat, M., ... & Carelse, H. (2016). Community asset mapping for violence prevention: A comparison of views in Erijaville, South Africa and Memphis, USAAfrican Safety Promotion: A Journal of Injury and Violence Prevention14(1), 1-25.

    Erasmus, E., Lehmann, U., Agyepong, I. A., Alwar, J., de Savigny, D., Kamuzora, P., ... & Gilson, L. (2016). Strengthening post-graduate educational capacity for health policy and systems research and analysis: the strategy of the Consortium for Health Policy and Systems Analysis in AfricaHealth Research Policy and Systems14(1), 29.

    Ghaffar, A., Gilson, L., Tomson, G., Viergever, R., & Røttingen, J. A. (2016). Where is the policy in health policy and systems research agenda?. Bulletin of the World Health Organization94(4), 306. 

    Gilson, L. (2016). Everyday politics and the leadership of health policy implementationHealth Systems & Reform2(3), 187-193.

    Greyling, C., Maulit, J. A., Parry, S., Robinson, D., Smith, S., Street, A., & Vitillo, R. (2016). Lessons from the Faith-Driven Response to the West Africa Ebola EpidemicThe Review of Faith & International Affairs14(3), 118-123.

    Kamugumya, D., & Olivier, J. (2016). Health system's barriers hindering implementation of public-private partnership at the district level: a case study of partnership for improved reproductive and child health services provision in TanzaniaBMC Health Services Research, 16: 596.

    Le Roux, E., Kramm, N., Scott, N., Sandilands, M., Loots, L., Olivier, J., ... & O’Sullivan, V. (2016). Getting dirty: Working with Faith Leaders to Prevent and Respond to Gender-Based ViolenceThe Review of Faith & International Affairs14(3), 22-35.

    Molyneux, S., Tsofa, B., Barasa, E., Nyikuri, M. M., Waweru, E. W., Goodman, C., & Gilson, L. (2016). Research involving health providers and managers: ethical Issues faced by researchers conducting diverse health policy and systems research in Kenya. Developing World Bioethics16(3), 168-177.

    Olivier, J. (2016). Hoist by our own petard: Backing slowly out of religion and development advocacyHTS Theological Studies72(4), 1-11.

    Olivier, J. (2016). Interventions with local faith communities on immunization in development contextsThe Review of Faith & International Affairs14(3), 36-50.

    Olivier, J., & Smith, S. (2016). Innovative faith-community responses to HIV and AIDS: Summative lessons from over two decades of workThe Review of Faith & International Affairs14(3), 5-21.

    Oni T, Smit W,Matzopoulos R, Hunter Adams J, Pentecost M, Rother HA, Albertyn Z, Behroozi F, Alaba O, Kaba M, van der C Westhuizen C, Shung-King M, Levitt NS, Parnell S, Lambert EV, RICHE members (2016). Urban Health Research in Africa: Themes and Priority Research QuestionsJournal of Urban Health: Bulletin of the New York Academy of MedicinePublished Online First: 16 May 2016.

    Schneider, H., Okello, D., & Lehmann, U. (2016). The global pendulum swing towards community health workers in low-and middle-income countries: a scoping review of trends, geographical distribution and programmatic orientations, 2005 to 2014Human Resources for Health14(1), 65.

    Sheikh, K., Schneider, H., Agyepong, I. A., Lehmann, U., & Gilson, L. (2016). Boundary-spanning: reflections on the practices and principles of Global HealthBMJ Global Health1(1), e000058.

    Shung-King M, Engel ME, Zühlke L, Mayosi B (2016). Asymptomatic Rheumatic Heart Disease in South African Schoolchildren: Implications for screening of chronic health conditionsS Afr Med J. 106(8):761-762.

    Uzochukwu, B., Mbachu, C., Onwujekwe, O., Okwuosa, C., Etiaba, E., Nyström, M. E., & Gilson, L. (2016). Health policy and systems research and analysis in Nigeria: examining health policymakers’ and researchers’ capacity assets, needs and perspectives in south-east NigeriaHealth Research Policy and Systems14(1), 13.

    Uzochukwu, B., Onwujekwe, O., Mbachu, C., Okwuosa, C., Etiaba, E., Nyström, M. E., & Gilson, L. (2016). The challenge of bridging the gap between researchers and policy makers: experiences of a Health Policy Research Group in engaging policy makers to support evidence informed policy making in Nigeria. Globalization and Health12(1), 67.

    Whyle, E. B., & Olivier, J. (2016). Models of public–private engagement for health services delivery and financing in Southern Africa: a systematic reviewHealth Policy and Planning, 31(10), 1515-1529.

    Youkee, D., Williams, N., Laggah, M., Howlett, P., Lado, M., Brady, L., ... & Harrison, H. L. (2016). The impact of the 2014–15 Ebola virus disease epidemic on emergency care attendance and capacity at a tertiary referral hospital in Freetown, Sierra Leone: a retrospective observational study. The Lancet387, S109.

     

    2015

    Ashmore, J., & Gilson, L. (2015). Conceptualizing the impacts of dual practice on the retention of public sector specialists-evidence from South Africa. Human Resources for Health13(1), 3.

    Cleary, S., Schaay, N., Botes, E., Figlan, N., Lehmann, U. & Gilson, L. (2015). Re-imagining community participation at the district level: Lessons from the DIALHS collaboration. In South African Health Review 2014/15, edited by A. Padarath, J. King, & R. EnglishDurban: Health Systems Trust: 151-162.

    Engel, M. E., Haileamlak, A., Zühlke, L., Lemmer, C. E., Nkepu, S., van de Wall, M., ... & Mayosi, B. M. (2015). Prevalence of rheumatic heart disease in 4720 asymptomatic scholars from South Africa and Ethiopia. Heart101(17), 1389-1394.

    Haakenstad, A., Johnson, E., Graves, C., Olivier, J., Duff, J., & Dieleman, J. L. (2015). Estimating the development assistance for health provided to faith-based organizations, 1990–2013PLoS One10(6), e0128389.

    Oborien, K., Harris, B., Eyles, J., Orgill, M., McIntyre, D., Chimbindi, N., & Goudge, J. (2015) Understanding roles, enablers and challenges of district Clinical Specialist Teams in strengthening primary health care in South Africa. South African Health Review, 2014/2015,44–55.

    Okello, D. R., & Gilson, L. (2015). Exploring the influence of trust relationships on motivation in the health sector: a systematic reviewHuman Resources for Health13(1), 16.

    Olivier, J., & Wodon, Q. (2015). Religion, reproductive health, and sexual behavior in Ghana: why statistics from large surveys don't tell the whole storyThe Review of Faith & International Affairs13(2), 64-73.

    Olivier, J., Tsimpo, C., Gemignani, R., Shojo, M., Coulombe, H., Dimmock, F., ... & Haakenstad, A. (2015). Understanding the roles of faith-based health-care providers in Africa: review of the evidence with a focus on magnitude, reach, cost, and satisfactionThe Lancet386(10005), 1765-1775.

    Sato, M., & Gilson, L. (2015). Exploring health facilities’ experiences in implementing the free health-care policy (FHCP) in Nepal: how did organizational factors influence the implementation of the user-fee abolition policy? Health policy and planning30(10), 1272-1288.

    Shroff, Z., Aulakh, B., Gilson, L., Agyepong, I. A., El-Jardali, F., & Ghaffar, A. (2015). Incorporating research evidence into decision-making processes: researcher and decision-maker perceptions from five low-and middle-income countriesHealth research policy and systems13(1), 70.

     

    2014

    Daire, J., & Gilson, L. (2014). Does identity shape leadership and management practice? Experiences of PHC facility managers in Cape Town, South Africa. Health Policy and Planning29(suppl_2), ii82-ii97.

    Erasmus, E., Orgill, M., Schneider, H., & Gilson, L. (2014). Mapping the existing body of health policy implementation research in lower income settings: what is covered and what are the gaps?. Health Policy and Planning29(suppl_3), iii35-iii50.

    Gilson, L. (2014). Qualitative research synthesis for health policy analysis: what does it entail and what does it offer?. Health Policy and Planning29(suppl_3), iii1-iii5.

    Gilson, L., Elloker, S., Olckers, P., & Lehmann, U. (2014). Advancing the application of systems thinking in health: South African examples of a leadership of sensemaking for primary health care. Health Research Policy and Systems12(1), 30.

    Gilson, L., Schneider, H., & Orgill, M. (2014). Practice and power: a review and interpretive synthesis focused on the exercise of discretionary power in policy implementation by front-line providers and managers. Health Policy and Planning29(suppl_3), iii51-iii69.

    Lê, G., Mirzoev, T., Orgill, M., Erasmus, E., Lehmann, U., Okeyo, S., ... & de Savigny, D. (2014). A new methodology for assessing health policy and systems research and analysis capacity in African universities. Health Research Policy and Systems12(1), 59.

    Lehmann, U., & Gilson, L. (2014). Action learning for health system governance: the reward and challenge of co-production. Health Policy and Planning30(8), 957-963.

    Okungu, V., & Gilson, L. (2014). “… still waiting for chloroquine”: the challenge of communicating changes in first-line treatment policy for uncomplicated malaria in a remote Kenyan district. Malaria Journal13(1), 258.

    Olivier, J. (2014). Mapping interdisciplinary communication between the disciplines of religion and public health in the context of HIV/AIDS in Africa. Religion and Theology21(3-4), 251-289.

    Olivier, J., & Wodon, Q. (2014). Faith-inspired education in Ghana: A historical case example. The Review of Faith & International Affairs12(2), 27-37.

    Olivier, J., & Wodon, Q. (2014). Increased funding for AIDS-engaged faith-based organizations in Africa?. The Review of Faith & International Affairs12(1), 53-71.

    Olivier, J., Shojo, M., & Wodon, Q. (2014). Faith-inspired health care provision in Ghana: Market share, reach to the poor, and performance. The Review of Faith & International Affairs12(1), 84-96.

    Schneider, H., English, R., Tabana, H., Padayachee, T., & Orgill, M. (2014) Whole-system change: case study of factors facilitating early implementation of a primary health care reform in a South African province. BMC Health Services Research, 14 (1), 609. [link: https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-014-0609-y]

    Scott, V., Schaay, N., Olckers, P., Nqana, N., Lehmann, U., & Gilson, L. (2014). Exploring the nature of governance at the level of implementation for health system strengthening: the DIALHS experience. Health Policy and Planning29(suppl_2), ii59-ii70.

    Sheikh, K., George, A., & Gilson, L. (2014). People-centred science: strengthening the practice of health policy and systems research. Health Research Policy and Systems12(1), 19.

    Sheikh, K., Ranson, M. K., & Gilson, L. (2014). Explorations on people centredness in health systems. Health Policy and Planning29(Suppl 2), ii1.

    Shung-King, M., Orgill, M., & Slemming, M. (2014) School health in South Africa: reflections on the past and prospects for the new Integrated School Health Policy. In Padarath A, English R, editors. South African Health Review 2013/14. Durban: Health Systems Trust; 2014.

    Surender R, Van Niekerk R, Hannah B, Allan L, Shung-King M (2014). The drive for universal healthcare in South Africa: views from private general practitioners. Health Policy and Planning: 1-9. doi:10.1093/heapol/czu053.

    Walt, G., & Gilson, L. (2014). Can frameworks inform knowledge about health policy processes? Reviewing health policy papers on agenda setting and testing them against a specific priority-setting framework. Health Policy and Planning29(suppl_3), iii6-iii22.

    Wodon, Q., Olivier, J., Tsimpo, C., & Nguyen, M. C. (2014). Market share of faith-inspired health care providers in Africa. The Review of Faith & International Affairs12(1), 8-20.

    Young TWiysonge CSSchoonees AShung King MUauy RKain J (2014). Cochrane Column * Interventions for preventing obesity in children * Commentary: Childhood obesity: A growing dilemma for public health interventions and research alike * Commentary: Interventions for preventing obesity in children (Review). International journal of epidemiology : 2014.

     

    2013

    Orgill, M., Nxumalo, N., Amde, W., Erasmus, E., Lehmann, U., Goudge., J., & Gilson, L. (2013) Health Policy and Systems Research: Needs, Challenges and Opportunities in South Africa. In: Padarath A, English R, editors. South African Health Review 2012/13. Durban: Health Systems Trust; 2013.

    Mirzoev, T., Gillian Leˆ., Green, A., Orgill, M., Komba, A., Esena, R., Nyapada, L., Uzochukwu, B., Amde, W., Nxumalo, N., & Gilson, L. (2013). Assessment of capacity for Health Policy and Systems Research and Analysis in seven African universities: results from the CHEPSAA project. Health Policy and Planning, 1-11. 

  • Books and chapters in books

    2017

    Olivier, J., Scott, V., Molosiwa, D. & Gilson, L. (2017). Embedded systems approaches to health policy and systems research. In Applied Systems Thinking for Health Systems
    Research: A Methodological Handbook
    , edited by D. de Savigny, K. Blanchet & T. Adam. Maidenhead Berkshire: Open University Press: 9-37
     

    2016

    Röhrs S, Berry L, Lake L, Shung-King M. Policy and Legislative Developments. In. Delany A, Jehoma S & Lake L (eds) (2016). South African Child Gauge 2016.Cape Town: Children’s Institute, University of Cape Town: 12-19
     

    2015

    Gilson, L. (2015). Lipsky’s Street Level Bureaucracy. In Oxford Handbook of the Classics of Public policy, edited by E. Page, L. M, & S. Balla. Oxford: Oxford University Press.

    Olivier, J. (2015). Religion at the intersection of development and public health in development contexts: From advocacy about faith-based organizations to systems thinking. In The Routledge Handbook of Religions and Global Development, edited by E. Tomalin. London: Routledge: 346-358.

  • Reports and working papers

    2014

    Daire, J., Gilson, L. & Cleary, S. (2014) Developing leadership and management competencies in low and middle-income country health systems: a review of the literature. RESYST Working Paper 4.

 

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