Enhancing the role of medicine in the management of European Health systems: implications for control, innovation and user Voice (COST Action 2008-2-3031)

The main objective of the Action was to increase empirical, theoretical and policy relevant knowledge about the changing role of medical professionals in the management of healthcare. This Action was rooted in a number of recent trends in healthcare: the growing involvement of doctors in management and changes in medical education, training and career structures. These changes are assumed to be positive, leading to improvements in organization learning and control, innovation and user voice. However the evidence supporting such conclusions remains fragmented. While changes in the relationship between management and medicine have received some attention at national levels, there is less research adopting a rigorous, comparative, interdisciplinary perspective. Focusing on hospital doctors the Action attempted to address these limitations to advance theoretical, empirical and policy relevant knowledge.

Like in Europe, the doctors in South Africa play a dominant role within hospitals and other health facilities. South Africa is currently undergoing a major health care reform (introduction of National Health Insurance). The participation of the University of the Witwatersrand from South Africa which is associated with a number of academic hospitals (from tertiary to district level) allowed the COST and this specific Action to collect data from a middle income country. The wider benefit for society was expected to be the identification of promising practices of physicians and management positions and professionalise the education and training of medical (physician) managers.

Social Determinants of Health Network (SDH-Net) (2011-2015)

The Social Determinants of Health Network (SDH-Net) was a four year collaboration project, financed by the European Commission under the 7th Framework Research Programme and was launched in October 2011. SDH-Net’s aim was to strengthen and link research capacities for health and its social determinants in African and Latin American low and middle income countries in close collaboration with European partners. It was carried out by a strong consortium, based on clusters of existing networks of public health institutions from Mexico, Colombia, Brazil, South Africa, Tanzania and Kenya. For more details, visit the project website.

Tuberculosis in mining sector (2015- ongoing):

In order to prioritize contextualizing TB care in South African mines as a means of creating solutions, we initiated this study in collaboration with Dartmouth College, USA to explore the salient lived experiences of miners and ex-miners, their families, communities, and caregivers in order to elicit what matters most according to social, behavioural, and cultural dimensions of TB care in the Southern African mining communities and to identify characteristics of current practices and create solutions for design, monitoring, and administration of TB treatment and care. In the first phase, we have been conducting a two-part ethnographic study co-designed with miners and ex-miners to deepen our understanding of their perspectives and establish a record of their experiences

Health in All policies (2015- ongoing)

Health in All policies (HiAP) is an approach to public policies across sectors that systematically takes into account the health implications of decisions, seeks synergies, and avoids harmful health impacts in order to improve population health and health equity. As a concept, it reflects the principles of: legitimacy, accountability, transparency and access to information, participation, sustainability, and collaboration across sectors and levels of government. There is a need to translate these policies into action to improve health outcomes. The CMeRC has been working in collaboration with the WHO Country office to document the current state of HiAP in South Africa and to find ways to implement them into practice.

Cities Changing diabetes (2016- ongoing)

The programme is structured to understand the driving factors behind the rise of diabetes in urban areas, and to share that knowledge and apply it to real-world solutions. The project is currently being implemented in seven cities in the world including Johannesburg in collaboration with Novo Nordisk A/S, Denmark, Steno Diabetes Center, Denmark and University College, London, UK. The programme has three interconnected elements: Mapping, Sharing and Action. The Project partner for the Johannesburg District are Novo Nordisk (South Africa), City of Johannesburg, Gauteng Department of Health, CMeRC. For more details, visit the project website