SARChI Chair in Health Systems, Complexity and Social Change

The SARChI Chair in Health Systems Complexity and Social Change was established in 2013, and was held by Prof Wim van Damme.  The current incumbent, Professor Asha George, was appointed to the Chair in April 2016.

Working closely with the Chair in Health Systems Governance, also hosted at the SOPH, the Chairs seek to build the next generation of academics and researchers in the emerging field of Health Policy and Systems Research, and consolidating the position of UWC’s School of Public Health as a world class hub in the global South in this field.

Prof. Asha George

Professor and SARCHI Chair

Health systems complexity can help illuminate the intricate web of factors, both personal and structural, that determine health system’s responsiveness for ensuring quality services for disadvantaged groups. The Chair therefore seeks to further develop four strands of research that mutually reinforce and advance how complex health systems engage with and support social change.

  • To ensure that understanding of gender, intersectionality and other social power relations, as well as the social change methodologies to elucidate and transform them are applied to health policy and systems research. Gender along with other social determinants remains a pervasive power relation within health systems affecting how services are sought, provided and managed. Further research across comparative contexts is required to ensure that health systems can respond to such inequalities, rather than replicate them.
  • To further advance research on community health systems and how they are governed and networked across multiple stakeholders and health system levels. She continues to support research unpacking community action for maternal health, with a critical perspective on who directs such work and with what equity effects.
  • To highlight frontline health worker’s and manager’s lived realities and how this influences the negotiated interfaces with quality improvement initiatives, including initiatives that review and respond to maternal deaths. In the next phase of research, she will support research that unpacks how health workers and managers take ownership of local data to develop, implement and monitor local plans to improve the quality of service delivery either through maternal death reviews, service delivery certification, data dashboards or team management processes.
  • To explore the basis of multi-sectoral policy development and implementation that more holistically addresses how social determinants within health systems influences health outcomes for those most marginalised. Many of the social determinants that affect health outcomes, including those related to gender, lie outside the remit of the health sector. Yet how the health sector coordinates with education, water and sanitation, police and transport sectors is critical to ensuring effective services for marginalised groups such as adolescents or for societal problems such as gender based violence. The Chair will initiate research that will map out the governance of multi-sectoral coordination to address the health needs of marginalised groups such as adolescents or for gender issues such as gender based violence.

The Chair is a member of the Scientific and Technical Advisory Group of the Human Reproductive Program at WHO, one of only three formal research programs at WHO;  and is a Commissioner for the Lancet Commission on Child Health and Wellbeing in the SDG Era.

Key collaborators

The South African Research Chairs Initiative (SARChI) was established by the Department of Science and Technology (DST) and the National Research Foundation (NRF). The aim is to attract and retain excellence in research and innovation at South African public universities through the establishment of Research Chairs.

Related Projects

Overcoming blame culture key strategies to catalyse maternal and perinatal death surveillance and response

Staff inolved: MV Kinney, LT Day, F Palestra, A Biswas, D Jackson, N Roos, A de Jonge, P Doherty, AA Manu, AC Moran, AS George, on behalf of the MPDSR Technical Working Group