We caught up with Dr Musa Manganye as he shared with us his remarkable achievement of completing his PhD. He shared some insight around the content and some background information around himself. 

I was born 35 years ago in Siyandhani Village, Giyani in Limpopo Province. I am the 2nd born from the family of 7. Married to my lovely wife Cynthia Manganye and we are blessed with two children Shongile and Cayden. From the humble beginnings, I grew up with so much determination to study to change my impoverished background.

Despite being told by my relatives to drop off school and go look for job, I remained resilient to build my professional career. I then took the risk of going to University of Venda with no money to finance my studies. I was subjected to several rejections at school because I just could not afford to pay neither registration, accommodation nor meals. But no amount of exclusion could stop me to acquire my first degree in nursing science which earned me the overall best performing student in the school upon my graduation.

My attributes became looking beyond my background and remained determined, resilient, working hard and thirst to succeed. From my nursing degree, I never looked back, I went on to complete my Master of Public Health in Health Policy and Management through the University of Venda, as well as PhD / DrPH – Public Health in an area of Health System and Management through Sefako Makgatho Health Sciences University (MEDUNSA).  I am very active young innovative leader, dynamic, resilient, diplomatic, brave, fearless, loving, suave and generous.

I am currently a Technical Director for Hospice Palliative Care Association of South Africa (HPCA), Comprehensive Care and Support for Improved Patient Outcome (CaSIPO) project. I am also a Technical Advisor seconded by CaSIPO to the Care and Support Directorate at National Department of Health with 20% level of effort to the ministry of health.

Responsible for the technical direction and oversight of the CaSIPO Project and differentiated care models implementation. I previously held various technical leadership positions with companies such as Family Health International (FHI360), South African National AIDS Council (SANAC), US Centre for Disease Control & Prevention South Africa (CDC), Department of Health (Both National and Provincial), Health Information Systems Program (HISP-SA) and Foundational for Professional Development (FPD). I have successfully coordinated implementation of optimal combination of interventions aimed at addressing HIV prevention in South Africa; Coordinated South Africa Global AIDS Response Progress Reporting (GARPR) 2014 and Health Sector Reporting which is the highest level of reporting in the country.

Demonstrated experience on providing technical support and coordinated prime recipients and sub-recipients of The Global Fund through South African National AIDS Council (SANAC). Participated on Country Co-ordinating Mechanism (CCM) to develop, write and submit proposals to the Global Fund to source funding  for cross border HIV initiatives including SADC Countries, TB in Mines for mobile and migrant population and young women and girls program which were managed through National Strategic Plan (NSP) implementation unit at SANAC which I was involved.

Track record on providing direct management for Contracting Officer’s Representative (COR), Grants, Cooperative Agreements and Contracts Management at funder side with PEPFAR (CDC, USAID) funding mechanism and at implementer side with recipients ( both prime and sub). Also demonstrated experience in working with other donors such as Gates Foundation and European Union. My areas of expertise includes but not limited to: Technical leadership,  policy  analysis/ review, policy development, organizational development, epidemiology, monitoring and evaluation of health programmes, Positive Health Dignity and Prevention programmes and public private partnerships.

2. What made you choose to do a PHD?

I had a thirst and zeal to learn and explore new knowledge within the realm of public health. I wanted to contribute on addressing the reality found by the Higher Education that South African universities produce a woefully inadequate number of doctoral graduates. One significant constraint on the ability of many students to obtain masters and PhDs deemed to be poverty.

Poor students are under enormous pressure to leave university and get a job as soon as possible. It is recognised that overall, postgraduate provision deserves attention and that we need to drastically increase the number and quality of the masters and the PhD degrees that are obtained. Hence, one of the key recommendations in the 2011 National Health Research Summit Report was to build human resources for health research through a large-scale PhD programme for all health professional categories with degree-based qualifications.

The aim, as proposed by the National Health Research Committee, is to fund the education and training of 1000 PhDs in health sciences over the next 10 years. This was believed to help intensify the amount of PhD qualifications produced in the country. Given this contexts, I told myself that the sky is the limit, “Screw all the challenges, I’m going to do it and be counted among the statistics”. Most of all, I wanted to complete it when I turn 35 and break the chain that you need to be old to enrol for the PhD.

I also chose to do Doctor of Public Health (DrPH) over just doing pure PhD. This was mainly because DrPH is not only academic, theory and methodology application as we see with PhD, however, it is the combination of academic, theory, profession degree and practice. It has unlocked the possibilities for me to be able to:

    ·         Critically evaluate the interdisciplinary role of stakeholders in the application and evaluation of population-based public health strategies.

    ·         Evaluate approaches to inform and influence public health interventions and strategies.

    ·         Apply research methods in the investigation of public health problems.

    ·         Critically evaluate evidence-based research, theories, and models used in public health.

    ·         Apply systems-thinking skills and strategies for the promotion of public health policy and advocacy.

    ·         Apply evidence-based research and practices to promote positive social change.

    ·         Examine the application of economic theories in relation to public health systems across diverse community settings.

    ·         Apply community health assessment techniques to identify, prioritize, and formulate solutions to community public health problems.

3. What do you plan to do now that you have completed your PHD?

I aspires to establish a South Africa Institute for Health Policy, Research and Development (SAIHPORED). This institute will enable me to identify, analyse, collaborate, and solve pressing societal needs and issues through the efforts of broadly engaged citizen organizations. Implicit in this capacity are two levels of engagement, where young people with skills and commitment engage with others at the level of a community to address shared problems.

It will create an atmosphere to develop and disseminate new knowledge, innovation, tools and methods to strengthening Health systems, health promotion and in the prevention and control of diseases. The Institute will build and produce well trained and experience young innovative leaders. It will be a cross-disciplinary, cross-sectoral and policy-oriented research with a focus on poverty-related, human, social, structural, diseases and related health problems. I plan to utilize my skills to contribute towards talent development, organizational structures and processes that develop and engage emerging and current leaders in community problem solving.

4. What were the main findings & recommendations that your study formulated?

This study applied the Social Cognitive Theory-based Intervention viz “Choosing Life, Empowerment, Action, Results Intervention (CLEAR)” to test if it is efficacious in reducing alcohol-related sexual behaviour among young adults in Mamelodi, Pretoria.

A community randomised-controlled trial was conducted among the 18 to 35 year old young adults and data was collected at baseline and two waves (3 and 6 months) of trial implementation.

At baseline, the findings revealed multiple sexual partnerships, non-use of condoms, unprotected sex whilst drunk, engaging in transactional sex, and heavy alcohol consumption.

Predictors of HIV risk among young adults were sexual risk-related attitudes and heavy alcohol consumption. After the implementation of the CLEAR intervention, data from wave 1 and 2 of the trial showed progressive decline in risky behaviours, which gives an indication of positive attributes of the CLEAR intervention.

Multiple sexual partnerships

The young adults in the intervention group reported a statistical significant (p-value 0.000) reduction in their number of multiple sex partners from 41% - 5%, in the first three months up to month 6 follow-up compared to control group which remained at 69%.

Condom use

On condom use, there was a significant reduction in the proportion of the participants in the intervention group (2%) who never used a condom, as against in the control group (41%), at the month 6 follow-up.

Transactional sex

There was a statistically significant (P-value 0.000) decrease on the proportions of unprotected sex in exchange for money or material things in both the intervention group (from a 12% baseline; 12% in month 3, to 8% in month 6 follow-up) and the control group (from an 18% baseline; 40% in month 3, to 10%  in month 6 follow-up).

Alcohol and unprotected sex

Another statistically significant result (p value 0.000) was noted in the reduction in engaging in unprotected sex whilst drunk, which, during the 6 month follow-up was 24% in the intervention group as against 44% in the control group.

Alcohol consumption levels

On the other hand, the results showed that there was a reduction in alcohol consumption from the baseline through to the month 6 follow-up. However, the difference in alcohol reduction was not statistically significant between the intervention and control groups. Interestingly, a high proportion of the participants moved from gross alcohol consumption to moderate drinking (15 – 21 Units), sensible drinking ( 08 – 14 Units) and infrequent drinking ( 0 – 7 Units). Notably, at baseline 77% of both groups reported high alcohol consumption with ranges from 22 Units to above. At month 3 follow-up there was a significant reduction in alcohol consumption with only 45% reporting high levels of consumption. At 6 month follow-up only 3% reported high levels of consumption.

Efficacy of CLEAR Intervention

The CLEAR intervention, which is of Western origin, proves to have the traits of cross-cultural utility since after adaptation to the South African context it achieved to retain efficacy in reducing sexual risk behaviours. The spinoff of this intervention was that youth reported non-condom use at baseline in the intervention group compared to the control group.

Month 3 follow-up showed infrequent condom use, with a positive increase in consistent condom use was reported at month 6 follow-up. This increase was more predominant in the intervention group than in the control group.  The results of this study imply that the CLEAR intervention is able to increase consistency in condom use when applied in a population that practises high-risk sexual behaviour such unprotected sex. The CLEAR intervention may also have influenced reduction of transactional sex for intervention group.

Proportions of unprotected sex in exchange for money or material goods were low for both groups at baseline and were subsequently unchanged at month 3 follow-up, but there was a statistically significant decrease at month 6 follow-up. Overall, this trial concludes that Social Cognitive Theory through CLEAR intervention increases the propensity of young adults to reduce alcohol-related HIV-risk behaviour especially in relation to reducing multiple sexual partnerships, transactional sex, and increasing condom use.

Recommendations

Future studies should continue testing more interventions for cross-cultural utility in order for health education and health promotions programs to achieve protective behaviour among high risk behaviour groups.

5. What kept you motivated to successfully complete your PHD?

It has to be the Almighty God because through the strengths I got, I was able to do everything possible to complete. The immeasurable support and love from my wife Cynthia has been amazing and I couldn’t imagine having done it without her love and support. This program has been a true test of character and I have been through the worse that were evident enough to quit by Cynthia has been there throughout to support. So she kept me motivate to complete.

My kids, Shongile and Cayden were patient enough when I spent sleepless nights and that gave me reasons to stay committed to the course. My grandmother (Josephine Ngoveni), never had an opportunity to go to school but she kept encouraging me to study and never allow where I come from to dictate who I should be.  

My mother has been a source of inspirations. My mentors, supervisors, my research assistants, my research participants made it all possible even when the journey was not smooth. Lastly, working hard

6. Tell the readers something interesting about yourself?

    ·         I don’t mind swimming against the tide and living life according to the rhythm of my own drum and that stand out to my uniqueness.

    ·         I have a great sense of humour.

    ·         I always think before I speak and sometimes not speak at all when it’s not necessary to do so.

    ·         I am humble but also possesses firm character at the same time.

    ·         I am always calm but remain proactive and assertive on my approach.

    ·         I am naturally shy person but I never shy away from doing the work I ought to do.

    ·         I don’t know everything but have an ability to learn quickly and adapt quicker.

    ·         I can speak 6 of the 11 South African languages.

    ·         I never give up until I get what I want no matter how long it takes. Patience is my perfectly fit to be my second name.

    ·         I believe I’m destined for much greater heights and I shall live up to its realization.

    ·         I am a young innovative leader within the public health realm with my drive being the passion that keeps me motivated.