The Sefako Makgatho Health Sciences University (SMU) has celebrated a major academic achievement after Muisaphanda Enos Rampamba, Manager for Professional Affairs (Education) at the South African Pharmacy Council, graduated with a Doctor of Philosophy (PhD) in Pharmacy during the university’s autumn graduation ceremony.
Dr Rampamba’s doctoral study, titled Development of a quality indicator framework for hypertension at public primary health care level in South Africa, addresses persistent challenges in the management of hypertension within South Africa’s primary healthcare (PHC) system. Conducted through SMU’s School of Pharmacy, the research developed and tested practical quality indicators to strengthen healthcare delivery to and improve patient outcomes across PHC clinics.
Hypertension remains one of the leading contributors to cardiovascular disease in lower- and middle-income countries, including South Africa. Although national policies and clinical guidelines have been introduced to strengthen the management of non-communicable diseases (NCDs), inconsistent treatment outcomes and weak monitoring systems continue to affect patient care at PHC facilities.
Dr Rampamba said the study was motivated by the urgent need to improve the quality of care provided to patients living with hypertension.
“This study was driven by the need to strengthen the quality of care provided to patients with hypertension at the primary healthcare level. The findings revealed important gaps in patient monitoring, medicine availability and data management, but also highlighted opportunities to improve patient outcomes through practical and measurable quality indicators,” he said.
The mixed-methods research was conducted in three phases and included rapid evidence reviews, expert panel consultations, clinical audits and clinicians’ interviews across 12 PHC clinics in Limpopo’s Vhembe District. Through the study, Dr Rampamba developed 45 evidence-based quality indicators focused on patient monitoring, review, lifestyle counselling, laboratory testing, intermediate outcomes, referrals and practice indicators.
The findings exposed serious challenges in hypertension management at PHC level. Only 35% of patients maintained controlled blood pressure over 12-months period, while just 38% received all prescribed antihypertensive medication at their most recent clinic visit. The study further revealed that poor routine data collection systems limited the effective measurement and monitoring of healthcare quality in many clinics.
Dr Rampamba emphasised the importance of strengthening digital healthcare systems to improve patient care and clinical decision-making.
“Nurses participating in the study strongly supported the migration from manual systems to electronic data management. Improved data systems will strengthen patient monitoring, support better decision-making and ultimately improve the quality of care delivered in clinics,” he said.
With more than two decades of experience in pharmaceutical management and leadership, Dr Rampamba currently oversees pharmacy education standards, accreditation processes and professional development initiatives at the South African Pharmacy Council. Before joining the council, he served in several senior roles within the Limpopo Department of Health, including Pharmacy Manager at Tshilidzini Regional Hospital.
Throughout his career, he has maintained a strong focus on healthcare quality improvement, patient education and research. His doctoral work has already received national and international recognition and has been presented at two national and two international conferences, including the 82nd FIP World Congress of Pharmacy and Pharmaceutical Sciences held in Cape Town in 2024.
The study has also produced several peer-reviewed journal publications, contributing to broader global discussions on hypertension management and healthcare quality in Africa.
Dr Rampamba said he hopes the framework developed through the research will support policymakers and healthcare professionals in strengthening NCD management across South Africa.
“Implementing these indicators nationally could improve healthcare quality, enhance patient outcomes and ensure more efficient use of limited healthcare resources. The framework also has the potential to be adapted for other non-communicable diseases in South Africa and elsewhere on the continent,” he said.
The achievement reflects SMU’s growing contribution to health sciences research, innovation and evidence-based healthcare solutions. As a dedicated health sciences university, SMU continues to advance research that responds directly to the healthcare challenges facing South Africa and the broader African continent.
By Tumelo Moila
