Advancing public health through community engagement

Kirsty Scott

9 January 2025

This is an article from the CSC Development Theme: Strengthening health systems and capacity
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“I identify as a ‘pracademic’- a practitioner and an academic. I place immense value on social work education and equally on bridging the gap between scientific knowledge and public service.”

Professor Rachel Johanna Freeman

Commonwealth Alumnus Professor Rachel Johanna Freeman is the Head of UNAM Cares, in the Office of the Vice Chancellor of the University of Namibia. UNAM Cares is the University of Namibia’s corporate social responsibility and community engagement initiative. With a mission ‘to provide a lasting vehicle for social impact through the power of community engagement and partnerships’, UNAM Cares advances the university’s third mission: to serve and empower local communities through community engagement.

The programme is grounded in six key pillars: Community Education, Research, Innovation and Development, One Health, Climate Change, Humanitarian Aid, and International Development for Partnerships. In her leadership role, Professor Freeman is responsible for overseeing the University of Namibia’s One Health Community Engagement pillar, as well as coordinating and implementing the UNAM Cares project strategy.

Community engagement for local impact

The University of Namibia is committed to participatory, community-based research to address pressing health, educational, and social issues. For Professor Freeman, this work represents both a professional commitment and personal passion to translating research into responsive public service.

“We conduct community-based participatory research and translate scientific evidence into policy formulation or reformulation. Research findings are then used to co-develop tailored, community-based interventions.”

Community engagement is a cornerstone of the university’s work to give back to the community, with 10% of academic staff time allocated to community service initiatives. However, it was Professor Freeman’s translational research in 2018, during the 2017 Hepatitis E outbreak in informal settlements in Namibia, that catalysed a more proactive, interdisciplinary approach that resulted in the launch of UNAM Cares.

Mobilising students and partnerships to combat Hepatitis E (HEV)

Professor Freeman was appointed co-investigator during the 2017 HEV outbreak, during which she examined the socio-behavioural factors contributing to disease spread. Her knowledge-attitude-practice (KAP) survey revealed that residents lacked access to clean water and soap, critical for preventing the spread of hepatitis E. Hepatitis E is a faecal-oral transmitted virus, meaning the lack of access to proper sanitation was fuelling the outbreak.

Rather than confining the findings to academic discourse, Professor Freeman engaged her social work students in developing real-world responses. This process involved compiling community profiles, conducting needs assessments and extensive consultations with affected populations to co-develop real-life solutions. Based on the findings, the students proposed a community education campaign to raise awareness of the symptoms of hepatitis E and how to report these.

Collaborating with the university’s Visual Arts Department, students designed educational stickers featuring a yellow eye, key symptoms of hepatitis E, and launched a soap donation drive, collecting 1,500 bars of soap. The bars of soap were affixed with the educational stickers and distributed to over 2,000 individuals in one day by 40 university students.

“Together with the visual arts students, we created educational stickers and distributed soap to over 2,000 community members. This was a powerful, student-led work integrated service-learning intervention.”

The efforts of Professor Freeman and her students drew university and national attention.

The Vice-Chancellor of the University of Namibia attended the Bar of Soap distribution session and subsequently tasked Professor Freeman to replicate such interventions on a bi-monthly basis as part of the University of Namibia’s relevance and responsiveness in addressing the needs of society.

In March 2022, the Minister of Health and Social Services, Dr Shangula, formally declared an end to the outbreak of HEV, and acknowledged the University of Namibia’s significant contribution to the public health response.

“If 40 students can make such an impact in one day, imagine the transformational potential of a fully engaged university- an intellectual hub and think tank actively working to address societal challenges.”

Responding to COVID-19 and building future resilience

During the COVID-19 pandemic, UNAM Cares played a pivotal role in the national response. Under Professor Freeman’s leadership, the initiative established vaccination clinics that contributed to the immunisation of 20% of Namibia’s population.

It also led extensive public health campaigns and secured funding through the Wales Africa Grant to set up oxygen generation plants and train 217 healthcare professionals in patient ventilation techniques.

Transformative experiences through the Commonwealth Professional Fellowship

In 2022, following the completion of a Commonwealth Professional Fellowship at Cardiff University, Professor Freeman was appointed Head of UNAM Cares in the Office of the Vice-Chancellor.

Reflecting on this experience, Professor Freeman shares the Professional Fellowship experience served as a catalyst for cross-sector collaboration. Alongside five other Fellows from the University of Namibia and the Ministry of Education, the programme strengthened professional networks and institutional cooperation.

A key outcome of the Professional Fellowship was exposure to the Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer) at Cardiff University. DECIPHer brings together leading experts from a range of disciplines to tackle public health issues.

Inspired by DECIPHer’s interdisciplinary approach, the Fellows adapted this model to establish a Namibian School Health Research Network. With Cardiff University’s ongoing support and mentorship, they launched a pilot study to gather data to inform national school health research interventions. The pilot study was conducted in 32 schools representing four political regions in Namibia.

“Our placement at DECIPHer, Cardiff University deeply inspired us. Upon our return, we co-developed a joint grant to explore the feasibility of establishing a Namibian School Health Research Network.”

The Commonwealth Professional Fellowship has also had a profound impact on Professor Freeman’s professional development.

“Beyond institutional change, the Fellowship enriched my academic capabilities, particularly in grant writing, research proposal development, and academic publishing. These skills have underpinned my success in securing major research grants and elevating my academic profile.”

Championing community engagement for One Health and development- looking to the future

As a passionate One Health pracademic and advocate for championing community engagement for development, Professor Freeman has played a pivotal role in launching Namibia’s National Tripartite One Health Strategy in close collaboration with the Ministries of Health, Agriculture, and Environment and Tourism. This strategy emphasises the interdependence of human, animal and environmental health.

Her work has attracted funding from the Friedrich-Loeffler Institute (FLI) in Germany for a One Health in Action community-based research project, and from Capacitating One Health in Eastern and Southern Africa (COHESA) to implement sustainable One Health community gardens and deliver Indigenous-focused One Health capacity building trainings.

Looking to the future, Professor Freeman hopes to continue in her role at UNAM Cares and work with and give back to local communities and Namibia.

“Our vision through UNAM Cares is to empower individuals with the knowledge and skills to become self-sustaining—generating income, reducing poverty, and improving resilience to drought. In the next five years, we aspire to be a responsive, relevant university delivering tangible societal impact and in improving quality of life.”

Professor Rachel Johanna Freeman is a 2021 Commonwealth Professional Fellow from Namibia. She completed her Fellowship at Cardiff University.