Dr Lungiswa Nkonki, a lecturer in the Division of Health Systems and Public Health, is among a selected group of Stellenbosch University (SU) staff members who are participating in the Future Professors Programme (FPP), an initiative of the Department of Higher Education and Training. The FPP aims to develop a transformed next generation of South African professors across all disciplines. Read more about her career journey.
“People often dislike thinking of health and money at the same time. But although health is a human right, it is still one that must be paid for by someone. And this leads to difficult trade-offs," says health economist Dr Lungiswa Nkonki. This senior lecturer in the Division of Health Systems and Public Health in Stellenbosch University's Department of Global Health has helped conduct economic evaluations of a number of public health interventions over the years. These include those aimed at curbing the mother-to-child transmission of HIV, the use of community workers to strengthen neonatal care, HIV testing in rural settings, and cervical cancer screening.
More recently, she helped evaluate the unintended health consequences of COVID-19, as well as the Gauteng provincial government's interventions during different alert stages of the pandemic. She is also a project member of the “If I were Thabo" gender-transformative intervention programme on sexual and reproductive health aimed at young adolescents. The programme is run by SU and Queen's University Belfast in Khayelitsha and Maseru (Lesotho).
Dr Nkonki does her number crunching as part of a team, either alongside other economists or in support of the work of epidemiologists and other health professionals – all to address public health issues. “Economic evaluation is about how much an intervention costs, and whether the effect that we get from it is worth the money," she explains. “There is always a possibility that we spend lots of money on things that do not produce the value we desire. My work allows policymakers and researchers to say whether the results of a project justify the resources allocated and, therefore, whether the project is worth continuing."
She has no illusions as to the reality of profiteering in the health sector. “Do not be naïve to think that profiteers in the private and public sector will not exploit any opportunity for their own intent. Therefore, oversight always has to go into what is being purchased with allocated funds, and the strategy being followed."
Dr Nkonki, who grew up in Port Elizabeth, obtained her PhD in Health Economics from the University of Bergen, Norway, in 2012. She also holds master's degrees from the universities of Sussex (United Kingdom) and Cape Town, and a BScHons in Applied Herbal Science from the University of the Western Cape. With a Y-rating from the National Research Foundation to her name, she was previously recognised as an emerging voice in science by the Institute of Tropical Medicine in Belgium, and is a member of the South African Young Academy of Science.
Her previous work experience includes stints at the South African Medical Research Council and the Health Systems Trust. For five years in the mid-2010s, she also served on the Competition Commission's panel who conducted an inquiry into the country's private health sector.
Support in unprecedented times
Her academic track record earned her a spot in the inaugural intake for the Future Professors Programme (FPP) in 2020. This preparatory programme of the Department of Higher Education and Training supports the next generation of professors at South African universities to lead by example and through excellence. Since then, FPP sessions on different aspects of scholarship, regular small-group coaching sessions, advice on NRF ratings procedures and funding applications, and lectures or workshops by eminent scholars have been part of Dr Nkonki's weekly routine.
She describes these sessions as “a place of real support and camaraderie" where fellows can freely share their fears and coping strategies with regard to their work and the “new normal" of the pandemic. “The FPP has provided me with tremendous support in unprecedented times."
Dr Nkonki has indeed gone through the mill this past while. At the beginning of 2021, she lost both her parents, Temba and Xoliswa Nkonki, to COVID-19 in short succession. The FPP team arranged grief counselling to help her cope with her double loss. “I really felt supported," says Dr Nkonki, who too contracted COVID-19. Her parents were guiding lights in her life, and she will carry their example with her as she continues on her career path.
“My dad was an unskilled labourer in a car factory. He was very organised and systematic, and ran our household like a factory belt," she reminisces. “My mother was a graceful and dedicated primary school teacher who loved imparting knowledge." After her mother's passing, the principal of the school she worked at mentioned how well Xoliswa had handled financial matters. “It was only then that I realised I had received my interests from her," Dr Nkonki reflects.
She is very clear about her goals going forward: “I want to do meaningful health economics research and build capacity in the field through teaching, mentoring and supervising students, and by building a research team." Everything she does is aimed at “contributing to the overall well-being of the South African population".
Dr Nkonki is also a prolific curriculum designer. In 2012, for instance, she designed an elective module on conducting economic evaluations, which she introduced for SU students enrolled in the MSc Clinical Epidemiology and MPhil Health Systems and Services Research programmes. And earlier this year, she introduced a short course on performing systematic reviews of economic evaluations, which is a follow-up to a course on advanced economic evaluations she created in 2018.
“I like academia because I like to learn. I will not be able to survive in an environment where you just do the same thing over and over again, without exploring anything new," she admits.