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Effective Care Research Unit (ECRU)
East London Hospital Complex (ELHC), Eastern Cape Province, South Africa

Lindeka Mangesi
Effective Care Research Unit, Cecilia Makiwane Hospital, P/Bag X 13003, Cambridge, 5207, South Africa


Lindeka Mangesi is working as a research midwife and Deputy Director of Effective Care Research Unit (ECRU) in East London Hospital Complex (ELHC) in the Eastern Cape Province, South Africa. She started working for the unit in August 2000. The purpose of her visit at the Geneva Foundation for Medical Education and Research in October to November 2004 was to update the World Health Education training manuals for Evidence Based Reproductive Health Care.

About ECRU

ECRU is the research unit of the University of Witwatersrand and University of Fort Hare and Eastern Cape Department of Health, based in the Obstetrics and Gynaecology Department of ELHC. The objective of ECRU is to promote evidence-based affordable care appropriate to the needs of low income communities. ECRU comprises of five staff members: the director, three research midwives and the administrator. In East London, the unit was opened in 2000 subsequent to the arrival of Professor Hofmeyr in Eastern Cape from Gauteng Province. The unit started in Gauteng Province in 1988.


The main activities at ECRU are conducting randomised clinical trials, conducting systematic reviews and conducting Evidence-Based Health Care (EBHC) Workshops. The research unit has, in partnership with the Department of Health: Eastern Cape Province and the University of Fort Hare successfully implemented the Better Births Initiative (BBI) to promote humane and evidence-based child birth in Hospitals in Eastern Cape. ECRU participated in the Magpie Trial, Amnioinfusion Trial (Canadian MRC), WHO Calcium Supplementation for Prevention of Pre-eclampsia Trial and other clinical trials.

ECRU member with a patient on calcium trial during the site visit by WHO representative

The first EBHC workshop conducted by ECRU in East London was in 2001 and it has continued annually without fail. South African Cochrane Centre is of great support to ECRU in conducting the workshops. ECRU staff has authored 36 Cochrane systematic reviews and protocols, and have mentored other health care professionals in conducting systematic reviews. ECRU disseminates the findings of the studies in the form of presentations in conferences and publications. The unit has so far published over 200 scientific papers.

The director is a founding editor of WHO Reproductive Health Library which is distributed in English and Spanish to over 20 000 health workers in developing countries each year. ECRU has developed video material for teaching obstetric procedures, published in RHL.

2004 evidence-based health care workshop facilitators and participants

About ELHC

ELHC is a referral hospital comprising of two hospitals (Cecilia Makiwane and Frere Hospitals) which are 23 km apart. The two hospitals are currently in the process of merging and are under the same management. ECRU has offices in both hospital and the clinical trials are also conducted in O & G Departments of both hospitals. The complex has a total of 13 000 deliveries per annum. The most prevalent condition in O&G Department is hypertension in pregnancy.


  1. Hofmeyr GJ, Mlokoti Z, Nikodem VC, Mangesi L, Ferreira S, Singata M, Jafta Z, Merialdi M, Hazelden C, Villar J. Calcium supplementation during pregnancy for preventing hypertensive disorders is not associated with changes in platelet count, urate, and urinary protein: a randomized control trial. Hypertens Pregnancy. 2008;27(3):299-304.
  2. Mangesi L, Hofmeyr GJ. Fetal movement counting for assessment of fetal wellbeing. Cochrane Database Syst Rev. 2007;(1):CD004909.
  3. Hofmeyr G, Ferreira S, Nikodem V, Mangesi L, Singata M, Jafta Z, Maholwana B, Mlokoti Z, Walraven G, G├╝lmezoglu A. Misoprostol for treating postpartum haemorrhage: a randomized controlled trial [ISRCTN72263357]. BMC Pregnancy Childbirth [Internet]. 2004 Aug 6 [cited 2009 Mar 27];4(1):16. Available from: http://www.biomedcentral.com/1471-2393/4/16
  4. Mangesi L, Hofmeyr GJ. Early compared with delayed oral fluids and food after caesarean section. Cochrane Database Syst Rev. 2002;(3):CD003516.


Pictures from Geneva