Health Systems

Postal address
Nationalestraat 155
Phone: +32(0)32476384

Research expertise

Bruno Marchal is associate professor and head of the Health Systems unit. He is currently working mainly on strategic management of health care organisations and stewardship, urban health and research methodologies for complex issues in health. Since 2013, Bruno is a visiting researcher at the School of Public Health, University of the Western Cape, Cape Town (South Africa).

After graduating as a medical doctor and obtaining a degree in Tropical Medicine at the ITM, Bruno worked for 6 years in Nyamira District (Kenya) as a medical doctor and hospital director. He joined the Department of Public Health, ITM in 2000 after obtaining a Master in Public Health. He held the position of tutor and coordinator of the ITM’s Master in Public Health course. Between 2002 and 2005, he was a researcher in the IMMPACT project, focusing on capacity strengthening for research and evidence-based policy in Burkina Faso, Ghana and Indonesia. From 2005 to 2011, he led the work packages on Management and on Human Resource Management of REACT, an FP6-INCO programme in Kenya, Tanzania and Zambia. He carried out his doctoral research on the influence of (health workforce) management practices on performance of hospitals in Ghana and Tanzania, using realist evaluation as the main methodology. In 2011, he successfully presented his PhD dissertation on this subject, titled: "Why do some hospitals perform better than others? A realist evaluation." Between 2011 and 2013, Bruno was a post-doctoral researcher at the Health Services Organisation unit, focusing on research on health worker motivation and non-financial incentives, for instance for the International Federation of the Red Cross (IFRC), and on effects of policy implementation (e.g. FemHealth project).

His current research includes:

Innovative stewardship and governance arrangements at the level of local health systems

The PhD research of Zakaria Belrhiti (Morocco) focuses on complex leadership and public service motivation. In Benin, Jean-Paul Dossou works on policy formulation and implementation gaps. Marsha Orgill carries out her PhD research on strengthening district management as a key lever in health system strengthening in two district health systems in South Africa. With Guillermo Hegel, exploratory research on urban health systems is starting in Villa Nueva, Guatemala.

Complexity and the challenges for research, policymaking and management

This theme includes methodological development of theory driven inquiry in health policy and systems research, with a specific focus on realist evaluation. Projects include the Results4TB in Georgia (MRC/ESRC/DfID/Wellcome Trust) and the EU-funded ALERT project in Benin, Tanzania, Uganda and Malawi. Bruno supported/s a large number of research projects with a realist or theory-driven component. Since one year, he applies the methods in the field of eco-health.


Teaching expertise

Bruno Marchal is the Programme director of the Postgraduate Certificate Course in Tropical Medicine and International Health (TMIH) and Course Leader of the Short Course Strategic Management of Health systems.

His teaching assignments include:

  • Teaching the topics of Strategic management, Health care organisation performance and Health workforce management, Health Policy and Systems Research in the MSc – Public Health of ITM 
  • Teaching in the Postgraduate Certificate Course in Tropical Medicine and International Health, ITM.
  • Coaching of master and post-graduate students at ITM.
  • Supervision of PhD candidates at ITM and UWC.
  • Teaching Health systems in the International MPH of the Ecole de Hautes Etudes de Santé Publique (Rennes) à Paris.

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