!!Postal address
Nationalestraat 155

Telefoon: +32(0)32476384


Bruno Marchal is associate professor and head of the Health Systems unit, currently working mainly on strategic management of health care organisations and stewardship, research methodologies for complex issues in health and life-long conditions. 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 at the ITM in 2000 after obtaining a Master in Public Health. He held the position of tutor and later of 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."


His recent/current research includes:

Strategic management of local health systems

(1) Development of innovative stewardship and governance arrangements to ensure public accountability of local health systems (multi-level meta-governance and distributed stewardship). Projects include Participation for local action by Tanya Seshadri and Prashanth NS (Vivekananda Tribal Health Centre, Vivekananda Girijana Kalyana Kendra, Chamarajanagar, Karnataka, India), for which he provided methodological support (realist evaluation).

(2) Leadership and decision-making (including complex and distributed leadership), with research in Morocco (PhD research of Zakaria Belghriti)

(3) The concept of public service motivation and its relevance to health system management in low- and middle-income countries (PhD research of Zakaria Belghriti)

Evaluation and research methodologies for complex health (system) problems
(1) Complexity and the challenges for research, policymaking and management

(2) Methodological development of theory driven inquiry in health policy and systems research, with a specific focus on realist evaluation. Projects include the EU project Health Sector Reform in Tanzania and South Africa (UNITAS), in which he provides mainly methodological support to the Tanzanian team (theories of change). Bruno also supported/s a number of PhD projects with a realist or theory-driven component (see, for instance, Prashanth et al. 2012Robert et al. 2012Prashanth et al. 2014), a realist evaluation on intimate partner violence in Spain (Goicolea et al. 2013Goicolea et al. 2015) and a study on volunteer motivation with the International Federation of the Red Cross (Vareilles et al. 2015).

(3) Development of better methods for research of social complexity, with specific attention for the interface between quantitative and qualitative approaches to complexity (e.g. Qualitative Comparative Analysis) (see Goicolea et al. 2015).

Innovative platforms for care for life-long conditions 
The focus is on strategies to enhance a shift from biomedical and patient-centred care models to person-centred care approaches that contribute to patient autonomy and self support. Self Determination Theory and the consequences for the organisation of care and services are being explored. Bruno participates in the EU Horizon 2020 project A people-centred approach through Self-Management and Reciprocal learning for the prevention and management of Type-2-Diabetes (Smart2D), which focuses on autonomy supportive care and services for people with diabetes in Uganda, South Africa and Sweden. Also the International Diabetes Foundation project Mobile Phone Diabetes Self-Management managed by Josefien van Olmen focuses on this theme.


  • 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 Course in Tropical Medicine, ITM.
  • teaching the module Intercultural aspects of gerontology and geriatrics of the International Master in Gerontology since Oct. 2014
  • Coaching of master and post-graduate students at the ITM.
  • Supervision of PhD candidiates 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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