- Users of research expertise:
Bruno Marchal is associate professor and head of the Complexity and Health unit. He is currently working on strategic management of health care organisations and stewardship, urban health, research methodologies for complex issues in health and ecohealth.
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).
Current research interests
Health and health systems are complex in nature. This requires not only research and evaluation methods that allow understanding the complex causal pathways in health and health systems, but also appropriate models of management, leadership, governance and decision-making.
In Benin, Jean-Paul Dossou explores policy formulation and policy implementation gaps and how managers and providers at the local health system influence these processes. 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. Guillermo Hegel implements participatory approaches to priority-setting, management and evaluation in urban health systems in Villa Nueva, Guatemala. Samuel Bosongo investigates the role of regional and district health management in RD Congo. Bruno is also involved in the ICRD-funded RECOVER and Catalyse projects in West-Africa, which focus on the effects of COVID-19 and the response on health systems and communities with a resilience perspective.
Methodologically, theory-driven inquiry and specifically realist evaluation offers avenues to understand complex pathways. Projects include the Results4TB in Georgia (MRC/ESRC/DfID/Wellcome Trust) and the EU-funded ALERT project in Benin, Tanzania, Uganda and Malawi. Virginia Castellano explores the use of complexity theory in evaluation and research. Christelle Boyi uses realist evaluation to investigate the implementation of quality improvement strategies to reduce maternal mortality in Benin. Bruno supported/s a large number of research projects with a realist or theory-driven component. He applies the methods also in the field of urban health and eco-health.