Projects per year
Personal profile
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.
Teaching expertise
Bruno Marchal is the Course director of ITM's Master in Science Public Health. His teaching assignments include:
- Teaching the topics of Strategic management, Health care organisation performance and Health workforce management, Health System Strengthening and Health Policy and Systems Research in the MSc – Public Health of ITM
- Coaching of master 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.
Education/Academic qualification
PhD
Master
MD
External positions
Adjunct Faculty, Institute of Public Health, Bengaluru, India
May-2017 → …Fingerprint
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Is mistreatment of women during facility-based childbirth an independent risk factor for postpartum depression? A mixed methods prospective study in Ethiopia and Guinea
Asefa, A., Marchal, B., Delamou, A., Gebremedhin, S., Benova, L. & Van Aerde, K.
Fonds voor Wetenschappelijk Onderzoek
1/10/22 → 30/09/25
Project: Mandate
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Accountability and Collective Action in Urban India: How are Socially Marginalized Adolescent Girls and Young Women organized to Negotiate Sexual and Reproductive Health Rights (SRHR)?
Contractor, S. Q., Marchal, B., Van Belle, S., Nambiar, D. & Ruano, A. L.
1/01/22 → …
Project: PhD-project
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RECOVER: Rectifying the effects of COVID-19 on Vulnerable Populations in West-Africa : a Research Action
Marchal, B., Van Belle, S., Affun-Adegbulu, C., De Maesschalck, J., Everaert, R. & Dossou, J.
9/06/21 → 30/11/23
Project: Research Project
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A qualitative study to investigate the use of complex perspectives in policy evaluation in public health
Castellano Pleguezuelo, V., Marchal, B. & Petticrew, M.
27/04/21 → …
Project: PhD-project
Research output
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The tale of nine Belgian health ministers and a multi-level fragmented governance system: six guiding principles to improve integrated care, responsiveness, resilience and equity; a response to the recent commentaries
Van Belle, S., Michielsen, J., Cornu, T., Martens, M. & Marchal, B., 2023, In: International Journal of Health Policy and Management. 12, p. 7848 2 p.Research output: Contribution to journal › Letter › peer-review
Open AccessFile5 Downloads (Pure) -
A perspective on urban health systems and research for equitable healthcare in Africa
Abejirinde, I-O. O., Gwacham-Anisiobi, U., Affun-Adegbulu, C., Vanhamel, J., Van Belle, S. & Marchal, B., 2022, In: BMJ Global Health . 7, 9, 4 p., e010333.Research output: Contribution to journal › A1: Web of Science-article › peer-review
Open AccessFile4 Downloads (Pure) -
Methodological reflections on health system oriented assessment of maternity care in 16 hospitals in sub-Saharan Africa: an embedded case study
Asefa, A., Dossou, J-P., Hanson, C., Hounsou, C. B., Namazzi, G., Meja, S., Mkoka, D. A., Agballa, G., Babirye, J., Semaan, A., Annerstedt, K. S., Delvaux, T., Marchal, B., Van Belle, S., Pleguezuelo, V. C. & Benova, L., 2022, In: Health Policy and Planning. 37, 10, p. 1257–1266 10 p., czac078.Research output: Contribution to journal › A1: Web of Science-article › peer-review
Open AccessFile3 Downloads (Pure) -
Realist evaluation in times of decolonising global health
Renmans, D., Sarkar, N., Van Belle, S., Affun-Adegbulu, C., Marchal, B. & Mukumbang, F. C., 2022, In: International Journal of Health Planning and Management. 37, S1, p. 37-44 8 p.Research output: Contribution to journal › A1: Web of Science-article › peer-review
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Strengthening capacity in hospitals to reduce perinatal morbidity and mortality through a codesigned intervention package: protocol for a realist evaluation as part of a stepped-wedge trial of the Action Leveraging Evidence to Reduce perinatal morTality and morbidity (ALERT) in sub-Saharan Africa project
Abejirinde, I-O. O., Castellano Pleguezuelo, V., Benova, L., Dossou, J-P., Hanson, C., Metogni, C. B., Meja, S., Mkoka, D. A., Namazzi, G., Sidney, K., Marchal, B. & Delvaux, T., 2022, In: BMJ Open. 12, 4, 10 p., e057414.Research output: Contribution to journal › A1: Web of Science-article › peer-review
Open AccessFile8 Downloads (Pure)