Marchal Bruno

Bruno Marchal is professor and head of the Complexity and Health unit.

Bruno is currently working on urban health systems, health system adaptation to climate change and resilience, and research methodologies for complex issues in health and ecohealth.

Current research interests

Health systems are social systems and thus complex systems. The current global challenges of climate change and urbanisation are wicked problems because of their complex causal pathways. Ensuring adaptation of health services and systems to the evolving needs of people requires not only research and evaluation methods that address complex causality, but also appropriate models of management, leadership, governance and decision-making.

Thematically, Bruno’s research agenda focuses on urban health systems, local health system adaptation to the climate crisis and resilience. Recent urban health projects focused on the role of urban first line health zones in Flanders and in Kinshasa to the Covid-19 pandemic. With Joris Michielsen and Guillermo Hegel, he examines how urban health authorities collect, interpret and use health data in decision-making in Antwerp and Lima. With Kirsten Accoe, he tested health system resilience frameworks in Mauretania. Orawan Tawaytibhongs’ study focuses on resilience of local health systems in Thailand. In Mali, Houssynatoy Sy and Bruno focus on the resilience of communities of internally displaced people in Bamako (Mali).

Methodologically, Bruno focuses of theory-driven inquiry and specifically realist evaluation and research. (Recent) 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. Virginia Castellano explores the use of realist evaluation and complexity theory in evaluation and decision-making. Christelle Boyi used realist evaluation to investigate the implementation of quality improvement strategies to reduce maternal mortality in Benin. Samuel Bosongo applied realist evaluation in a study of the capacity strengthening programme of regional health directorates in RDC, while Marsha Orgill examined innovation in two South African districts through realist evaluation.