- Users of research expertise:Present position
I joined the Institute of Tropical Medicine at the end of 1990. I am currently a Senior Lecturer at the Health Policy and Financing Unit, Department of Public Health. My main areas of work are the study of health care delivery systems and of systems of social protection in health in low-and middle income countries. In ITM’s Masters courses, I am in charge of (sections of) the module on health services organization. I am involved in coaching a number of action-research projects in the field of health care delivery at district level in Benin and DRCongo. I am also responsible for streamlining the institutional collaborations ITM has developed with sister academic institutions in DRCongo (School of Public Health in Lubumbashi), India (Institute of Public Health in Bangalore) and Uganda (Makerere University School of Public Health in Kampala).Professional career
- 1974-1981: Trained as a Medical Doctor at the Catholic University of Louvain (KUL 1981). I obtained a Diploma in Tropical Medicine & Hygiene at ITM in the same year.
- October 1981- September 1982: 1 year as a resident assistant consultant in the department of Internal Medicine of the Stuyvenberg Hospital in Antwerp. From October 1982 to April 1983 I worked as a General Practitioner in the greater Antwerp region.
- May 1983- July 1990: Medical Officer in Kasongo and Bwamanda (Zaire) for the Belgian Technical Cooperation. I interrupted my stay in Zaire for one year to obtain a Master of Science degree in Public Health at the London School of Hygiene and Tropical Medicine (LHSTM).
- I joined ITM at the end of 1990 and obtained my PhD in 1998.
My research activities are mainly situated in two areas. A first domain concerns the planning, organization and management of health care delivery systems at district level. The focus is on sub-Saharan Africa (Benin, DRCongo, Uganda) and, to a lesser extent, on India. The aim of this research is to study the organizational and managerial modalities for the development of more effective, efficient and equitable health care delivery in rapidly changing environments characterized by important social, political, epidemiological and demographic changes. The research mainly takes the form of action-research in selected districts, where the local stakeholders – health providers and communities - are closely involved in the analysis of the problems and the identification and testing of possible solutions. Links with the central level of the health system are established in order to help local findings feed into policy-making at national level. As far as possible, this research is conducted in collaboration with partner academic institutions: for Uganda and India comprehensive collaborative agreements exist with the Makerere University School of Public Health in Kampala and the Institute of Public Health in Bangalore respectively.
A second domain is the study of arrangements for social protection in health. We focus on the investigation of experiences that develop at micro and meso-levels of the health system: community health insurance schemes and increasingly also arrangements of social assistance for health care developed for the poorest in the community. Again, we are mainly involved through local action-research projects. However, we also increasingly take up consultancy work and participate in policy-making at the central levels of the health system.
My involvement in service activities is consistently linked to (current) research activities. In that respect, a number of collaborations have been developed with non-governmental and bilateral aid organizations active in the field of health care in low-income countries (Cordaid Netherlands, Memisa Belgium, Belgian Technical Cooperation). I am also a member of the network organization Medicus Mundi International that groups a dozen NGOs specialized in Primary Health Care. Over the past years, I was also strongly involved in the design and implementation of social policies at municipality level in Belgium. This experience with social work in a high-income country, in the field of health but also more generally, greatly inspires my overseas work.
- Study of international health policies including the investigation of Global Health Initiatives.
- Study of arrangements of social protection for health care ranging from mechanisms of social assistance to Community Health Insurance schemes.
- Study of innovative health care delivery models and institutional arrangements to cope with dramatically changing environments (increasing verticalisation and privatisation in the financing of health care, HIV/AIDS epidemic, aging population, demographic changes, more vocal patient populations, ...).
- Public Health Concepts
- Health Service Organisation and Integration
- Development of First Line Health Services
- Analysis of Belgian Health Services
- The Interface Between Health Services and Health programs
- Social Protection in Health
- User perspectives in Health Care Delivery Systems