Dr. Bossert is involved in five major areas in health systems research, all related to key policy issues of health reform:

• decentralization of health systems
• governance and political process of policy change
• organizational reform of public institutions
• human resource strategies
• social capital and health

Dr. Bossert is currently Director of International Health Systems Program an interdisciplinary program which supports work on economics, politics, organizational and financing issues of health systems and health reform, including decentralization of health systems, public/private mix, political and policy analysis of reform processes, and institutional and governance reforms. 

Dr. Bossert has been involved in research on decentralization of health care systems for over twenty years in Latin America, Africa, and Indonesia. In the last few years he has developed an innovative analytical approach, called the "Decision Space Approach" based on principal agent theory. This approach provides a comparative tool for analyzing the range of choice over different functions that is allowed to decentralized authorities. Dr. Bossert has used the approach in studies of decentralization in Chile, Colombia, Bolivia, Nicaragua, Morocco, Zambia, Uganda, Ghana, Guatemala, the Philippines, Pakistan and India. This research was supported by projects funded by the United States Agency for Development, World Bank, and DfID. Lessons drawn from the research are included in the module on decentralization prepared for the World Bank Flagship Course on Health Sector Reform and presented special seminars in various countries. Dr Bossert is currently using the decision space approach in research projects to evaluate the impact of decentralization in Pakistan, India and Mexico; assessing the range of choice, capacities and accountability of district officials as a baseline for projects to improve performance of decentralized systems. Recently he completed a study of the decentralization of logistics systems in Guatemala and Ghana and supported an innovative needs based allocation formula in Nicaragua.

Dr. Bossert’s research on political processes of health policy reform has involved directing a comparative study of the policy process of reform in Chile, Colombia and Mexico. This research applied stakeholder and institutional approaches and developed the innovative concept of "change teams" of politically astute technocrats from several key ministries who drive the reforms forward. Research on the policy process of health reform in Poland concluded that usual stakeholder analysis is inadequate because many of the stakeholders do not consistently pursue policy objectives. Research in this area was funded by the USAID and Inter-American Development Bank projects.

Research on organizational development and institutional reform involved the transformation of the Colombian Ministry of Health during the period of major health reform. This research developed a multi-dimensional approach based on recent organization theories and assessed the existing structure and human resource skills in relation to the desired functions in the new health reform. The research resulted in proposed specific reorganization and transformation processes. This research was conducted when Dr. Bossert was Director of the Harvard Project in Health Sector Reform in Colombia, funded by the Colombian government and the Inter-American Development Bank. Lessons from this activity is used in the Andhra Pradesh project.

Recently, Dr. Bossert has directed a WHO initiative to develop a evidence based approach to strategic planning for the financing, education and management of human resources in health. This activity involved a careful review of evidence based literature on human resources and on health system elements related to human resources. After developing a framework and assessment guide, the approach was applied to field work in Ethiopia. This research has also been incorporated into the IHSP training program in a course on strategic planning for human resources.

In a recent study of social capital and health led by Dr. Bossert in Nicaragua, the impact of leadership and management inteventions on the levels of trust and participation was measured using two household surveys. The study clearly demonstrated one important strategy for strengthening social captial and health in poor, post-conflict communities. This project was funded by USAID.

In the area of health financing, as Director of the Harvard Project in Health Sector Reform in Colombia, Dr. Bossert participated in a three-year assessment of the process and performance of the health financing reform in Colombia. This research produced a major report and ten-year implementation plan and several articles in various journals. This research also produced course material for the World Bank Flagship Course on Health Sector Reform.

Ph.D., 1976, University of Wisconsin
A.B., 1968, Princeton University, Woodrow Wilson School