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Thomas John Bossert, Ph.D.

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Thomas J. Bossert, PhD. is a Senior Lecturer and the Director of the International Health Systems Program of the Harvard T. H. Chan School of Public Health. He has many years of experience in international health in Latin America and the Caribbean, Africa, Asia and Central and Eastern Europe. His specialties include health reform, decentralization, sustainability and transition, implementation science, social capital, human resources strategic planning and political feasibility analysis. His publications have appeared in Social Science and Medicine, Health Policy and Planning, WHO Bulletin, The Lancet among other journals and monographs. His innovative "decision space" approach to decentralization has appeared in many peer-reviewed journals and recently in an edited book on decentralization: Federalism and Decentralization in Health Care: A Decision Space Approach. Toronto: University of Toronto Press, 2018. He has developed a guide to strategic planning for human resources for WHO. His pioneering work on sustainability of donor-funded projects was published in Social Science and Medicine in 1990, and he has recently studied sustainability and transition for projects funded by CDC and the Gates Foundation. He has provided technical assistance, conducted research and project management for contracts with various donors including USAID, DfID, World Bank, WHO and the Inter-American Development Bank. At Harvard, he teaches courses on health system reform and political economy of health systems and was the recipient of a Teaching Citation Award based on student evaluations for the academic year 2013-14. He also teaches in the Harvard/World Bank Flagship Course on Health System Strengthening in Washington and in various countries around the world. He also teaches executive training courses on decentralization and on human resources for the International Health Systems Program at Harvard and for country courses around the world.

Publications listed below are automatically derived from MEDLINE/PubMed and other sources, which might result in incorrect or missing publications. Faculty can login to make corrections and additions.
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  1. Delamou A, Grovogui FM, Miller L, Nye A, Kourouma M, Kolié D, Goumou T, Bossert TJ. Implementation research protocol on the national community health policy in Guinea: A sequential mixed-methods study using a decision space approach. PLoS One. 2023; 18(1):e0280651. PMID: 36662762; PMCID: PMC9858093.
    Citations:    Fields:    
  2. Feldhaus I, Chatterjee S, Clarke-Deelder E, Brenzel L, Resch S, Bossert TJ. Examining decentralization and managerial decision making for child immunization program performance in India. Soc Sci Med. 2023 Jan; 317:115457. PMID: 36493499.
    Citations:    Fields:    Translation:Humans
  3. Bossert TJ, Lenz R, Guerrero R, Miranda R, Soto Rojas VE, Maldonado Vargas ND. Decentralization Can Improve Equity, but Can It Be Sustained? Health Syst Reform. 2022 01 01; 8(1):e2064793. PMID: 35666239.
    Citations:    Fields:    Translation:Humans
  4. Glenn J, Moucheraud C, Payán DD, Crook A, Stagg J, Sarma H, Ahmed T, Epstein A, Luies SK, Rahman M, Kruk ME, Bossert TJ. What is the impact of removing performance-based financial incentives on community health worker motivation? A qualitative study from an infant and young child feeding program in Bangladesh. BMC Health Serv Res. 2021 Sep 17; 21(1):979. PMID: 34535147.
    Citations:    Fields:    Translation:Humans
  5. Moucheraud C, Sarma H, Ha TTT, Ahmed T, Epstein A, Glenn J, Hanh HH, Huong TTT, Luies SK, Moitry AN, Nhung DP, Payán DD, Rahman M, Tariqujjaman M, Thuy TT, Tuan T, Bossert TJ, Kruk ME. Can complex programs be sustained? A mixed methods sustainability evaluation of a national infant and young child feeding program in Bangladesh and Vietnam. BMC Public Health. 2020 Sep 04; 20(1):1361. PMID: 32887601.
    Citations: 6     Fields:    Translation:Humans
  6. Glenn J, Kamara K, Umar ZA, Chahine T, Daulaire N, Bossert T. Applied systems thinking: a viable approach to identify leverage points for accelerating progress towards ending neglected tropical diseases. Health Res Policy Syst. 2020 Jun 03; 18(1):56. PMID: 32493485.
    Citations: 3     Fields:    Translation:HumansPHPublic Health
  7. Sarma H, Jabeen I, Luies SK, Uddin MF, Ahmed T, Bossert TJ, Banwell C. Performance of volunteer community health workers in implementing home-fortification interventions in Bangladesh: A qualitative investigation. PLoS One. 2020; 15(4):e0230709. PMID: 32236114.
    Citations: 6     Fields:    Translation:Humans
  8. Sarma H, Mbuya MN, Tariqujjaman M, Rahman M, Askari S, Khondker R, Sultana S, Shahin SA, Bossert TJ, Banwell C, Neufeld LM, Ahmed T, D'Este C. Role of home visits by volunteer community health workers: to improve the coverage of micronutrient powders in rural Bangladesh. Public Health Nutr. 2021 04; 24(S1):s48-s58. PMID: 32131922; PMCID: PMC8042577.
    Citations: 6     Fields:    Translation:Humans
  9. Sarma H, D'Este C, Ahmed T, Bossert TJ, Banwell C. Developing a conceptual framework for implementation science to evaluate a nutrition intervention scaled-up in a real-world setting. Public Health Nutr. 2021 04; 24(S1):s7-s22. PMID: 32102713.
    Citations: 7     Fields:    Translation:Humans
  10. Sarma H, Tariqujjaman M, Mbuya MN, Askari S, Banwell C, Bossert TJ, D'Este C, Ahmed T. Factors associated with home visits by volunteer community health workers to implement a home-fortification intervention in Bangladesh: a multilevel analysis. Public Health Nutr. 2021 04; 24(S1):s23-s36. PMID: 31983364.
    Citations: 10     Fields:    Translation:Humans
  11. Bossert TJ, Villalobos Dintrans P. Health Reform in the Midst of a Social and Political Crisis in Chile, 2019-2020. Health Syst Reform. 2020 01 01; 6(1):e1789031. PMID: 32706280.
    Citations: 2     Fields:    Translation:Humans
  12. Annear PL, Tayu Lee J, Khim K, Ir P, Moscoe E, Jordanwood T, Bossert T, Nachtnebel M, Lo V. Protecting the poor? Impact of the national health equity fund on utilization of government health services in Cambodia, 2006-2013. BMJ Glob Health. 2019; 4(6):e001679. PMID: 31798986; PMCID: PMC6861123.
    Citations: 3     Fields:    
  13. Villalobos Dintrans P, Bossert TJ, Sherry J, Kruk ME. A synthesis of implementation science frameworks and application to global health gaps. Glob Health Res Policy. 2019; 4:25. PMID: 31485483; PMCID: PMC6712702.
    Citations: 16     Fields:    
  14. Epstein A, Moucheraud C, Sarma H, Rahman M, Tariqujjaman M, Ahmed T, Glenn J, Bossert T, Kruk ME. Does health worker performance affect clients' health behaviors? A multilevel analysis from Bangladesh. BMC Health Serv Res. 2019 Jul 24; 19(1):516. PMID: 31340809; PMCID: PMC6657138.
    Citations: 3     Fields:    Translation:Humans
  15. Bowser D, Krech L, Mabirizi D, Chang AY, Kapaon D, Bossert T. Associations Between Practices and Behaviors at the Health Facility Level and Supply Chain Management for Antiretrovirals: Evidence from Cameroon, Namibia, and Swaziland. Glob Health Sci Pract. 2019 06; 7(2):300-316. PMID: 31249025; PMCID: PMC6641807.
    Citations: 1     Fields:    Translation:Humans
  16. Chukwuma A, Mbachu C, McConnell M, Bossert TJ, Cohen J. The impact of monetary incentives on referrals by traditional birth attendants for postnatal care in Nigeria. BMC Pregnancy Childbirth. 2019 May 20; 19(1):150. PMID: 31104629; PMCID: PMC6526614.
    Citations: 2     Fields:    Translation:Humans
  17. Chukwuma A, Bossert TJ, Croke K. Health service delivery and political trust in Nigeria. SSM Popul Health. 2019 Apr; 7:100382. PMID: 30984814; PMCID: PMC6446063.
  18. Assari Arani A, Atashbar T, Antoun J, Bossert T. Iran's Health Reform Plan: Measuring Changes in Equity Indices. Iran J Public Health. 2018 Mar; 47(3):390-396. PMID: 29845027; PMCID: PMC5971176.
    Citations: 8     
  19. Chukwuma A, Mbachu C, Cohen J, Bossert T, McConnell M. "Once the delivery is done, they have finished": a qualitative study of perspectives on postnatal care referrals by traditional birth attendants in Ebonyi state, Nigeria. BMC Pregnancy Childbirth. 2017 Dec 19; 17(1):429. PMID: 29258459.
    Citations: 3     Fields:    Translation:Humans
  20. Geldsetzer P, De Neve JW, Boudreaux C, Bärnighausen T, Bossert TJ. Improving the performance of community health workers in Swaziland: findings from a qualitative study. Hum Resour Health. 2017 09 18; 15(1):68. PMID: 28923076.
    Citations: 9     Fields:    Translation:Humans
  21. De Neve JW, Garrison-Desany H, Andrews KG, Sharara N, Boudreaux C, Gill R, Geldsetzer P, Vaikath M, Bärnighausen T, Bossert TJ. Harmonization of community health worker programs for HIV: A four-country qualitative study in Southern Africa. PLoS Med. 2017 Aug; 14(8):e1002374. PMID: 28792502.
    Citations: 22     Fields:    Translation:Humans
  22. Bowser D, Abbas Y, Odunleye T, Broughton E, Bossert T. Pilot study of quality of care training and knowledge in Sub-Saharan African medical schools. Int J Med Educ. 2017 Jul 24; 8:276-282. PMID: 28753130; PMCID: PMC5572428.
    Citations: 4     Fields:    Translation:Humans
  23. Geldsetzer P, Vaikath M, De Neve JW, Bossert TJ, Sibandze S, Bärnighausen T. Household coverage of Swaziland's national community health worker programme: a cross-sectional population-based study. Trop Med Int Health. 2017 Aug; 22(8):1012-1020. PMID: 28556502.
    Citations: 2     Fields:    Translation:Humans
  24. De Neve JW, Boudreaux C, Gill R, Geldsetzer P, Vaikath M, Bärnighausen T, Bossert TJ. Harmonizing community-based health worker programs for HIV: a narrative review and analytic framework. Hum Resour Health. 2017 07 03; 15(1):45. PMID: 28673361; PMCID: PMC5496353.
    Citations: 4     Fields:    Translation:Humans
  25. Geldsetzer P, Vaikath M, De Neve JW, Bossert TJ, Sibandze S, Mkhwanazi M, Bärnighausen T. Distrusting community health workers with confidential health information: a convergent mixed-methods study in Swaziland. Health Policy Plan. 2017 Jul 01; 32(6):882-889. PMID: 28407083.
    Citations: 12     Fields:    Translation:Humans
  26. Moucheraud C, Schwitters A, Boudreaux C, Giles D, Kilmarx PH, Ntolo N, Bangani Z, St Louis ME, Bossert TJ. Sustainability of health information systems: a three-country qualitative study in southern Africa. BMC Health Serv Res. 2017 01 10; 17(1):23. PMID: 28073361.
    Citations: 16     Fields:    Translation:Humans
  27. Zhang L, Bossert T, Mahal A, Hu G, Guo Q, Liu Y. Attitudes towards primary care career in community health centers among medical students in China. BMC Fam Pract. 2016 07 16; 17:75. PMID: 27423474.
    Citations: 8     Fields:    Translation:Humans
  28. Reich MR, Yazbeck AS, Berman P, Bitran R, Bossert T, Escobar ML, Hsiao WC, Johansen AS, Samaha H, Shaw P, Yip W. Lessons from 20 Years of Capacity Building for Health Systems Thinking. Health Syst Reform. 2016 Jul 02; 2(3):213-221. PMID: 31514596.
    Citations: 2     Fields:    
  29. Bossert TJ. Decision Space and Capacities in the Decentralization of Health Services in FijiComment on "Decentralisation of Health Services in Fiji: A Decision Space Analysis". Int J Health Policy Manag. 2016 07 01; 5(7):443-444. PMID: 27694673; PMCID: PMC4930351.
    Citations: 11     Fields:    Translation:Humans
  30. Moucheraud C, Sparkes S, Nakamura Y, Gage A, Atun R, Bossert TJ. PEPFAR Investments In Governance And Health Systems Were One-Fifth Of Countries' Budgeted Funds, 2004-14. Health Aff (Millwood). 2016 05 01; 35(5):847-55. PMID: 27140991.
    Citations: 6     Fields:    Translation:Humans
  31. Bossert TJ, Leisewitz T. Innovation and Change in the Chilean Health System. N Engl J Med. 2016 Jan 07; 374(1):1-5. PMID: 26735989.
    Citations: 13     Fields:    Translation:Humans
  32. Bossert TJ, Mitchell AD, Janjua MA. Improving Health System Performance in a Decentralized Health System: Capacity Building in Pakistan. Health Syst Reform. 2015 May 19; 1(4):276-284. PMID: 31519095.
    Citations: 3     Fields:    
  33. Kunaviktikul W, Chitpakdee B, Srisuphan W, Bossert T. Preferred choice of work setting among nurses in Thailand: A discrete choice experiment. Nurs Health Sci. 2015 Mar; 17(1):126-133. PMID: 24804849.
    Citations: 1     Fields:    
  34. Brenner S, Muula AS, Robyn PJ, Bärnighausen T, Sarker M, Mathanga DP, Bossert T, De Allegri M. Design of an impact evaluation using a mixed methods model--an explanatory assessment of the effects of results-based financing mechanisms on maternal healthcare services in Malawi. BMC Health Serv Res. 2014 Apr 22; 14:180. PMID: 24751213.
    Citations: 25     Fields:    Translation:Humans
  35. Bowser D, Sparkes SP, Mitchell A, Bossert TJ, Bärnighausen T, Gedik G, Atun R. Global Fund investments in human resources for health: innovation and missed opportunities for health systems strengthening. Health Policy Plan. 2014 Dec; 29(8):986-97. PMID: 24197405.
    Citations: 28     Fields:    Translation:Humans
  36. Brinkerhoff DW, Bossert TJ. Health governance: principal-agent linkages and health system strengthening. Health Policy Plan. 2014 Sep; 29(6):685-93. PMID: 23411121.
    Citations: 48     Fields:    
  37. Farzadfar F, Murray CJ, Gakidou E, Bossert T, Namdaritabar H, Alikhani S, Moradi G, Delavari A, Jamshidi H, Ezzati M. Effectiveness of diabetes and hypertension management by rural primary health-care workers (Behvarz workers) in Iran: a nationally representative observational study. Lancet. 2012 Jan 07; 379(9810):47-54. PMID: 22169105.
    Citations: 94     Fields:    Translation:Humans
  38. Bossert TJ. Health systems. Health Policy Plan. 2012 Jan; 27(1):8-10. PMID: 21330310.
    Citations: 10     Fields:    
  39. Bossert TJ, Mitchell AD. Health sector decentralization and local decision-making: Decision space, institutional capacities and accountability in Pakistan. Soc Sci Med. 2011 Jan; 72(1):39-48. PMID: 21134705.
    Citations: 44     Fields:    Translation:Humans
  40. Bossert TJ, Ono T. Finding affordable health workforce targets in low-income nations. Health Aff (Millwood). 2010 Jul; 29(7):1376-82. PMID: 20606191.
    Citations: 7     Fields:    Translation:Humans
  41. Mataria A, Khatib R, Donaldson C, Bossert T, Hunter DJ, Alsayed F, Moatti JP. The health-care system: an assessment and reform agenda. Lancet. 2009 Apr 04; 373(9670):1207-17. PMID: 19268349.
    Citations: 18     Fields:    Translation:HumansPHPublic Health
  42. Brune NE, Bossert T. Building social capital in post-conflict communities: evidence from Nicaragua. Soc Sci Med. 2009 Mar; 68(5):885-93. PMID: 19155112.
    Citations: 16     Fields:    Translation:Humans
  43. Mitchell AD, Bossert TJ, Yip W, Mollahaliloglu S. Health worker densities and immunization coverage in Turkey: a panel data analysis. Hum Resour Health. 2008 Dec 22; 6:29. PMID: 19102741.
    Citations: 6     Fields:    
  44. Poblete FC, Sapag JC, Bossert TJ. [Social capital and mental health in low income urban communities in Santiago, Chile]. Rev Med Chil. 2008 Feb; 136(2):230-9. PMID: 18483679.
    Citations: 2     Fields:    Translation:Humans
  45. Bossert TJ, Bowser DM, Amenyah JK. Is decentralization good for logistics systems? Evidence on essential medicine logistics in Ghana and Guatemala. Health Policy Plan. 2007 Mar; 22(2):73-82. PMID: 17324947.
    Citations: 19     Fields:    
  46. Mitchell AD, Bossert TJ. Measuring dimensions of social capital: evidence from surveys in poor communities in Nicaragua. Soc Sci Med. 2007 Jan; 64(1):50-63. PMID: 17014943.
    Citations: 7     Fields:    Translation:HumansPHPublic Health
  47. Mello MM, Powlowski M, Nañagas JM, Bossert T. The role of law in public health: the case of family planning in the Philippines. Soc Sci Med. 2006 Jul; 63(2):384-96. PMID: 16488063.
    Citations: 11     Fields:    Translation:HumansPHPublic Health
  48. Bossert T, Chitah MB, Bowser D. Decentralization in Zambia: resource allocation and district performance. Health Policy Plan. 2003 Dec; 18(4):357-69. PMID: 14654512.
    Citations: 23     Fields:    
  49. Bossert TJ, Larrañaga O, Giedion U, Arbelaez JJ, Bowser DM. Decentralization and equity of resource allocation: evidence from Colombia and Chile. Bull World Health Organ. 2003; 81(2):95-100. PMID: 12751417; PMCID: PMC2572397.
    Citations: 21     Fields:    
  50. Bossert TJ, Beauvais JC. Decentralization of health systems in Ghana, Zambia, Uganda and the Philippines: a comparative analysis of decision space. Health Policy Plan. 2002 Mar; 17(1):14-31. PMID: 11861583.
    Citations: 95     Fields:    
  51. Bossert T, Larrañaga O, Ruiz Meir F. Decentralization of health systems in Latin America. Rev Panam Salud Publica. 2000 Jul-Aug; 8(1-2):84-92. PMID: 11026777.
    Citations: 6     Fields:    
  52. Bossert T. Analyzing the decentralization of health systems in developing countries: decision space, innovation and performance. Soc Sci Med. 1998 Nov; 47(10):1513-27. PMID: 9823047.
    Citations: 89     Fields:    Translation:Humans
  53. Bossert T, Hsiao W, Barrera M, Alarcon L, Leo M, Casares C. Transformation of ministries of health in the era of health reform: the case of Colombia. Health Policy Plan. 1998 Mar; 13(1):59-77. PMID: 10178186.
    Citations: 6     Fields:    Translation:Humans
  54. de la Jara JJ, Bossert T. Chile's health sector reform: lessons from four reform periods. Health Policy. 1995 Apr-Jun; 32(1-3):155-66. PMID: 10156636.
    Citations: 3     Fields:    Translation:Humans
  55. Bossert TJ. Can they get along without us? Sustainability of donor-supported health projects in Central America and Africa. Soc Sci Med. 1990; 30(9):1015-23. PMID: 2336568.
    Citations: 35     Fields:    
  56. Bossert TJ, Parker DA. The political and administrative context of primary health care in the Third World. Soc Sci Med. 1984; 18(8):693-702. PMID: 6374912.
    Citations:    Fields:    Translation:Humans
  57. Bossert T. Health policies in Africa and Latin America: adopting the primary care approach. Soc Sci Med. 1979 Jun; 13C(2):65-8. PMID: 472790.
    Citations:    Fields:    Translation:Humans
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Funded by the NIH National Center for Advancing Translational Sciences through its Clinical and Translational Science Awards Program, grant number UL1TR002541.