Challenges in Health Systems Innovation


Course Objective

The student acquires knowledge and insight relevant to
- Innovation and reform of health systems
- Central concepts in transition theory
- Different mechanisms of innovation development, so-called niche
experiments, in the health system
- Effects and challenges of ‘niche experiments’ in different
cultural contexts
- Different theoretical perspectives on innovation studies
- Theoretical concepts and methods for the management of system
innovation, including transition and strategic niche management,
essential for sustainable health systems and transdisciplinary research
- Theoretical concepts and methods to interpret and evaluate the
results of system innovation and its efficiency
The student learns to:
- Apply theoretical knowledge to practical cases
- Evaluate his/her own actions, thinking and decision-making
- Be solution-oriented
- Reflect on responsibilities with respect to the implementation of

Course Content

The course consists of complementary theoretical and research
components. The theoretical component develops insight, through
lectures and seminars, into the central theoretical concepts of
innovations and reform of health systems.
Illustrative case studies are reality-based and use former as well as
current innovations and developments in health care systems of low- and
higher-income countries, such as the introduction of primary health care
or long-term care system innovations). Discussion focuses on:
• Difficulties in tackling certain persistent health problems
• Systemic factors that form the basis of these persistent problems
• The moderate effect of health reforms and emergence of
unsustainable niche experiments
• Exploration of possibilities to effectively link niche
experiments to existing regimes
• The importance of transdisciplinary research for system
In the research component of the course, students work in pairs to
analyse efforts to address a concrete persistent problem in a health
system. This involves identification of underlying systemic factors,
such as structures, culture, and existing practices, and delineating the
role of the significant actors. Students conclude the course by
designing a niche experiment for this problem according to the
principles of transition management.

Teaching Methods

Lectures, work groups (flipped classroom), problem-based learning,

Method of Assessment

Oral exam (50%) and assignment (50%). All parts need to be passed

Entry Requirements

Basic knowledge of health policy and health systems.


Book 'Toward Sustainable Transitions in Healthcare Systems' edited by
J.E.W. Broerse and J. Grin, 2017, Routledge.
Other selected scientific articles

Target Audience

First-year students MSc Global Health

Additional Information

Elective for Global Health students. Also open to other students after
approval of the course coordinator, Jacqueline Broerse

General Information

Course Code AM_1026
Credits 6 EC
Period P3
Course Level 500
Language of Tuition English
Faculty Faculty of Science
Course Coordinator prof. dr. J.E.W. Broerse
Examiner prof. dr. J.E.W. Broerse
Teaching Staff M. Moleman MSc
L. Meiqari
I.O. Abejirinde MD
L. Verwoerd

Practical Information

You need to register for this course yourself

Last-minute registration is available for this course.

Teaching Methods Study Group*, Lecture

*You cannot select a group yourself for this teaching method, you will be placed in a group.

Target audiences

This course is also available as: