Group | Systems Innovation Research
We are living through a period of profound systemic change driven by rapid demographic changes, epidemiological transitions, climate change, social inequalities, commercial pressures, and political turmoil—all of which affect and determine the health and wellbeing of populations. These emerging global health challenges highlight our failure to engage with the complex interplay between health and other systems.
Policymakers face increasing pressure to address these intertwined challenges and integrate evidence-based decision-making. Short planning cycles and limited resources force decision-makers to oversimplify health system complexities, perpetuating historical decision-making patterns and reinforcing path dependency. This fragmented approach results in piecemeal health strategies, which are ill-equipped to address the complexity of current public health challenges.
By applying systems thinking and modeling methods, Swiss TPH can influence policy processes and improve decision-making in health systems management, facilitating more adaptive, evidence-based responses to complex health challenges.
Daniel Cobos Muñoz
PhD, MD, MSc
Group Leader
+41612848720
daniel.cobos@swisstph.ch
Selected Projects
Strengthening mortality systems to inform health policy
Our group works at the intersection of research, policy-making, and global health recommendations, focusing on advancing mortality surveillance systems and civil registration and vital statistics (CRVS) in low- and middle-income countries (LMICs). The group is linked to multiple global efforts, including World Health Organization (WHO) Reference Group for Verbal Autopsy (VARG) and contributing to the WHO Reference Group on Health Statistics (RGHS).
With extensive experience in systems analysis of CRVS across more than 25 countries in Africa, Asia, and Latin America, we employ systems thinking methods to identify gaps and opportunities for intervention. Our research has contributed to the development of globally accepted standards, such as the "Ten CRVS Milestones," which guide the understanding and improvement of CRVS systems in LMICs.
Through initiatives like the Bloomberg Data for Health Initiative, the group conducts implementation research to build robust mortality information systems that inform public policy. Our work on mortality surveillance focuses on understanding and improving the information architecture of systems capturing mortality data, mapping information silos, and identifying opportunities for system integration.
WHO Collaborating Center for Verbal Autopsy
Verbal autopsy (VA) is an essential public health tool for estimating cause-specific mortality fractions for deaths without medical certification. Ideally, physicians use the standard medical certificate of cause of cause of death. In settings where this is not possible, VA is used to determine the cause through interviews with the deceased's next of kin or caregivers. Using a standardized questionnaire, information on symptoms, medical history, and circumstances preceding death is collected. Physicians or computer algorithms then interpret this data to ascertain the cause of death. Read more
Health sector response to violence against women and girls (VAWG)
Violence against women (VAW) remains a critical global issue with significant implications for public health and societal well-being. Effective detection and response by the health sector are essential for mitigating the impacts of VAW, ensuring that survivors receive necessary care, and facilitating access to legal and social services. The MISSOP study aimed to investigate missed opportunities in the health sector's response to VAW in Tirana, Albania, and Belo Horizonte, Brazil, to identify systemic gaps and inform improvements in healthcare practices and policies. Read more
Computational modeling of cardiovascular risk interventions simulator, São Paulo, Brazil
The project developed a cardiovascular risk intervention simulator in São Paulo, focused on hypertension management. Utilizing system dynamics, the simulator integrates feedback, delays, and non-linear interactions to explore the complex system behaviours. The methodology adopts an iterative approach, combining quantitative and qualitative data for a comprehensive analysis. Rigorous calibration and validation processes were implemented to enhance the simulator’s robustness and confidence. Engaging local stakeholders through participatory model building strengthened acceptance and ownership of the simulator. Additionally, a user-friendly interface was designed for decision-makers, facilitates scenarios simulation, policy design, and experiential learning. Read more
Daniel Cobos Muñoz
Don de Savigny
Anna Duchenko
Fatemeh Ehteshami
Pei Shan Loo
Amilcar Magaço
Rebeca Revenga Becedas
Carmen Sant Fruchtman
Soukvixay Sikhanxay
Maryam Tavakkoli
Lidia Zabala
Partners and Collaborators
Videos
Strengthen the Response to Violence Against Women
Applying Systems Thinking to Improve Road Safety
Sixth Global Symposium on Health Systems Research
Better Hearts Better Cities: : The power of communities
Selected Projects
All ProjectsLatest Publications
All PublicationsRao C et al. The role of mortality surveillance in pandemic preparedness and response. Bull World Health Organ. 2025;103(3):213-222. DOI: 10.2471/blt.24.292423
Sant Fruchtman C et al. Telephonic verbal autopsies among adults in South Africa: a feasibility and acceptability pilot study. BMJ Open. 2025;15(2):e090708. DOI: 10.1136/bmjopen-2024-090708
Socha A et al. Investigating the enablers and barriers for hypertension control in Dakar: a qualitative system effectiveness study. BMJ Open. 2025;15(3):e089548. DOI: 10.1136/bmjopen-2024-089548
Avezum Á et al. An intersectoral approach to hypertension care: solutions for improving blood pressure control in São Paulo, Brazil. Am J Hypertens. 2024;37(5):366-378. DOI: 10.1093/ajh/hpae005
Ehteshami F, Cassidy R, Tediosi F, Fink G, Cobos Muñoz D. Combining theory-driven realist approach and systems thinking to unpack complexity of type 2 diabetes and hypertension management in low and middle-income countries: protocol for a realist review. Systems. 2024;12(1):16. DOI: 10.3390/systems12010016
Hossain A.T et al. Excess mortality during COVID-19 pandemic in Bangladesh: evidence from a rural survey. J Glob Health. 2024;14:05031. DOI: 10.7189/jogh.14.05031