Jul 26, 2013 | health policy analysis, humanitarian aid
Valéry Ridde (2012, mis en ligne le 19 juillet 2013) Réflexions sur les per diem dans les projets de développement en Afrique, Bulletin de l’APAD, 34-36. [html]
Résumé
La pratique des per diem dans les projets est largement connue de tous les acteurs concernés par l’aide publique au développement. En plus de leur salaire, des fonctionnaires touchent des primes fournies par des responsables de projets pour se réunir, pour participer à des ateliers et des formations ou pour réaliser des activités qui sont pourtant prévues dans leurs tâches officielles. D’un autre côté, des experts internationaux reçoivent des frais de mission qui dépassent souvent largement le montant des dépenses nécessaires pour vivre le temps de leur mission. Si ces pratiques sont connues, leur description et discussion sont inversement proportionnelles à leur influence dans la mise en œuvre des interventions. Nous proposons dans cet article une esquisse d’anthropologie de cette pratique. Son histoire et ses origines multiples sont reconstituées, nous en décrivons les diverses facettes, leurs causes et conséquences afin d’en proposer une typologie. Nous tentons, enfin, d’analyser en quoi les per diem sont révélateurs des effets pervers de l’aide, de la transformation du rôle de l’État, et des changements de la fonction publique en Afrique.
Jul 22, 2013 | health policy analysis, research methodology
In third position, an article by Valéry Ridde et Florence Morestin:
Jun 14, 2013 | health policy analysis, research methodology
A Torbica, M De Allegri, D Yugbare Belemsaga, A Medina-Lara, V Ridde (2013). What factors influence health policy entrepreneurs in West Africa? (Working paper) [pdf]
Abstract
This paper investigates the agenda-setting criteria used by policy entrepreneurs directly involved in the implementation of user-fee abolition or reduction policies for maternal care services in Africa. The study uses an experimental technique, best-worst scaling (BWS), to identify the criteria that drive their decision making. Results suggest that political commitment and impact on health are identified as the most important criteria, while international pressure and donor money are ranked as the least important. Respondents confirm that a strong leadership role is required at the governmental level in order to effect policy change, but attribute relatively little importance in decision making for increasing equity of health care among population groups or for the ability of the health system capacity to carry out new policy.
Jun 12, 2013 | equity of access to healthcare, health policy analysis
Elhadji Mamadou Mbaye, Valéry Ridde, Ousseynou Kâ (2013).“Good intentions are not enough”: analysis of a health policy for the elderly in Senegal. Santé publique, France), 25, 107–112. [pdf. Article in French]
Abstract
In 2006, the Senegalese government introduced the “Plan Sésame”, an unprecedented policy in West Africa aimed at reducing social vulnerability among the elderly (i.e. people aged over 60 years). This paper examines the process of implementa- tion of the “Plan Sésame”. Using a qualitative approach, the study was based on a unique case study authorized by the Senegalese Ministry of Health. Three methods were used: i) individual inter- views (n = 19), ii) discussion groups (n = 24), and iii) documen- tary study. Despite its social objective, the “Plan Sésame” was ultimately limited to free health care. However, even the health component of the plan has suffered from underfunding. Political obstacles, inadequate accompanying measures and short staffing have resulted in late reimbursements at a local level, thus limiting the implementation of the plan. While both health professionals and elderly people are in favor of free healthcare, they are also critical of the implementation issues surrounding the “Plan Sésame”. Although it appears to be a viable solution, these issues may spell the end of the plan. The task of designing solid tech- nical foundations and developing appropriate accompanying measures should not be overlooked because of the limited interest of international partners in the “Plan Sésame”, the national dimension of the plan and its electoral importance.
Jun 11, 2013 | health policy analysis, research methodology
Valéry Ridde, Christian Dagenais, Michèle Boileau (2013). An exploratory synthesis of knowledge brokering in public health. Santé publique, 25(2), 137–146. [pdf. article in French]
Abstract
There is a call for public health policies and interventions to be evidence-based. Also, using knowledge brokers to foster the use of research results is increasingly recommended. This article presents an exploratory synthesis of the current state of knowl- edge on this new strategy. We conducted a scoping study by consulting the main databases. Nineteen articles were included in the analysis, which was designed with a grid developed iteratively. The synthesis shows that knowledge brokering initiatives include i) planning activities (stakeholder identification, creation of networks and partnerships, context analysis, problem identifica- tion, needs identification), ii) support to the brokers (training, technical support, development of a practice guide), and iii) the brokerage activities themselves (information management, liaison between knowledge producers and users, training of users). Only four articles presented empirical data on the effects of brokers’ activities. Three were associated with increased knowledge in the target audience. No study showed any impact on clinical behaviours or on public policy content. This synthesis highlights the challenges involved in knowledge brokering activities, as well as the characteristics and skills a broker should possess. While knowledge brokering appears promising, efforts must nowbe made to evaluate it more system- atically to demonstrate its effectiveness.
Recherche originale
Jun 3, 2013 | health policy analysis
Valéry Ridde & Jean-Pierre Olivier de Sardan (2013). Abolishing user fees for patients in West Africa: lessons for public policy. À Savoir, (20). [lire en ligne] [pdf]
Résumé
Après trente ans de généralisation du paiement direct par les usagers des services de santé en Afrique, de plus en plus de pays s’engagent dans des politiques d’exemption pour améliorer l’accès aux soins de santé, notamment en faveur des groupes vulnérables liés aux Objectifs du millénaire pour le développement. Rares sont les travaux qui se sont penchés sur ces politiques publiques dans leur globalité, en analysant leurs contradictions, leurs incohérences et leurs perceptions par les acteurs concernés. Ce dossier présente les résultats d’un programme de recherche (2009-2012) qui documente l’émergence, la formulation, la mise en oeuvre et les effets de ces nouvelles politiques de gratuité des soins au Burkina Faso, Mali et Niger. Coordonnée par Valéry Ridde et Jean-Pierre Olivier de Sardan, cette contribution associe techniques quantitatives et approche qualitative de type socio-anthropologique, dans un contexte ouest-africain où ces politiques n’ont pas encore été analysées sous cet angle interdisciplinaire.
