References of "Paul, Elisabeth"
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See detailL'efficacité de l'aide en santé en Afrique de l'Ouest: maintenant plus que jamais
Paul, Elisabeth ULg; Eclou, Dieudonné; Sossouhounto, Nadine et al

in Global Health Promotion (2013)

La préoccupation d'améliorer l'efficacité de l'aide au développement dans le secteur de la santé est plus que jamais d’actualité. L'approche sectorielle permet d'obtenir des améliorations importantes à ce ... [more ▼]

La préoccupation d'améliorer l'efficacité de l'aide au développement dans le secteur de la santé est plus que jamais d’actualité. L'approche sectorielle permet d'obtenir des améliorations importantes à ce niveau et connaît un renouveau à travers le Partenariat International pour la Santé et initiatives liées (IHP+). Dans ce commentaire, nous montrons comment l'IHP+ a été mis en œuvre dans trois pays ouest-africains francophones: le Bénin, le Burkina Faso et le Mali. La dynamique existant dans le secteur de la santé dans chacun des pays a influencé la façon dont l'IHP+ s’y est traduit. Au-delà de ces dynamiques différentes, l'IHP+ a permis de renforcer la place des plans et dispositifs nationaux de coordination comme plateforme de suivi-évaluation et de redevabilité du secteur santé. Toutefois, certaines pratiques contraires aux principes de l'efficacité de l'aide perdurent encore, en particulier le manque d'alignement sur les systèmes de gestion nationaux et le manque de prévisibilité de l'aide. [less ▲]

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See detailAid for health in times of political unrest in Mali: Does donors' way of intervening allow protecting people's health?
Paul, Elisabeth ULg; Samaké, Salif; Berthé Issa Bara, Issa et al

in Health Policy & Planning (2013)

Mali has long been a leader in francophone Africa in developing systems aimed at improving aid effectiveness, especially in the health sector. But following the invasion of the Northern regions of the ... [more ▼]

Mali has long been a leader in francophone Africa in developing systems aimed at improving aid effectiveness, especially in the health sector. But following the invasion of the Northern regions of the country by terrorist groups and a coup in March 2012, donors suspended official development assistance, except for 20 support to NGOs and humanitarian assistance. They resumed aid after transfer of power to a civil government, but this was not done in a harmonized framework. This article describes and analyses how donors in the health sector reacted to the political unrest in Mali. It shows that despite its long sector-wide approach experience and international agreements to respect aid effectiveness principles, donors have not been able to intervene in view of safeguarding the investments of co-operation in the past decade, and of protecting the health systemss functioning. They reacted to the political unrest on a bilateral basis, stopped working with their ministerial partners, interrupted support to the health system which was still expected to serve populations needs and took months before organizing alternative and only partial solutions to resume aid to the health sector. The Malian example leads to a worrying conclusion: while protecting the health system's achievements and functioning for the population should be a priority, and while harmonizing donors' interventions seems the most appropriate way for that purpose, donors' management practices do not allow for reacting adequately in times of unrest. The article concludes by a number of recommendations. [less ▲]

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See detailResults from the implementation of aid effectiveness principles in the health sector in Mali
Paul, Elisabeth ULg; Ireland, Megan; Martini, Jessica et al

in Journal of Public Health Policy (2013), 34

The international community holds high expectations for aid producing demonstrable results in the health sector, at the global and developing country levels. Yet, measuring the effectiveness of aid ... [more ▼]

The international community holds high expectations for aid producing demonstrable results in the health sector, at the global and developing country levels. Yet, measuring the effectiveness of aid presents methodological challenges. Existing evaluation frameworks are not sufficiently geared toward learning whether and how practices have changed. We present a framework for measuring the results of implementing aid effectiveness principles at three levels: implementation process, health system strengthening, and outcomes/impact. We developed this framework in the context of monitoring results on the effectiveness of the aid agenda in the health sector in Mali. Despite some changes in behavior that resulted in increased aid effectiveness and improved results at system and outcome levels, overall, the aid effectiveness principles have not been fully implemented. Thus expectations in terms of health outcomes should be realistic. [less ▲]

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See detailDeveloping national health sector monitoring and accountability platforms. The opportunity of IHP+ in Benin, Burkina Faso, Mali and Senegal
Paul, Elisabeth ULg; Akpamoli, Alphonse; Ba, Amadou D. et al

Conference (2012, November 01)

There is now growing consensus about the importance of building and strengthening national monitoring platforms in order to facilitate the evaluation of large-scale health programmes and initiatives in ... [more ▼]

There is now growing consensus about the importance of building and strengthening national monitoring platforms in order to facilitate the evaluation of large-scale health programmes and initiatives in low- and middle-income countries [see the paper published in 2010 in The Lancet by Victora et al.]. This is also crucial for improving accountability, which is defined by the United Nations' Commission on Information and Accountability for Women's and Children's Health as a cyclical process of monitoring, review, and (remedial) action. The International Health Partnership and related initiatives (IHP+), World Health Organization and other partners have recently developed guidelines to support country-led platforms for monitoring, evaluation and review of national health strategies. The national Compacts promoted in the framework of IHP+ offer an excellent opportunity to foster the development of such country-led platforms for information and accountability. Indeed, a Compact formalises the commitments of the recipient government and health sector partners to increase financing efforts in the health sector, to respect aid effectiveness principles and to support the national health policy and strategies in a common planning, coordination, and monitoring & evaluation framework. IHP+ is also closely connected to initiatives such as the Health Metrics Network that aims to improve the quality of health information in developing countries. We propose to analyse how the Ministries of Health in four Francophone Western African countries (Benin, Burkina Faso, Mali and Senegal) have seized the opportunity of IHP+ to strengthen their monitoring and accountability platforms, and assess what further actions could be taken in the future. We present a comparative analysis grid filled on the basis of the experience of the co-authors in supporting the process in the four countries. This composes the first step of an on-going research and experience sharing project supported by GRAP-PA Santé. [less ▲]

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See detailMotivation of human resources for health: a case study at rural district level in Tanzania
Zinnen, Véronique; Paul, Elisabeth ULg; Mwisongo, Aziza et al

in International Journal of Health Planning and Management (The) (2012), 27(4), 327-347

An increasing number of studies explore the association between financial and non-financial incentives and the retention of health workers in developing countries. This study aims to contribute to ... [more ▼]

An increasing number of studies explore the association between financial and non-financial incentives and the retention of health workers in developing countries. This study aims to contribute to empirical evidence on human resource for health motivation factors to assist policy makers in promoting effective and realistic interventions. A cross-sectional survey was conducted in four rural Tanzanian districts to explore staff stability and health workers' motivation. Data were collected using qualitative and quantitative techniques, covering all levels and types of health facilities. Stability of staff was found to be quite high. Public institutions remained very attractive with better job security, salary and retirement benefits. atisfaction over working conditions was very low owing to inadequate working equipment, work overload, lack of services, difficult environment, favouritism and 'empty promotions'. Positive incentives mentioned were support for career development and supportive supervision. Attracting new staff in rural areas appeared to be more difficult than retaining staff in place. The study concluded that strategies to better motivate health personnel should focus on adequate remuneration, positive working and living environment and supportive management. However, by multiplying health facilities, the latest Tanzanian human resource for health plan could jeopardize current positive results. [less ▲]

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See detailForeign Aid Transaction Costs: What are they and when are they minimised?
Paul, Elisabeth ULg; Vandeninden, Frieda ULg

in Development Policy Review (2012), 30(3),

'Transaction costs' are commonly referred to in the recent literature on aid effectiveness. Aid transaction costs, however, have been neither consistently defined nor measured. This article defines aid ... [more ▼]

'Transaction costs' are commonly referred to in the recent literature on aid effectiveness. Aid transaction costs, however, have been neither consistently defined nor measured. This article defines aid transaction costs as all the economic costs associated with aid management that add no value to aid delivery. This enables the 'net' transaction costs that should be minimised to be identified. An analytical framework is then developed for assessing these costs. This allows the effectiveness of different aid modalities to be compared, according to the characteristics of the aid transaction. The article shows that the choice of aid modality should depend on these characteristics and, therefore, that the minimisation of transaction costs should not be an end in itself. [less ▲]

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See detailThe evaluation of the Paris declaration on aid effectiveness: what does it tell us? What results for the health sector?
Martini, Jessica; Paul, Elisabeth ULg; Ireland, Megan et al

in Tropical Medicine & International Health [=TM & IH] (2011), 16(S1), 331

Five years after the signing of the Paris Declaration on aid effectiveness by donors and developing countries, there is a climate of high expectations about the results achieved and the impact at sector ... [more ▼]

Five years after the signing of the Paris Declaration on aid effectiveness by donors and developing countries, there is a climate of high expectations about the results achieved and the impact at sector level. Several evaluations and monitoring surveys have been conducted by the OECD to measure progress made so far in implementing the principles of ownership, alignment, harmonisation, results and mutual accountability. For the health sector, results have also been documented in the context of the International Health Partnership (IHP+). We critically reviewed all the aid effectiveness surveys and evaluations published since 2005 by the OECD and IHP+ so as to analyse what results have been achieved so far as well as the relevance of the frameworks used. To date, results of the implementation of the Paris Declaration are mixed. In the health sector, good progress has been achieved in terms of country ownership and coordination, while alignment and use of country systems, managing for results and mutual accountability lag behind. However, the results recorded often reflect different interpretation of the indicators depending on the respondent, the data available or the time of the survey. Making generalisations is therefore difficult and comparisons between country surveys and over time may not be appropriate. Linking progress in aid effectiveness with improvements in health outcomes is also controversial. Results from the evaluations of the Paris Declaration should be used with caution in the current debate about aid effectiveness. What do the indicators used actually tell us? How realistically can aggregated scores reflect complex issues such as aid effectiveness in different countries, by different donors and over time? Improved evaluation is clearly needed. Data collection should be more rigorous and at sector level contextual factors and behaviour change should be better assessed, over a longer term and through more qualitative comprehensive methods. [less ▲]

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See detailWhat results can be expected from the agenda for aid effectiveness?
Paul, Elisabeth ULg; Ireland, Megan; Martini, Jessica et al

Conference (2011, October)

Introduction: Currently there is a climate of high expectations with regard to producing demonstrable results of aid effectiveness in the health sector. Yet, commitments to aid effectiveness have only ... [more ▼]

Introduction: Currently there is a climate of high expectations with regard to producing demonstrable results of aid effectiveness in the health sector. Yet, commitments to aid effectiveness have only partially been implemented so far. Existing evaluation frameworks developed in the context of the Paris Declaration and International Health Partnership (IHP+) are not sufficiently geared toward whether and how practices have changed at donor, central and operational levels, and thus how reforms have actually been implemented. Measuring their impact also presents methodological challenges. Methods: This communication aims to present an outline of how to measure results from the agenda for aid effectiveness. It argues that it should be carried out at three levels. A first, critical step for evaluating the results from the Paris Declaration and IHP+ is to evaluate its implementation process and the direct effects it has had on changes in behaviour for all stakeholders (donors, government, service providers, etc.). A second level of evaluation is to assess how far donor support and implementation of Paris principles have contributed to health system strengthening (HSS) up to the level of service delivery. The third level where improvement is expected and should be measured is at health outcome/status level. Qualitative methods can help to understand what constraining factors are, what reforms have led to improvements and why, and finally the impact on population health. Results: This three-level assessment was made in Mali. We found that some progress and positive changes have been observed in recent years that can be attributed to the agenda for aid effectiveness; outcome and impact indicators have also improved in the past years. However, donors have not fulfilled all their commitments. Conclusion: Whilst changes in behaviour and practices are occurring, adherence to the principles of aid effectiveness is far from complete, thus expectations should be realistic. [less ▲]

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See detailComparative analysis of two different approaches to putting IHP+ into practice: Mali and Benin
Paul, Elisabeth ULg; Berthé, Issa; Samaké, Salif

Conference (2011, October)

Introduction: The International Health Partnership and related initiatives (IHP+) seeks to achieve better results by mobilising development partners around a single country-led national health strategy ... [more ▼]

Introduction: The International Health Partnership and related initiatives (IHP+) seeks to achieve better results by mobilising development partners around a single country-led national health strategy, guided by the principles of the Paris Declaration on Aid Effectiveness. At country level, the IHP+ materializes through the preparation, signature, implementation, and monitoring and evaluation of a "Country Compact" – a negotiated and signed agreement in which partners commit to implement and uphold the priorities outlined in the national health strategy. Some of the main determining features of the IHP+ are the leadership of the recipient government over the preparation and implementation process of the Compact, broad domestic ownership of the national health plan, and mutual accountability for results. Methods: In this communication, we perform a comparative analysis of two very different approaches that have been followed in Mali and Benin. It is based on authors' experience in the IHP+ process in Mali, extensive document review and interviews with most significant stakeholders involved in the process both in Mali and Benin. Results: Mali has prepared its country Compact on the grounds of its 10-year experience in leading a sector-wide approach (SWAp) in the health sector. It has therefore benefited from improved donor coordination, MoH leadership in piloting the national programme, trust capital between partners and broad ownership of the health plan. It has succeeded in making the IHP+ process even more inclusive. On the contrary, Benin had no health SWAp to start with. The preparation process of the Compact was much less inclusive and country-led, resulting in narrow ownership and vague commitments. Nevertheless, it is hoped that the IHP+ can help launch a new partnership dynamic within the health sector. Conclusion: Beyond common principles, the IHP+ is put into practice in different ways from country to country according to their context. [less ▲]

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See detailCan performance-based financing be used to reform health systems in developing countries?
Ireland, Megan; Paul, Elisabeth ULg; Dujardin, Bruno

in Bulletin of the World Health Organization (2011), 89(9), 695-698

Over the past 15 years, performance-based financing has been implemented in an increasing number of developing countries, particularly in Africa, as a means of improving health worker performance. Scaling ... [more ▼]

Over the past 15 years, performance-based financing has been implemented in an increasing number of developing countries, particularly in Africa, as a means of improving health worker performance. Scaling up to national implementation in Burundi and Rwanda has encouraged proponents of performance-based financing to view it as more than a financing mechanism, but increasingly as a strategic tool to reform the health sector. We resist such a notion on the grounds that results-based and economically driven interventions do not, on their own, adequately respond to patient and community needs, upon which health system reform should be based. We also think the debate surrounding performance-based financing is biased by insufficient and unsubstantiated evidence that does not adequately take account of context nor disentangle the various elements of the performance-based financing package. [less ▲]

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See detailL'appui budgétaire est-il une solution pour le financement du secteur de la santé dans les pays en développement?
Paul, Elisabeth ULg

Scientific conference (2011, May)

L'aide au développement dans le secteur de la santé est extrêmement fragmentée, ce qui risque d’en diminuer l’efficacité (WHO 2007, Piva & Dodd 2009). L'appui budgétaire (AB) est souvent présenté comme un ... [more ▼]

L'aide au développement dans le secteur de la santé est extrêmement fragmentée, ce qui risque d’en diminuer l’efficacité (WHO 2007, Piva & Dodd 2009). L'appui budgétaire (AB) est souvent présenté comme un instrument de financement permettant d’améliorer l'efficacité de l'aide en respectant les principes énoncés dans la Déclaration de Paris. Si ceci est probablement vrai en théorie lorsque les conditions le permettent, il est très difficile d'évaluer l'impact de l’AB, vu les problèmes d’attribution que cela suppose. Des évaluations de l'AB général ont été réalisées dans plusieurs pays, mais qui n’ont pas étudié spécifiquement ses effets sur le secteur de la santé. La communication a pour objectif de faire le point des connaissances sur les effets de l'AB sur le secteur de la santé, et de discuter deux aspects qui n'ont guère fait l’objet d’études et qui pourtant sont des défis importants pour l'efficacité de l'AB dans le secteur: d'une part, les défis de gestion que l'AB pose aux ministères de la santé concernés et d'autre part, les avantages et inconvénients respectifs de l'AB général et sectoriel pour le secteur de la santé. Dans la première partie de la communication, nous présentons brièvement les résultats des principales évaluations de l'AB disponibles à ce jour, qui toutes se sont penchées sur l'AB général, mais dont certaines ont quelque peu traité du secteur de la santé (IDD and Associates 2006, Koeberle et al. 2006, Lawson et al. 2006, DfID 2008, European Court of Auditors 2008, OXFAM 2008, Beynon & Dusu 2010). Nous évoquons également une étude commissionnée par l'OMS qui a tenté de démontrer les liens entre l'AB général et les dépenses de santé (Fernandes Antunes et al. 2010). Dans la seconde partie de l'exposé, nous attirons l'attention des participants sur les implications pratiques de la gestion de l’AB pour les ministères de la santé des pays récipiendaires. Très peu a été écrit sur le sujet, mais nous nous baserons sur notre expérience d'assistante technique en appui à la gestion de l'AB au Ministère de la Santé du Mali pour dégager quelques leçons (Samaké et al. 2009). Ensuite, partant du fait qu'il n'existe une fois de plus quasiment pas de littérature sur les effets spécifiques de l'AB sectoriel en comparaison avec l'AB général, nous discutons des avantages et inconvénients perçus par les acteurs relatifs à ces deux modalités. Nous concluons en dégageant quelques leçons générales et en soulignant le fait que, bien qu'on en parle beaucoup, l'AB n'est pas encore très significatif dans le secteur de la santé comparé à la multiplication des interventions spécifiques (Ravishankar et al. 2009, Fernandes Antunes et al. 2010). Dès lors, des recherches bien ciblées sur ses effets pour le secteur de la santé sont bienvenues afin de documenter s’il s'agit ou non d'une modalité d'aide efficace qui devrait être encouragée. [less ▲]

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See detailDeveloping the HRH Policy and Plan in Mali
Paul, Elisabeth ULg; Samaké, Salif

Conference (2010)

Context: Deficient HRH management – especially insufficient training and motivation, and adverse distribution of qualified staff countrywide, at the expense of poor and remote areas – has been identified ... [more ▼]

Context: Deficient HRH management – especially insufficient training and motivation, and adverse distribution of qualified staff countrywide, at the expense of poor and remote areas – has been identified for over a decade as one major constraint for the implementation of Mali's national health policy. Main objective: The HRH policy aims to define a coherent framework for the ministry of health (MoH) and its partners in order to ensure the harmonious development, distribution, management and motivation of health staff so as to ultimately improve health results. The policy is translated into an operational plan dealing specifically with training, recruitment, motivation, and career management. Methodology: The HRH policy and plan were developed by a core team under the leadership of the Planning Department of the MoH, with the involvement from other departments of the MoH, the ministries in charge of finance (MoF) and civil service (MoCS), and donors. After analyzing existing studies and data, the diagnosis over the major problems to be tackled was done. This allowed identifying the main orientations of the policy, which were then translated into strategies and interventions, and then costed. Once the policy and plan have been drafted by the core team, they have been circulated to all departments and partners and discussed in several meetings with different stakeholders at central level. After integrating comments from these meetings, the MoH organized a validation workshop with very broad participation (including the operational level, private sector, and civil society) so as to ensure ownership. Final amendments were negotiated with the MoF and MoCS in order to be adopted as a national policy by the Counsel of Ministers by the end of 2009. Results: The HRH policy and plan now benefit from wide political support by major stakeholders. Yet, implementation still has been delayed because of the management modalities at operational level still need to be definitively agreed upon. Conclusion: The inclusive development process has been necessary to move on with the complex and highly sensitive issue of HRH management, and to get the support from MoF, MoSC and donors who are supposed to contribute to its financing. [less ▲]

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See detailImproved Aid Effectiveness but Waiting for Results: What are the Missing Links?
Paul, Elisabeth ULg; Dujardin, Bruno; Ireland, Megan et al

Conference (2010)

Objectives: The objective is to analyze the content of the Paris Declaration (PD) on aid effectiveness and Accra Agenda for Action (AAA), and their practical implications for the health sector in aid ... [more ▼]

Objectives: The objective is to analyze the content of the Paris Declaration (PD) on aid effectiveness and Accra Agenda for Action (AAA), and their practical implications for the health sector in aid-recipient countries. Design/methods: The study draws on (i) a critical analysis of the two declarations, (ii) a review of the literature on their implementation and (iii) interviews of people in charge of implementing them – both donors and government representatives. Results: The PD and AAA both have a "missing link" between, on the one hand, international cooperation policies (five pillars of the PD) and national development (health) plans; and, on the other hand, the operational level that is supposed to deliver results. They presume that by changing aid management and respecting a few principles, development results will automatically improve as through a "black box". The influence of international and national policies over health systems, service providers’ behaviour and health impacts is not treated at all by the agenda for aid effectiveness, while it is crucial for its success. Moreover, that agenda is mostly dealt with at a too high level (international forums or at best national sector level), thus deepening the disconnexion from field realities. Conclusions/policy implications: This "missing link" entails the risk that, if the "black box" does not perform as expected – that is, if health systems and health service providers’ behaviour do not evolve in a positive way – and health impacts do not improve, the aid effectiveness agenda may be rejected at all, notwithstanding its (incomplete) added value. Hence the need to closely monitor the processes of national health plans implementation, so in order to better understand how these processes are translated on the field and what could be done to ensure that health service delivery and health results ultimately improve. [less ▲]

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See detailMotivating Civil Servants for Reform and Performance
Paul, Elisabeth ULg

in ‘Capacity is Development’ Research Series (2010)

The paper aims to provide some informed reflections on how to motivate civil servants for performance and reform, especially in the perspective of sustaining capacity development

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See detailSWAps in motion: Lessons from case studies in six African countries
Paul, Elisabeth ULg; Laokri, Samia; Robert, Annie

in Tropical Medicine & International Health [=TM & IH] (2009), 14(Supplement 2), 18

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See detailLa Coopération au Développement répond à l’impact de la crise financière et économique sur les pays africains à bas revenu – Etude de cas du Sénégal
Paul, Elisabeth ULg; Faye, Ousmane

Report (2009)

Il est désormais reconnu que les pays africains seront touchés par la crise financière et économique mondiale, et ce à travers plusieurs canaux de transmission. Au Sénégal, la crise "externe" intervient à ... [more ▼]

Il est désormais reconnu que les pays africains seront touchés par la crise financière et économique mondiale, et ce à travers plusieurs canaux de transmission. Au Sénégal, la crise "externe" intervient à un moment où l’économie est affaiblie par les conséquences des crises alimentaire et énergétique des deux dernières années, ainsi que par la crise "interne" des finances publiques qui en a (en partie) découlé. Dès lors, le gouvernement a très peu d’espace fiscal pour combattre les effets de la crise mondiale. Si aucune évidence chiffrée n’est encore disponible, les principaux canaux de contagion potentiels de la crise économique au Sénégal sont la réduction des transferts des migrants, le report ou l’annulation de projets d’investissement, ainsi qu’une réduction des exportations et des activités liées au tourisme. Une réduction importante des flux d’aide n’est par contre pas à craindre dans l’immédiat. Les principaux impacts qui découleraient de la crise sont la réduction de la croissance et de l’emploi, de même qu’un appauvrissement direct des ménages bénéficiant de moins de transferts des expatriés. En outre, la réduction des recettes publiques et l’augmentation des pressions sur le budget laissent craindre une augmentation du déficit budgétaire et/ou une réduction des dépenses publiques. S’il n’y a aucune raison de s’alarmer des impacts de la crise mondiale dans l’immédiat, il convient toutefois de bien surveiller les différents canaux de contagion possibles, tout en continuant les efforts de plus longue haleine pour réduire la vulnérabilité structurelle de l’économie sénégalaise (développement intégré du secteur rural dans une perspective de réduction de la dépendance alimentaire, consolidation du tissu économique local), lutter contre la pauvreté et augmenter la protection sociale des plus vulnérables. Pour ce qui est du niveau conjoncturel, il n’existe pas encore de stratégie prête à l’emploi pour faire face aux impacts de la crise. Une révision des stratégies existantes, en particulier au niveau de l’amélioration de la sécurité alimentaire, de l’orientation de la croissance vers les pauvres (notamment par la création d’emplois formels et dans le monde rural) et de la protection sociale, s’imposent afin de fournir les bases à des actions cohérentes et ciblées de la part des partenaires. Vu le faible espace fiscal du gouvernement, une aide des donateurs et dans la mesure du possible, la captation d’autres sources de financement, seront donc nécessaires. Le secteur privé fait entièrement partie des stratégies de croissance du Sénégal, mais son potentiel est encore insuffisamment exploité. Un système de financement innovant pouvant être développé serait d’inciter les migrants à consacrer leurs transferts à des investissements productifs et/ou à de réelles fins de protection sociale à vocation plus universelle. Les donateurs n’ont pas encore réagi de manière coordonnée à la crise "externe", mais avaient réagi assez unanimement à la crise "interne" qui a récemment frappé le Sénégal. Ils peuvent contribuer à atténuer les impacts de la crise et à réduire la vulnérabilité de l’économie tout en s’inscrivant dans les stratégies nationales, à la fois au niveau structurel (infrastructures rurales, gouvernance, extension de la sécurité sociale, etc.) et au niveau conjoncturel (« programme social d’urgence » de large échelle). Une augmentation de l’appui budgétaire est une piste intéressante, pourvu que le pays évite tout dérapage budgétaire, poursuive ses réformes de la gestion des finances publiques vers davantage de contrôles et de transparence, et renforce ses capacités de mise en œuvre des réformes et stratégies nationales. Quant à la coopération belge plus particulièrement, elle a intérêt à renforcer sa complémentarité avec les autres acteurs en bâtissant sur ses principales valeurs ajoutées que sont l’extension de la protection sociale (en particulier dans le domaine de la santé) et des interventions intégrées à plusieurs niveaux dans le domaine du développement rural. [less ▲]

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See detailVers un nouveau paradigme de l'aide au développement: l'approche sectorielle en santé, quels constats?
Zinnen, Véronique; Laokri, Samia; Paul, Elisabeth ULg

in Sanni Yaya, Hachimi (Ed.) Le défi de l'équité et de l'accessibilité en santé dans le tiers-monde (2009)

Confrontées à des critiques pressantes et à une remise en cause de l'efficacité de l'aide au développement, les agences de coopération, en particulier la Banque Mondiale, ont entrepris depuis une ... [more ▼]

Confrontées à des critiques pressantes et à une remise en cause de l'efficacité de l'aide au développement, les agences de coopération, en particulier la Banque Mondiale, ont entrepris depuis une quinzaine d’années de vastes évaluations de leurs actions et modes de fonctionnement. Ces études ont mis en avant les limites des modalités d'interventions traditionnelles et suscité l'amorce d’un changement dans le système d'aide internationale. Le "nouveau paradigme partenarial de l'aide" qui a alors émergé est basé sur des principes tels qu'appropriation, responsabilité conjointe, partenariat, vision globale, réduction de la pauvreté, gouvernance et orientation vers les résultats. Ce paradigme a été renforcé par la signature en mars 2005 de la Déclaration de Paris sur l'Efficacité de l'Aide au Développement. Le besoin d'intégrer les programmes de coopération dans les structures des pays bénéficiaires, d'appuyer les politiques conçues par ces pays en utilisant des systèmes de gestion harmonisés, est à présent bien reconnu. L'émergence de l'approche sectorielle – soit une méthode de travail entre un gouvernement et des bailleurs de fonds, qui travaillent ensemble à la mise en place progressive d'une politique et d'une stratégie sectorielles cohérentes pour l'ensemble d'un secteur–, avec ses avantages et ses défis, se situe et va être présentée dans ce contexte. [less ▲]

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