La participation des populations au financement des soins de santé: Synthèse des expériences et perspectives pour la santé publique

Résumé: Les pays en développement, notamment au lendemain des indépendances, ont presque toujours adopté la gratuité des soins de santé comme principe de fonctionnement des structures publiques de sané. L'Etat était supposé financer ces soins. Le niveau du financement était relativement modeste, mais on avait l'espoir que la situation allait s'améliorer. La crise économique, au milieu des années 70, est apparue, engendrant une réduction des finances publiques dans ces pays. Des ressources additionnelles s'avéraient nécessaires pour soutenir le développement des systémes de sané. L'aide extérieure n'étant qu'une solution partielle, il fallait par conséquent trouver d'autres sources de financement. La participation des populations au financement des soins de santé apparaît alors comme un palliatif. C'est la pénurie des ressources financitéres de l'Etat qui entraîne son adoption et elle est généralement jugée à I'aulne de ce seul objectif. Cet article vise deux objectifs. Premiérement, un schéma d'analyse économique est présenté pour mieux comprendre I'impact de I'introduction d'une participation financière des populations sur la demande de soins de santé. Deuxièmement, il cherche à montrer comment un système de partage des coûts peut être utilisé par I'Etat pour mettre en place une politique de santé publique. Cet article est basé sur un rapport élaboré par le Bureau de la Coopération Internationale de I'Organisation Mondiale de la Santéà Genéve. Ce rapport est destiné surtout à ceux qui sont impliqués dans la prise de décision et le suivi quotidien des actions dans les pays les plus démunis, notamment ceux de I'Afrique au Sud du Sahara. Abstract: In almost all developing countries, especially during the post-independence period, free medical care was adopted as the fundamental principle of operation of the public health services. The governments were required to finance this care and the level of financing was relatively modest, though it was hoped that the situation would improve. The economic crisis emerging in the mid-70's had the effect of reducing these countries' public finances. Additional resources because necessary to support the development of health systems. Since external aid provided only a partial solution, other sources of financing had to be sought. The population's involvement in health financing was thus seen as a palliative measure. It was adopted in view of the scarcity of public funds, and is generally judged from that sole standpoint. This article has two objectives. Firstly, it presents an economic analysis, for a clearer understanding of the impact of the populations' financial participation on the demand for health care. Secondly, it seeks to show how governments can use a shared-cost system in putting in place a public health policy. This article draws from a report prepared by the International Cooperation Bureau of the World Health Organization, Geneva. The report particularly addresses persons involved in decision-making and day-to-day monitoring of action taken in the poorer countries, such as those of sub-Saharan Africa.     

Global Issues in Selecting Athlete Endorsers for National Markets: A Macroinvestigation

ABSTRACT

Little advertising research explores the role of culture in selecting celebrity endorsers. The purpose of this study is to explore how the selection process of athlete endorsers is shaped by national contexts. Based on interviews with advertising practitioners in 10 countries, the study reveals similarities in practitioners’ thinking across countries on a variety of matters related to athlete endorsement. It reveals the importance given by practitioners to the “cultural attractiveness” of national athlete endorsers when using them to connect with their national audience and shows that the selection process depends greatly on various cultural pressures linked to sporting traditions of each country. The study also shows how practitioners believe that athlete endorsers should be used mainly to generate brand and advertising awareness principally under pressure from clients’ emotional input.     

Third Parties and Contract Design: The Case of Contracts for Technology Transfer

Given the challenges associated with drafting technology‐transfer contracts, we examine decisions to involve third parties offering technical or legal support in the contract‐drafting process. We first argue that the attributes of the transaction are key drivers of third‐party involvement. We then draw on the behavioral theory of the firm to develop arguments regarding the influence of third parties on contract complexity. Our results reveal that the involvement of legal third parties tends to magnify the contract's overall complexity. In contrast, the involvement of technical third parties reduces the inclusion of monitoring provisions and increases the inclusion of coordination provisions. Copyright © 2015 John Wiley & Sons, Ltd.     

The democratic transition

Over the last two centuries, many countries experienced regime transitions toward democracy. We document this democratic transition over a long time horizon. We use historical time series of income, education and democracy levels from 1870 to 2000 to explore the economic factors associated with rising levels of democracy. We find that primary schooling, and to a weaker extent per capita income levels, are strong determinants of the quality of political institutions. We find little evidence of causality running the other way, from democracy to income or education.