Les approches de l'économie sociale et de l'économie solidaire face aux mutuelles de santé en Afrique

Ce papier examine dans quelle mesure les approches "économie sociale" et "économie solidaire" peuvent éclairer les réalités des mutuelles de santé en Afrique, mais aussi leurs limites respectives face à ces pratiques de plus en plus répandues

Ecological Associations of Littoraria irrorata with Spartina cynosuroides and Spartina alterniflora

It is well-documented that marsh periwinkles (Littoraria irrorata) consume and inhabit smooth cordgrass (Spartina alterniflora), but their interactions with big cordgrass (Spartina cynosuroides) remain unknown. Plant communities in mesohaline marshes will change as sea-level rise shifts species from salt-intolerant (e.g., S. cynosuroides) plants to salt-tolerant (e.g., S. alterniflora) ones. Therefore, understanding how L. irrorata interacts with different habitats provides insight into this species’ generalist nature and allows us to predict the potential impacts of changing plant communities on L. irrorata. We show, for the first time, that L. irrorata inhabits, climbs, and grazes S. cynosuroides. We compared both habitats and found snails were larger, plant tissue was tougher, and sediment surface temperatures were higher in S. alterniflora than S. cynosuroides. Snails had greater survivorship from predators in S. cynosuroides than in S. alterniflora. Further, snails grazed S. cynosuroides more than S. alterniflora, evidenced by a greater number of radulation scars. Despite these differences, snail densities were equal between habitats suggesting functional redundancy between S. cynosuroides and S. alterniflora for L. irrorata. Our results indicate L. irrorata is a habitat generalist that uses both S. alterniflora and S. cynosuroides, which may allow it to gain an ecological foothold as sea-level rises

Private medical practice in Benin: dynamics of a growing sector

In Benin, like in many countries in sub-Saharan Africa, the setting up of structural adjustment programs forces, in the middle of eighties, the government to limit the recruitment in civil service. As they were systematically hired by the State, most of health professionals are unemployed from 1986. Henceforth, private health sector grow progressively, without any legislation, through the development of many formal and informal private surgeries and clinics. The article will focus mainly on the development of private profit-making medical practice in Benin. It will be based on three empirical researches about medical profession in this country, from March 2009 to April 2011. In this paper, we will refer to qualitative interviews on the one hand with actors from both private and public medical structures, mainly doctors, paramedical staffs and patients, and one the other hand, with representatives of professional organizations, public policies in Ministry of Health and international organizations. First, the article will briefly describe the historical development of private medical practice in Benin, and consider governmental responses to this process. Thus we will address to the belated drawing up of a regulatory framework and the lack of control by the profession consequences, notably in terms of qualification, ethics and quality of health care. We will also examine recent reactions aimed at remedying to these different pitfalls. In this context, the paper will interest secondly in new entanglements between the public medical sector and the private medical structures emerging at local level. We will examine doctors’ practices and strategies, with only private practitioners and with doctors working in both private and public sectors. Finally, the article will give attention to how these private medical surgeries and clinics and the access conditions to these structures are perceived by health providers and patients. In this part of the paper, we will also address to tactics worked by patients regarding the different medical facilities. As a conclusion, we will wonder whether this medical private sector would contribute to reproduce some mechanisms of inequality in health sector

Characterization, Analysis, and Brand Audit of Macroplastic Litter in Selected Coastal Areas of Sarangani Bay

Plastic pollution in the Philippines' coastal areas has been rampant over the years. Still, the studies on assessing and quantifying such issues are limited and not fully explored. This study assessed and characterized a snapshot of the current macroplastic pollution in various coastal sites in Sarangani Bay. A perpendicular transect survey was employed in the study wherein any observed plastic item larger or longer than 25 mm was recorded and identified based on the type of plastic product and the polymer composition. Additionally, details of macroplastic items with identifiable labels and brand names will be recorded for the brand audit. Being an urban site, the City of General Santos survey area has recorded the highest count (n=190) and density of macroplastic litter at 0.9572 items per square meter. Results also showed that more than half of the waste surveyed comprises plastic bags (n=134) and food items (n=129) packaging. Polypropylene (n=138) was the dominant polymer type among the wastes tallied, which is utilized in a wide array of plastic items such as food packaging, plastic utensils and containers, ropes, and lids. Most of the brands audited are involved in manufacturing food, beverage, and personal care products, whereby most of the plastic wastes that originate from consumer goods are single-use packaging such as sachet and pillow pouches. Generally, the insights gathered from this study augment the knowledge of various policymakers and the local government, which can be used in implementing appropriate programs or enacting local policies that can help improve the current pollution status in the bay's coastal area

Community-Based Health Insurance Schemes in Africa: Which Factors Really Induce Membership ?

Health micro-insurance systems have experienced a fast development for some fifteen years in sub-Saharan Africa as a means of improving the access of the poor to healthcare services. The present article focuses mainly on community-based health insurance (CBHI) systems, as they currently constitute one of the most developed forms of health micro-insurance. However, it must be acknowledged that the enrolment rates remain particularly weak and coverage of the target population only rarely reaches 10%. Several authors have already observed this fact and undertaken research on the factors which influence enrolment. Nevertheless, the methodologies used, size of the samples, characteristics of the surveyed individuals, inclusion or not of non-members in the surveys, geographical areas etc. vary a lot from one author to the other. This is why this article aims at synthesizing the empirical studies carried out to date and to identify major concurring results beyond methodological differences. We finally come out with two factors which seem to play a major role and six others which seem to have a significant influence on enrolment, while surveys do not confirm the role of various other variables. We conclude with some lessons regarding the roles of the promoters and supporting NGOs in the establishment of CBHI schemes

Les déterminants de l'adhésion aux mutuelles de santé en Afrique subsaharienne : un inventaire des travaux empiriques

The enrolment rates in Community-Based Health Insurance Schemes remain particularly weak in Sub-Saharan African countries. This article aims at synthesizing the empirical studies carried out to date about factors influencing enrolment. Beyond methodological differences among studies, we finally come out with two factors which, as expected, seem to play a major role (the population?s financial capacity and the quality of health care services) and both are put into a larger perspective. A few other factors also seem to have a significant influence upon enrolment although empirical results show weaker convergences.health care, health insurance, community-based organization, enrolment, Sub-Saharan Africa

Governance in cooperatives

En complément des codes de gouvernance d’entreprise en Belgique, le Conseil National de la Coopération (CNC) envisage d’établir un code de bonnes conduites spécifique aux sociétés coopératives. Dans ce cadre, le CNC a formulé six questions principales concernant la gouvernance des entreprises coopératives. Dans un premier temps, nous énoncons brièvement ces différentes interrogations. Dans un second temps, nous envisageons les différents outils utiles à l’analyse de ces questions. Dans un troisième temps, nous formulons des propositions quant à l’élaboration du code de bonnes conduites en regard des différents outils. Enfin, dans un quatrième temps, nous présentons les principaux problèmes de gouvernance et recommandations relevés dans la littérature sur le sujet

Les déterminants de l'adhésion aux mutuelles de santé en Afrique subsaharienne : un inventaire des travaux empiriques

peer reviewedEn Afrique Subsaharienne, les taux d’adhésion aux mutuelles de santé restent généralement à des niveaux très faibles. Cet article vise à synthétiser les résultats des enquêtes déjà réalisées pour identifier les facteurs qui influencent la décision d’adhérer ou non à ces mutuelles. Au-delà des différences méthodologiques entre ces travaux, notre synthèse fait ressortir deux facteurs majeurs qui étaient plutôt attendus (la capacité financière des populations et la qualité des soins) et les resitue dans une perspective plus large. Elle permet également d’identifier quelques autres paramètres qui semblent aussi jouer un rôle significatif même si les convergences entre les enquêtes sont moins nettes