References of "Fecher-Bourgeois, Fabienne"
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See detailLes mutuelles de santé subventionnées comme instruments de la Couverture Maladie Universelle au Sénégal
Deville, Céline ULiege; Fecher-Bourgeois, Fabienne ULiege; Poncelet, Marc ULiege

Conference (2018, July 11)

Les premières mutuelles de santé à base communautaire ont été créées à la fin des années 1980 au Sénégal, et se sont multipliées dans le courant des années 1990. Leur développement a cependant été freiné ... [more ▼]

Les premières mutuelles de santé à base communautaire ont été créées à la fin des années 1980 au Sénégal, et se sont multipliées dans le courant des années 1990. Leur développement a cependant été freiné par la faible capacité contributive des ménages ainsi que la faible attractivité du paquet de soins proposé. L’Etat s’est progressivement engagé dans le soutien aux mutuelles de santé, mettant en place un cadre juridique et des structures d’appui à la promotion et au développement de ces organisations communautaires. Un tournant décisif a eu lieu en 2013, avec la mise en œuvre de la politique de Couverture Maladie Universelle (CMU), qui a abouti à la création d’une mutuelle de santé dans chaque commune du pays et vise, à travers ces organisations communautaires, à couvrir contre le risque maladie l’ensemble de la population des secteurs rural et informel. Pour encourager l’adhésion de la population, le paquet de soins couvert par les mutuelles de santé a été considérablement élargi et harmonisé à l’échelle du pays et une politique de subvention étatique de la cotisation est mise en œuvre. Notre recherche vise à étudier le processus d’élaboration de cette politique de CMU, ainsi qu’à analyser les conséquences de sa mise en œuvre sur le fonctionnement des mutuelles de santé dans le département de Kaolack. Basée sur une approche de terrain de type socio-anthropologique, notre analyse repose sur des matériaux qualitatifs issus d’entretiens semi-directifs avec différentes parties prenantes ainsi que d’observations non-participantes. Les données quantitatives disponibles ont également été collectées et analysées. La stratégie de « Décentralisation de l’Assurance Maladie (DECAM) » à travers les mutuelles de santé à base communautaire trouve son origine dans un projet pilote élaboré et mis en œuvre par Abt-Associates. Elle s’est progressivement imposée face à d’autres projets de développement de l’assurance maladie pour les secteurs rural et informel. Des moyens techniques et financiers considérables ont été mis en œuvre par l’Etat et ses partenaires pour soutenir le développement et la professionnalisation des mutuelles de santé à base communautaire depuis 2013. Bien que les responsables mutualistes perçoivent ces nouvelles modalités de collaboration comme une opportunité unique de développement du système, ce partenariat n’est pas exempt de tensions. Les principes à la base de ces organisations communautaires et leurs logiques de fonctionnement peuvent entrer en contradiction avec celles de l’Etat. Largement tributaires des financements étatiques, qui subsidient entièrement la cotisation d’une majorité de leurs membres et rémunèrent leurs gérants, les mutuelles de santé doivent trouver un équilibre entre autonomie, représentation communautaire et prestation de service public. Face aux retards de paiement de l’Etat, elles doivent également mettre en place de nouvelles stratégies pour garder leur crédibilité face aux prestataires de soins et éviter la cessation de paiement. Enfin, l’augmentation du taux de pénétration et le recouvrement des cotisations constituent encore aujourd’hui des défis majeurs, face à une population qui reste perplexe et ce, malgré les campagnes de promotion et de sensibilisation déployées depuis de nombreuses années. [less ▲]

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See detailUniversal Health Coverage in Francophone Sub-Saharan Africa: Assessment of Global Health Experts' Confidence in Policy Options
Paul, Elisabeth ULiege; Fecher-Bourgeois, Fabienne ULiege; Meloni, Remo et al

in Global Health, Science and Practice (2018)

Many countries rely on standard recipes for accelerating progress toward universal health coverage (UHC). With limited generalizable empirical evidence, expert confidence and consensus plays a major role ... [more ▼]

Many countries rely on standard recipes for accelerating progress toward universal health coverage (UHC). With limited generalizable empirical evidence, expert confidence and consensus plays a major role in shaping country policy choices. This article presents an exploratory attempt conducted between April and September 2016 to measure confidence and consensus among a panel of global health experts in terms of the effectiveness and feasibility of a number of policy options commonly proposed for achieving UHC in low- and middle-income countries, such as fee exemptions for certain groups of people, ring-fenced domestic health budgets, and public-private partnerships. To ensure a relative homogeneity of contexts, we focused on French-speaking sub-Saharan Africa. We initially used the Delphi method to arrive at expert consensus, but since no consensus emerged after 2 rounds, we adjusted our approach to a statistical analysis of the results from our questionnaire by measuring the degree of consensus on each policy option through 100 (signifying total consensus) minus the size of the interquartile range of the individual scores. Seventeen global health experts from various backgrounds, but with at least 20 years' experience in the broad region, participated in the 2 rounds of the study. The results provide an initial “mapping” of the opinions of a group of experts and suggest interesting lessons. For the 18 policy options proposed, consensus emerged only on strengthening the supply of quality primary health care services (judged as being effective with a confidence score of 79 and consensus score of 90), and on fee exemptions for the poorest (judged as being fairly easy to implement with a confidence score of 66 and consensus score of 85). For none of the 18 common policy options was there consensus on both potential effectiveness and feasibility, with very diverging opinions concerning 5 policy options. The lack of confidence and consensus within the panel seems to reflect the lack of consistent evidence on the proposed policy options. This suggests that experts' opinions should be framed within strengthened inclusive and “evidence-informed deliberative processes” where the trade-offs along the 3 dimensions of UHC—extending the population covered against health hazards, expanding the range of services and benefits covered, and reducing out-of-pocket expenditures—can be discussed in a transparent and contextualized setting. [less ▲]

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See detailL’Assurance pour le renforcement du capital humain (ARCH) au Bénin : processus d’élaboration et défis de mise en oeuvre
Deville, Céline ULiege; Fecher-Bourgeois, Fabienne ULiege; Poncelet, Marc ULiege

in Revue Française des Affaires Sociales (2018), 2018/1

This article, based on a socio-anthropological field survey, examines the process of developing the Human Capital Insurance (ARCH) scheme in Benin and the challenges, risks and stakes in implementing this ... [more ▼]

This article, based on a socio-anthropological field survey, examines the process of developing the Human Capital Insurance (ARCH) scheme in Benin and the challenges, risks and stakes in implementing this social protection policy, especially in health care. As a first step, we analyze the process of development of the project that up to now has been characterized by the domination of national experts on the main orientations and a lack of debate and involvement of stakeholders. Since the ARCH scheme relies on an identification of poor and extreme poor population categories, the targeting process is then discussed. Finally, we pinpoint various risks and potential tensions that must be taken into account in the implementation of the project, as regards the financing, the quality, and the governance of health care availability but also the factors of the population’s support and the persistence of barriers to access to care. [less ▲]

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See detailMatrices d’indicateurs et de mesures des deux modèles de FBR au Bénin
Paul, Elisabeth ULiege; Badarou, Soliou; Bodson, Oriane ULiege et al

in Chaire Réalisme - Note de politique (2017, March)

Cette note de politique fait l'analyse critique des matrices d’indicateurs quantitatifs et de mesures qualitatives des deux programmes de FBR au Bénin, et proposer des pistes pour améliorer la cohérence ... [more ▼]

Cette note de politique fait l'analyse critique des matrices d’indicateurs quantitatifs et de mesures qualitatives des deux programmes de FBR au Bénin, et proposer des pistes pour améliorer la cohérence et l’intégration du FBR dans la perspective de l’atteinte de la CSU [less ▲]

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See detailEstimating the economic impact of a possible equine and human epidemic of West Nile virus infection in Belgium
Humblet, Marie-France ULiege; Vandeputte, Sébastien; Fecher-Bourgeois, Fabienne ULiege et al

in Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles (2016), 21(31),

This study aimed at estimating, in a prospective scenario, the potential economic impact of a possible epidemic of WNV infection in Belgium, based on 2012 values for the equine and human health sectors ... [more ▼]

This study aimed at estimating, in a prospective scenario, the potential economic impact of a possible epidemic of WNV infection in Belgium, based on 2012 values for the equine and human health sectors, in order to increase preparedness and help decision-makers. Modelling of risk areas, based on the habitat suitable for Culex pipiens, the main vector of the virus, allowed us to determine equine and human populations at risk. Characteristics of the different clinical forms of the disease based on past epidemics in Europe allowed morbidity among horses and humans to be estimated. The main costs for the equine sector were vaccination and replacement value of dead or euthanised horses. The choice of the vaccination strategy would have important consequences in terms of cost. Vaccination of the country’s whole population of horses, based on a worst-case scenario, would cost more than EUR 30 million; for areas at risk, the cost would be around EUR 16–17 million. Regarding the impact on human health, short-term costs and socio-economic losses were estimated for patients who developed the neuroinvasive form of the disease, as no vaccine is available yet for humans. Hospital charges of around EUR 3,600 for a case of West Nile neuroinvasive disease and EUR 4,500 for a case of acute flaccid paralysis would be the major financial consequence of an epidemic of West Nile virus infection in humans in Belgium. [less ▲]

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See detailLa couverture santé universelle dans les pays à revenus faibles et intermédiaires : analyses économiques
Paul, Elisabeth ULiege; Bodson, Oriane ULiege; Ridde, Valéry et al

in Reflets et Perspectives de la Vie Economique (2016), 1

Les pays à revenu faible et intermédiaire sont confrontés à des besoins de financement élevés pour assurer une couverture santé universelle (CSU) permettant à chacun d'avoir accès à des services de santé ... [more ▼]

Les pays à revenu faible et intermédiaire sont confrontés à des besoins de financement élevés pour assurer une couverture santé universelle (CSU) permettant à chacun d'avoir accès à des services de santé de qualité sans encourir de difficultés financières. Cet article tente de montrer comment l'analyse économique peut être mobilisée pour identifier des stratégies utiles pour tendre vers la CSU. Trois axes complémentaires où l'analyse économique a une plus-value sont présentés : i) la mobilisation des ressources et l'équité verticale ; ii) l'amélioration de l'efficacité dans l'allocation des ressources et l'équité horizontale ; iii) la gestion opérationnelle des ressources, en particulier à travers le financement basé sur les résultats (efficience). Pour chacun, nous présentons un bref état des lieux de l'état des connaissances et évoquons quelques perspectives de recherche. [less ▲]

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See detailServing the general interest with public enterprises. New forms of governance and trends in ownership
Fecher-Bourgeois, Fabienne ULiege; Bance, Philippe; Obermann, Gabriel

in Annals of Public and Cooperative Economics (2015), 86(4), 529-718

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See detailPresentation : Some current issues and challenges in the social economy
Fecher-Bourgeois, Fabienne ULiege; Lévesque, Benoît

in Annals of Public and Cooperative Economics (2015), 86(2), 179-189

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See detailSome current issues and challenges in the social economy
Fecher-Bourgeois, Fabienne ULiege; Lévesque, Benoît; Vallet, Nathalie

in Annals of Public and Cooperative Economics (2015), 86(2), 179-400

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See detailLes inégalités en santé : diagnostics et remèdes
Fecher-Bourgeois, Fabienne ULiege

Scientific conference (2015, May 30)

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See detailThe Production of Statistics for the Social Economy in Belgium: a focus on Mutuals and Cooperatives
Fecher-Bourgeois, Fabienne ULiege; Ben Sedrine, Wafa ULiege

in Bouchard, Marie; Rousselière, Damien (Eds.) The Weight of the Social Economy - An International Perspective (2015)

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See detailThe Governance of Mixed Companies: Policy Implications for Local Governments
Marra, A; Cruz, N.F.; Marques, R.C. et al

in Annals of Public and Cooperative Economics (2014), 85(1), 1-164

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See detailPolitiques Sociales et de l'Emploi
Fecher-Bourgeois, Fabienne ULiege

Learning material (2014)

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See detailUne comparaison internationale des systèmes de santé. A la recherche de l’efficacité et de l’équité
Fecher-Bourgeois, Fabienne ULiege

Conference given outside the academic context (2013)

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See detailECONOMIC IMPACT OF USING AN ANTIVIRAL IN THE CONTROL OF A FOOT-AND-MOUTH DISEASE EPIZOOTIC IN SOUTHERN BELGIUM
Dal Pozzo, Fabiana ULiege; Humblet, Marie-France ULiege; Vandeputte, Sébastien ULiege et al

Poster (2013, October)

Foot-and-mouth disease virus (FMDV) is a highly contagious pathogen of cloven-hoofed mammals and one of the biggest concerns for veterinary authorities. The control measures to be applied in case of an ... [more ▼]

Foot-and-mouth disease virus (FMDV) is a highly contagious pathogen of cloven-hoofed mammals and one of the biggest concerns for veterinary authorities. The control measures to be applied in case of an outbreak vary in function of the disease-free or disease-enzootic status. Vaccination depends on the prior identification of the involved viral serotype and subtype, it confers an immunity limited to 6 months and it requires between 4 to 7 days to trigger the immune response (i.e. immunity-gap). The use of anti-FMD drugs has been discussed as an alternative or supplementary method to be used in previously FMD-free countries/zones. Such an antiviral treatment could protect against the viral dissemination to fill the gap between vaccination and the rise of a protective immunity. Apart from broad spectrum antiviral agents, such as ribavirin, specific anti-FMDV molecules have been identified in vitro, but none of them has been used in clinical studies involving ruminants or pigs. Next to the anti-FMDV activity, the absence of toxicity and the withdrawal period influencing the food safety, the cost of the treatment would be another important parameter influencing the potential use of an antiviral agent in the control of a FMD outbreak. The aim of this study was to assess the economic impact of using an antiviral in the control of a FMD epizootic in southern Belgium (Walloon Region). This work was based on the results of previous investigations concerning the epidemiological and economic data of a FMD outbreak in Southern Belgium. In the considered scenario, the epizootic was caused by the introduction of an infected cow (during the incubation time) in a beef cattle farm during winter. During the two weeks between the brood cow introduction and the official declaration of the outbreak, animal movements occurred between other beef cattle farms. The economic effects of the epidemic were evaluated taking into account the air-borne transmission of FMDV, the occurrence of animal movements (two scenarios were considered, with a minimum of 2 and a maximum of 17 movements), the presence of bovine and small ruminant farms, as well as pig farms in the protection and surveillance zones around the initial and secondary outbreaks. The wild fauna was not involved in the epidemic. In order to integrate in the above scenario the application of an antiviral agent in the control of the disease, it was assumed that the efficacy of the anti-FMDV drug was proven by reducing viral excretion in infected animals as well as by preventing the infection in animals at risk. Two hypothetical prices were used to introduce in the model the costs related to the administration of the antiviral drug (5€ and 10€ per dose). Furthermore, different strategies of control could be envisaged, such as the administration of the drug to both domestic ruminants and pigs, or depending on the epidemiological role of these species in the FMD transmission and their density in the territory, the administration of the drug to only one of them. Other scenarios could be characterized by the use of the antiviral in the control of the epizootic within the protection and surveillance zones or in only one of them. The costs associated with the use of antivirals in the different proposed scenarios are compared to the costs and socio-economic losses associated with the FMD outbreak and the implementation of control measures. [less ▲]

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See detailCadrage et lois de l’Economie sociale en Belgique et en Région wallonne
Fecher-Bourgeois, Fabienne ULiege

Conference (2013, May 09)

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