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"How can the impact of aid be estimated in the presence of fungibility? And how far does fungibility reduce its benefits? These questions are analyzed in a context where a donor wants to target its efforts on a specific sector and specific geographic areas. A traditional differences-in-differences method comparing the change in outcomes between the target and nontarget areas before and after the project risks misestimating the project's benefits. The paper develops an alternative estimation method in which intersectoral fungibility reduces project benefits insofar as government spending has a smaller impact in the sector to which the funds leak than in the target sector, while intrasectoral fungibility reduces benefits insofar as the donor is able to leverage productivity increases in government spending in the target areas. The methods are applied to two contemporaneous World Bank health projects that set out to target assistance on approximately one-half of Vietnam's provinces. Aid is not apparently fungible between Vietnam's health sector and other sectors, but is fungible across provinces within the health sector. Differences-in-differences yield an insignificant impact on infant mortality, while the use of the new method yields a statistically significant impact of around 4 per 1000 live births. The results, however, are ambiguous on the costs associated with intrasectoral fungibility. "--World Bank web site.

Medical assistance

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L'arrêté du 11 avril 2006 a redéfini la profession d'aide médico-psychologique comme étant la « première qualification de la filière éducative » et lui a donné un diplôme d'État. Pourtant, largement méconnue, elle peine à construire son identité et à obtenir la reconnaissance de sa spécificité et de son ambition : prendre soin au quotidien. Comment rendre compte de cette dimension très complexe mais peu visible et peu spectaculaire des « petits riens » du travail au jour le jour des AMP ? En quoi peut-on dire que les AMP sont les sentinelles, les guetteurs de l'inconfort, de la souffrance, du mal-être, qu'ils soient physique, psychique ou social ? Quelles représentations les AMP ont de leur métier ? Comment conçoivent-ils leur engagement auprès des personnes gravement handicapées, de tous âges, au sein de diverses institutions ? Comment les autres acteurs de l'accompagnement (psychologues, médecins, juristes, paramédicaux) perçoivent-ils la fonction d'AMP ? Professionnels, résidents, formateurs témoignent dans cet ouvrage de l'importance de l'accompagnement sensible et humain que les AMP mènent au plus près de l'intimité des personnes les plus vulnérables.

Medical assistance.

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"Aid to developing countries has largely neglected the population-wide health services that are core to communicable disease control in the developed world. These mostly non-clinical services generate "pure public goods" by reducing everyone's exposure to disease through measures such as implementing health and sanitary regulations. They complement the clinical preventive and treatment services which are the donors' main focus. Their neglect is manifested, for example, in a lack of coherent public health regulations in countries where donors have long been active, facilitating the spread of diseases such as avian flu. These services can be inexpensive, and dramatically reduce health inequalities. Sri Lanka spends less than 0.2% of GDP on its well-designed population-wide services, which contribute to the country's high levels of health equity and life expectancy despite low GDP per head and civil war. Evidence abounds on the negative externalities of weak population-wide health services. Global public health security cannot be assured without building strong national population-wide health systems to reduce the potential for communicable diseases to spread within and beyond their borders. Donors need greater clarity about what constitutes a strong public health system, and how to build them. The paper discusses gaps in donors' approaches and first steps toward closing them. "--World Bank web site.

Medical assistance.

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Medical assistance, French --- Medical assistance. --- Public health --- Medical assistance

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« Qu'est-ce que la médecine humanitaire ? Celle qui s'adresse à des populations marginalisées, éprouvées par une crise ou privées d'accès aux soins. Celle qui s'exerce sans autre objectif que de se rendre utile. Tout membre d'une organisation œuvrant dans ce domaine se reconnaîtra sans doute dans cette définition.Mais au-delà de ces principes essentiels et partagés, les situations sur le terrain conduisent à interroger les enjeux, les limites, les contraintes politiques, les paradoxes, les développements possibles de cette médecine. Car, plus que dans l'acte, ce sont les situations qui font la spécificité de la médecine humanitaire et que Rony Brauman nous invite à comprendre. » -- Résumé de l'éditeur.

Medical assistance. --- Humanitarian assistance.