Suchergebnisse

L'allocation d'aides financières gouvernementales soulève toujours un certain débat. Est-ce que les aides financières ont un réel impact sur la performance des entreprises ? Cet article s'intéresse aux impacts de l'aide financière sur la performance des entreprises manufacturières en région non-métropolitaine (Bas-St-Laurent, Québec, Canada). La performance est mesurée sous deux angles distincts, mais complémentaires : i) la survie des établissements et ii) la croissance de l'emploi. Une analyse par méthode d'appariement (matching), basée sur les caractéristiques individuelles et les caractéristiques du voisinage, permet d'isoler l'effet des aides à partir d'une riche base de micro-données portant sur l'ensemble des établissements actifs sur le territoire du Bas-Saint-Laurent entre 2006 et 2015. Les résultats montrent que les aides financières gouvernementales ont un effet positif sur la croissance de l'emploi des établissements ainsi que sur la survie des établissements.

Pour le gouvernement du Québec, l'évaluation de programme est incontournable pour que les organisations rendent compte de leurs performances et les améliorent (Lalande, 2010). Pourtant, peu de démarches évaluatives sont réalisées en contexte carcéral, malgré les besoins importants (Cortoni & Lafortune, 2009), les nombreux défis qui y guettent les chercheurs pouvant expliquer la réticence de plusieurs chercheurs. Les défis rencontrés par une équipe de recherche dans le cadre de l'évaluation d'un programme spécialisé en toxicomanie offert dans un établissement de détention québécois sont présentés ainsi que les façons dont ils ont été appréhendés et surmontés.For Quebec's government, program evaluation is now regarded as a necessity in order for public organizations to monitor and improve their performance (Lalande, 2010). However, relatively few evaluations are conducted in prison, despite the significant needs (Cortoni & Lafortune, 2009). The numerous challenges facing researchers may partially explain their reluctance. This article deals with the challenges faced by a team of researchers in the evaluation of a specialized addiction program offered in a provincial prison and the strategies implemented to overcome those challenges.

In this article, we describe the framework of the Lancet Global Health Commission on High Quality Health Systems, propose new and undermeasured indicators of TB care quality, and discuss implications of the Commission's key conclusions for measuring and improving the quality of TB care services. The Commission contends that measurement of quality should focus on the processes of care and their impacts. In addition to monitoring treatment coverage and the availability of tools, governments should consider indicators of clinical competence (for e.g. ability of providers to correctly diagnose TB and adhere to treatment guidelines), of timely, continuous and integrated care and of respectful and patient-centered care. Indicators of impact include TB mortality and treatment success rates, but also quality of life and daily functioning among TB patients, public trust in TB services, and bypassing of the formal health system for TB care. Cascades of care, from initial care seeking to recurrence-free survival, should be built in every high-burden country to monitor quality longitudinally. In turn, improvement efforts should target the foundations of health systems and consider the Commission's four universal actions: governing for quality, redesigning service delivery, transforming the health workforce and igniting demand for quality TB services. Important work remains to validate new indicators of TB care quality, develop data collection systems for new measures, and to test new strategies for improving the delivery of competent and respectful TB care.

Declines in health service use during the Coronavirus Disease 2019 (COVID-19) pandemic could have important effects on population health. In this study, we used an interrupted time series design to assess the immediate effect of the pandemic on 31 health services in two low-income (Ethiopia and Haiti), six middle-income (Ghana, Lao People's Democratic Republic, Mexico, Nepal, South Africa and Thailand) and high-income (Chile and South Korea) countries. Despite efforts to maintain health services, disruptions of varying magnitude and duration were found in every country, with no clear patterns by country income group or pandemic intensity. Disruptions in health services often preceded COVID-19 waves. Cancer screenings, TB screening and detection and HIV testing were most affected (26–96% declines). Total outpatient visits declined by 9–40% at national levels and remained lower than predicted by the end of 2020. Maternal health services were disrupted in approximately half of the countries, with declines ranging from 5% to 33%. Child vaccinations were disrupted for shorter periods, but we estimate that catch-up campaigns might not have reached all children missed. By contrast, provision of antiretrovirals for HIV was not affected. By the end of 2020, substantial disruptions remained in half of the countries. Preliminary data for 2021 indicate that disruptions likely persisted. Although a portion of the declines observed might result from decreased needs during lockdowns (from fewer infectious illnesses or injuries), a larger share likely reflects a shortfall of health system resilience. Countries must plan to compensate for missed healthcare during the current pandemic and invest in strategies for better health system resilience for future emergencies.