Lara Gautier

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• Doctor of Philosophy
• Professor (Assistant) at Université de Montréal

There has been much talk about decolonizing global health lately. The movement, which has arisen in various communities around the world, suggests an interesting critique of the Western dominant model of representations. Building upon the ‘decolonial thinking’ movement from the perspective of Francophone African philosophers, we comment on its pote...

In January 2010, Haiti was hit by a terrible earthquake that pushed thousands of people to migrate. Many of them chose to settle in Quebec, Canada. Years after the earthquake, many Haitians continue to migrate to the Quebec province. Several studies however have shown that this population's socioeconomic status is lower than the provincial average....

Unaccompanied minors (UMs) are children under the age of 18 who settle in a foreign country without a legal representative. In France, many UMs are left unprotected from child welfare services because assessment systems evaluate that they are not minors. In Paris, the non-governmental organization Médecins du Monde (MdM) offers unprotected UMs medi...

Background Refugees, asylum seekers, and migrants without status experience precarious living and working conditions that disproportionately expose them to coronavirus disease 2019 (COVID-19). In the two most populous Canadian provinces (Quebec and Ontario), to reduce the vulnerability factors experienced by the most marginalized migrants, the publ...

Résumé Prior studies on the impacts of the COVID-19 pandemic on migrants with precarious immigration status (refugees, asylum seekers, and undocumented migrants who arrived in a host country fewer than five years ago) have shown that they have been disproportionately affected by the pandemic because of their migration and socioeconomic status. Acro...

Contexte. Si les sciences sociales ont mené de nombreuses recherches sur le rôle des cabinets de conseil privés dans les politiques publiques, on dispose de peu d’informations sur leur intervention dans la gestion des crises sanitaires et des épidémies. La pandémie de COVID-19 a révélé à quel point les administrations publiques du monde entier ont...

Purpose This article provides a narrative review of recent research on entrepreneurship and self-employment among immigrant women in Canada. The aim was to identify the state-of-the-art, current trends and findings in existing literature to suggest future research avenues. Design/methodology/approach Focusing on the Canadian context, a thorough se...

Background: Newcomer populations in urban centers experienced an exacerbated effect of coronavirus disease 2019 (COVID‑19) due to their precarious living and working conditions. Addressing their needs requires holistic care provisioning, including psychosocial support, assistance to address food security, and educational and employment assistance....

In France, government protection of unaccompanied minors (UMs) depends upon the recognition of their minority status and often result in a rejection. A significant proportion of UMs therefore find themselves unprotected. This qualitative study explores the contextual and individual factors that shape the physical and mental health needs of unprotec...

This study explored community workers' experiences during COVID-19, focusing on their well-being and organizational coping strategies. A mixed-method approach included five focus group discussions (FGDs) (three with practitioners and two with managers) and an online survey with 47 frontline workers. Statistical analysis using SPSS 21 and thematic a...

Le contexte pandémique a exacerbé les inégalités et les problèmes de santé mentale, transformant profondément le travail des intervenant·e·s communautaires et augmentant leur vulnérabilité et épuisement, malgré le rôle essentiel des organismes communautaires. Cette contribution expose une initiative montréalaise de coconstruction d’activités pour l...

Background: Newcomer populations in urban centers experienced an exacerbated effect of COVID-19 due to their precarious living and working conditions. Addressing their needs requires holistic care provisioning, including psychosocial support, assistance to address food security, and educational and employment assistance. Intersectoral collaboration...

The COVID-19 syndemic has disproportionately affected socially vulnerable populations, such as low-income individuals, Indigenous peoples, and riverine communities. Social Determinants of Health (SDH) have played a crucial role in the state of Amazonas, where unique geography and social disparities pose significant challenges to health access and e...

The COVID-19 syndemic has disproportionately affected socially vulnerable populations, such as low-income individuals, Indigenous peoples, and riverine communities. Social Determinants of Health (SDH) have played a crucial role in the state of Amazonas, where unique geography and social disparities pose significant challenges to health access and e...

Context While there is ample research in the social sciences on the role of private consulting firms in public policy, there is little information about their intervention in managing public health crises and epidemics. The COVID-19 pandemic revealed how much public administrations across the globe have been using these firms. The purpose of this e...

We measured disparities in COVID-19 mortality associated with increasing vulnerability to severe outcomes of infectious disease at the neighbourhood level to identify domains for prioritization of public interventions. In this retrospective ecological study, we calculated COVID-19 mortality rate ratios (RR) comparing neighbourhoods with the greates...

L’accès au système de santé se définit comme la possibilité offerte à une personne de satisfaire ses besoins en matière de soins 1 . Il résulte du processus complexe d’interactions entre l’offre – les établissements de santé, les prestataires de soins – et la demande – les patients – de soins. Comme tout système social, le système de santé s’inscri...

L’accès au système de santé se définit comme la possibilité offerte à une personne de satisfaire ses besoins en matière de soins. Il résulte du processus complexe d’interactions entre l’offre – les établissements de santé, les prestataires de soins – et la demande – les patients – de soins. Comme tout système social, le système de santé s’inscrit d...

Globally, the COVID-19 pandemic took a high toll on health human resources, especially in contexts where these resources were already fragile. In Quebec, to make up for the shortage of health human resources, and to contain the COVID-19 outbreaks in long-term care facilities, many hospital staff (including a majority of nurses) were sent to those f...

During the COVID-19 pandemic outbreak, COVID-19 healthcare-associated infections (HAI) and risk management became major challenges facing hospitals. Using evidence from a research project, this commentary presents: 1) various communication and information strategies implemented by four hospitals and their staff in Brazil, Canada and France to reduc...

In this concluding article of the special issue, we examine lessons learned from hospitals’ resilience to the COVID-19 pandemic in Brazil, Canada, France, Japan, and Mali. A quality lesson learned (QLL) results from a systematic process of collecting, compiling, and analyzing data derived ideally from sustained effort over the life of a research pr...

In response to the disruptions caused by COVID-19, hospitals around the world proactively or reactively developed and/or re-organized their governance structures to manage the COVID-19 response. Hospitals’ governance played a crucial role in their ability to reorganize and respond to the pressing needs of their staff. We discuss and compare six hos...

Among hospital responses to the COVID19 pandemic worldwide, service reorganization and staff reassignment have been some of the most prominent ways of adapting hospital work to the expected influx of patients. In this article, we examine work reorganization induced by the pandemic by identifying the operational strategies implemented by two hospita...

Innovation by health service organizations can enable adaptation to and transformation of challenges caused by health shocks. Drawing on results from case studies in Brazil, Canada, and Japan, this study looked at innovations the study hospitals introduced in response to challenges caused by COVID-19 to identify: 1) attributes of the innovations th...

During the first and second waves of the pandemic, Quebec was among the Canadian provinces with the highest COVID-19 mortality rates. Facing particularly large COVID-19 outbreaks in its facilities, an integrated health and social services center in the province of Quebec (Canada), developed resilience strategies. To explore these diverse responses...

Objective: In Canada and globally, the COVID-19 pandemic has increased social inequalities in health (SIH), furthering the vulnerability of certain groups and communities. Contact-tracing is a cornerstone intervention with COVID-19 prevention and control programs. The aim of this study was to describe whether and how SIH were considered during the...

Digital technology offers several opportunities to improve access to professional expertise in primary care, and the offer of various “virtual” services has exploded in the past few years. The aim of this study was to evaluate the implementation of a direct-to-consumer on-line pharmacy consultation service (Ask Your Pharmacist - AYP) to a universal...

The COVID-19 pandemic highlighted the impact of social inequalities in health (SIH). Various studies have shown significant inequalities in mortality and morbidity associated with COVID-19 and the influence of social determinants of health. The objective of this qualitative case study was to analyze the consideration of SIH in the design of two key...

This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

In the fight against infectious diseases, social inequalities in health (SIH) are generally forgotten. Mali, already weakened by security and political unrest, has not been spared by the COVID-19 pandemic. Although the country was unprepared, the authorities were quick to implement public health measures, including a SARS-CoV-2 testing program. Thi...

À l'échelle mondiale, la pandémie de la COVID-19 a affecté de manière disproportionnée les migrants en termes de risque d'infection, de santé mentale, de processus d'immigration et d'accès aux services de santé et sociaux et aux ressources de soutien. Face à la COVID-19, les organismes communautaires et les établissements du réseau public de servic...

Background Refugees, asylum seekers, and migrants without status experience precarious living and working conditions which disproportionately expose them to COVID-19. In the two most populous Canadian provinces (Quebec and Ontario), to reduce the vulnerability factors experienced by the most marginalized migrants, the public and community sectors e...

More than ever, health services evaluators are in high demand. In such context, evaluation deliverables are time‐ and/or culturally‐sensitive. For the target communities or for those with an interest in the evaluation, the priority is to make sure their voice is prominently featured in evaluation deliverables. This priority coincides with a context...

Objective: The aim of this descriptive article was to compare mass testing for SARS-CoV-2 during the first wave of the COVID-19 pandemic in Montreal, Canada; Bamako, Mali; Paris, France; and Recife, Brazil. Methods: Data was collected through interviews with key informants involved in the testing response and a review of the grey literature. The TI...

Low enrolment in micro-health insurance (MHI) schemes is a recurring issue affecting the viability of such schemes. Beyond the efforts addressing low subscription and retention in these schemes, little is known on how social representations are related to micro-health insurance schemes enrolment and retention. This scoping review aimed at exploring...

Objective: This article is a case study of a capacity-building project to reduce malnutrition, implemented by a non-governmental organization (NGO) in Niger. It aims to generate a set of lessons learned on the processes of sustaining health interventions in vulnerable contexts. Methods: Using a theoretical framework on sustainability, we carried...

Background Evidence continues to demonstrate that certain marginalised populations are disproportionately affected by COVID-19. While many studies document the impacts of COVID-19 on social inequalities in health, none has examined how public health responses to the pandemic have unfolded to address these inequities in Canada. The purpose of our st...

More than 40 years after the Alma-Ata Declaration on Primary Health Care, it is time to take stock. A look back at the evolution of pharmaceutical policies reveals the extent to which international health has transformed in the last four decades. The imperative of equitable access to healthcare, reaffirmed in Astana in 2018, has still not been achi...

The aim of this scoping review is to produce a state of knowledge about the role of private consulting firms in the public management of epidemics. The review will also identify theories, approaches and methods used by researchers to study this subject.

Bringing evidence into policy and practice discussions is political; more so when evidence from health studies or programme data are deemed controversial or unexpected, or when results are manipulated and misrepresented. Furthermore, opinion and misinformation in recent years has challenged our notions about how to achieve evidence-informed decisio...

Policy ideas travel through space and time thanks to people and communities who give them meaning. Public policy analysts, development anthropologists and others, have conceived a wide array of terminologies to designate those influential policy actors who actively participate in the ‘traveling’ of those policy ideas. In this chapter, we adopt the...

Objectives: The COVID-19 pandemic represents a major crisis for governments and populations. The public’s risk perceptions, knowledge, and behaviors are key factors that play a vital role in the transmission of infectious diseases. Our scoping review aims to map the early evidence on risk perceptions, knowledge, and behaviors of general and high-ri...

Le contexte de la santé mondiale est propice au processus de co-production des connaissances scientifiques et d'un ordre social et économique du fait de la proximité des différents acteurs (recherche, politique, expertise). Ils sont encouragés à se rapprocher afin de produire des connaissances pour l'action et favoriser les politiques informées par...

Les mineurs non accompagnés (MNA) sont des enfants de moins de 18 ans qui s’établissent dans un pays étranger sans représentant légal. Les gouvernements des pays d’accueil sont responsables de la prise en charge des MNA. En France, les mineurs non accompagnés bénéficient théoriquement d’une protection au titre de l’assistance éducative (Aide Socia...

Background: Transnational networks such as Communities of Practice (CoPs) are flourishing, yet their role in diffusing health systems reforms has been seldom investigated. Over the past decade, performance-based financing (PBF) has rapidly spread in Africa. This study explores how, through the PBF Community of Practice's attributes, structure, and...

Health financing policies are critical policy instruments to achieve Universal Health Coverage, and they constitute a key area in policy analysis literature for the health policy and systems research (HPSR) field. Previous reviews have shown that analyses of policy change in low- and middle-income countries are under-theorised. This study aims to e...

Background All prevention efforts currently being implemented for COVID-19 are aimed at reducing the burden on strained health systems and human resources. There has been little research conducted to understand how SARS-CoV-2 has affected health care systems and professionals in terms of their work. Finding effective ways to share the knowledge and...

Background: All prevention efforts currently being implemented for COVID-19 are aimed at reducing the burden on strained health systems and human resources. There has been little research conducted to understand how SARS-CoV-2 has affected healthcare systems and professionals in terms of their work. Finding effective ways to share the knowledge and...

Background: The COVID-19 pandemic represents a major crisis for governments and populations around the globe. A large number of studies have been conducted worldwide to understand people’s awareness and behavioral response towards the disease. The public’s risk perceptions, knowledge, and behaviors are key factors that play a vital role in the tran...

Unaccompanied minors (UMs) are children under 18 who arrive on the territory of a foreign country without the care of a guardian. In many countries their access to social and health care services depends on their legal recognition as minors. For instance, in France, high rejection rates of minor status place unprotected UMs in social precarity, suc...

Le fait d’utiliser des connaissances explicites pour informer les décisions politiques est de plus en plus encouragé au niveau international, notamment par le mouvement d’information des politiques par les données probantes (evidence-informed policy making). Si la valeur sous-jacente à ce mouvement est de rationaliser le processus politique, les re...

Introduction Micro-health insurance (MHI) has been identified as a possible interim solution to foster progress towards Universal Health Coverage (UHC) in low- and middle- income countries (LMICs). Still, MHI schemes suffer from chronically low penetration rates, especially in sub-Saharan Africa. Initiatives to promote and sustain enrolment have yi...

Depuis 2009, le Mali s'est lancé dans une réflexion sur l'adoption du financement basé sur les résultats (FBR) afin d'améliorer l'utilisation et la qualité des services de santé maternelle et infantile. De nombreux acteurs étrangers d'Europe et d'Afrique ont contribué à diffuser l'idée et les principes du FBR auprès des acteurs et actrices malien-n...

À partir d'une approche conceptuelle relativement nouvelle, l'approche post-structuraliste de C. Bacchi, une analyse des discours a été réalisée afin de comprendre l'adoption en février 2019 d'une réforme du système de santé malien et son articulation avec d'autres réformes et cadres stratégiques élaborés ou en cours d'élaboration par le gouverneme...

De nombreux pays d'Afrique subsaharienne ont essayé le financement basé sur les résultats (FBR) dans le but d'améliorer les performances des systèmes de santé. Cette recherche qualitative vise à comprendre le processus de mise en oeuvre d'un projet pilote de FBR dans la région de Koulikoro au Mali. Nous avons mené une étude de cas multiple et contr...

Background: Addressing health in the Sustainable Development Goals (SDGs) calls for intersectoral strategies that mutually enhance both health promotion and sustainable development. Health in All Policies (HiAP) approach aims to address this as well as promote ownership among key stakeholders. Kenya was at the forefront of adopting the SDGs and ha...

This commentary aims to provide a glimpse into some of the early and continuing impacts of the COVID-19 pandemic on our global and public health projects: research in low-resourced settings; research with vulnerable populations, such as asylum seekers, Indigenous communities, children, and mental health service users; and research with healthcare p...

Objectives We describe the knowledge translation strategies in two projects and share lessons learned about knowledge sharing and uptake.Methods To generate findings for dissemination: (1) the Republic of Côte d’Ivoire (RCI) project relied on a multiple case study design to document barriers and facilitators to implementing a community-led preventi...

En France, les mineurs non accompagnés (MNA) rencontrent de multiples obstacles qui peuvent avoir des effets négatifs sur leur santé mentale. Les professionnels de la santé et du social qui participent à leur prise en charge doivent développer et mettre en œuvre des approches et outils adaptés aux réalités des mna et qui leur offrent un espace d’in...

Background Unaccompanied minors (UMs) are children under 18 settling in foreign countries without the care of a guardian. Host countries' governments are responsible for the care of UMs. In France, UMs theoretically receive child protection. However, assessment systems frequently deny their protection because of minority status rejection. As a resu...

Aujourd’hui, l’interdisciplinarité en recherche bénéficie d’une popularité remarquable : elle est tour à tour présentée comme un atout pour candidater aux subventions de recherche, comme un facteur contribuant à enrichir l’analyse et comme une marque de fabrique pour de nombreux laboratoires universitaires. Or, si l’approche interdisciplinaire s’av...

Perceptions, knowledge and attitudes of the adult populations towards COVID-19 are key factors in the community transmission of SARS-CoV-2. During outbreaks, populations play a key role in limiting the spread of infectious diseases by adopting preventive measures. In the context of COVID-19 pandemic, identifying the perceptions, knowledge and attit...

Introduction: Numerous sub-Saharan African countries have experimented with performance-based financing (PBF) with the goal of improving health system performance. To date, few articles have examined the implementation of this type of complex intervention in Francophone West Africa. This qualitative research aims to understand the process of imple...

Le financement basé sur les résultats (FBR) compte parmi les expérimentations récentes mises en place au Mali pour améliorer les indicateurs de santé maternelle et infantile. À partir d’une analyse basée sur la théorie des courants de Kingdon (1984) et d’une approche inspirée de l’anthropologie du développement, l’article présente une étude qualita...

Performance-based financing (PBF) is just one of a number of recent experiments implemented in Mali to improve maternal and child health indicators. This article presents a qualitative study based on Kingdon’s (1984) multiple streams theory and an approach inspired by development anthropology. The aim was to describe the forms of national ownership...

Background: Over the past 20 years, the polycentric nature of global health governance has shaped the emergence of autonomous actors with political influence at different levels. Since the late 2000s, influential policy actors have been supporting the implementation of a health financing reform: Performance-based financing (PBF). PBF relies on the...

Le 15 octobre 2018, l’Agence Française de Développement (AFD) et le Centre Population et Développement (CEPED/IRD) ont organisé une journée de travail et de réflexion sur les enjeux de la mobilisation de la recherche en faveur de la couverture santé universelle dans le contexte francophone. Cette journée a réuni 40 participants francophones : cherc...

For the past 15 years, several donors have promoted performance-based financing (PBF) in Africa for improving health services provision. European and African experts known as 'diffusion entrepre-neurs' (DEs) assist with PBF pilot testing. In Mali, after participating in a first pilot PBF in 2012-13, the Ministry of Health and Public Hygiene include...

Background: To improve the performance of the healthcare system, Mali's government implemented a pilot project of performance-based financing (PBF) in the field of reproductive health. It was established in the Koulikoro region. This research analyses the process of implementing PBF at district hospital (DH) level, something which has rarely been d...

Ageing and memory loss: opinions of Haitian migrants living in Quebec Introduction: ‘Dementia’ is usually presented as a syndrome characterized by the decline of one or more cognitive abilities such as memory loss. However, memory loss does not necessarily mean dementia. The most common type of dementia is Alzheimer’s disease. Its incidence increas...

Définition de la méthode Le cadre évaluatif de la fidélité d’implantation développé par Carroll et ses collègues (2007) met en lumière l’écart entre les intentions initiales des concepteurs et conceptrices de projets d’intervention et les moyens par lesquels ceux-ci sont mis en œuvre. Plus cet écart est large, moins la « fidélité d’implantation » e...

System resilience has long been an area of study, and the term has become increasingly used across different sectors. Studies on resilience in health systems are more recent, multiplying particularly since the 2014 Ebola epidemic in West Africa. World Health Organization (WHO) is calling for national governments to increase the resilience of their...

Background Health in All Policies (HiAP) is an intersectoral approach that facilitates decision-making among policy-makers to maximise positive health impacts of other public policies. Kenya, as a member of WHO, has committed to adopting HiAP, which has been included in the Kenya Health Policy for the period 2014–2030. This study aims to assess the...

Messages clés • L'inscription stratégique du FBR au sein des orientations nationales est impulsée par des entrepreneurs de la diffusion locaux et étrangers. Ils conduisent l'agenda d'apprentissage du FBR et suscitent l'émulation des acteurs. • L'existence préalable de relations sociales entre les acteurs étrangers et locaux est essentielle au proce...

Background Performance-based financing (PBF) in low- and middle-income settings has diffused at an unusually rapid pace. While many studies have looked at PBF implementation processes and effects, there is an empirical research gap investigating the ways PBF has diffused. Discursive processes are paramount elements of policy diffusion because they...

Comment Mobiliser la Recherche pour la Couverture Universelle en Santé ? : Atelier , Paris, FRA, -

Comment Mobiliser la Recherche pour la Couverture Universelle en Santé ? : Atelier , Paris, FRA, -

Une couverture universelle des soins de santé en 2030 pour tous les êtres humains, du Nord au Sud ? Réaliser cet objectif de développement durable aussi ambitieux que nécessaire exigera une exceptionnelle volonté politique, mais aussi de solides données probantes sur les moyens d’y arriver, notamment sur les interventions de santé mondiale les plus...

The World Bank, co-funded by Norway and the United Kingdom, created and managed an innovative financing mechanism, the Health Results Innovation Trust Fund (HRITF), to support performance-based financing (PBF) reforms in low- and middle-income countries. From its inception in late 2007, until the closing of fundraising in 2017, it has carried out a...