Le choix des projets d'investissements publics: limites de l'analyse coûts-avantages et intérêt d'une approche planificatrice. Application au secteur de la santé

The quest for equity, sustainability and applicability, among other things, has put the conventional Cost-Benefit Analysis (CBA) technique under fierce attack in the recent past. Attack concerns the Effects method as well as the Shadow price methods : even though they have not the same goals, they are interchangeable. However, usefullness and credibility of CBA can be increased if two conditions are taken into consideration : the first condition is to adopt a multi-approach with some complementary criterions : financial viability, economic efficiency, social equity, environmental sustainability,…… ; the second condition is to put into practice a development planning and to decentralize program and project planning. Health sector in a developing country is used as a relevant example to explain and give concrete expression to the processes.