Thesis (PhD)--Stellenbosch University, 2010. / ENGLISH ABSTRACT: Biological invasions are a growing threat to biodiversity, trade and agriculture in South Africa. Though alien reptiles and amphibians (herpetofauna) are not currently a major issue, escalating problems worldwide and increased trade in South Africa suggest a possible increase in future problems. In this thesis I explore practical measures for risk assessment implementable under national legislation. I began by documenting record-keeping and legislative differences between provinces in South Africa. This revealed some serious deficiencies, complicating attempts to compile accurate inventories and discern import trends. International trade data, however, revealed an exponential increase in the number of imports to South Africa over the last 30 years. Characterising the abundance of species in this trade is important as species introduced in large numbers pose a higher establishment risk. In South Africa, I found a tendency for venomous and expensive species to be traded in low numbers, whereas species that are easy to breed and handle, or that are colourful or patterned are traded in higher numbers. Unlike South Africa, California and Florida have had a large number of well-documented herpetofaunal introductions. These introductions were used to verify the role of several key predictors in species establishment. I first evaluated the role of each variable separately. I examined different approaches for bioclimatic modelling, the predictive power of different sources of distribution data, and methods of assigning a climate-match score. I also present the first test of Darwin’s naturalization hypothesis for land vertebrates using two new phylogenies inferred for native and introduced reptiles in California and Florida. I then used boosted regression trees (BRT) to infer the relative contribution of each factor to species establishment success. Results from the BRTs were incorporated into a user-friendly spreadsheet model for use by assessors inexperienced in complex modelling techniques. Introduction effort was found to be the strongest contributor to establishment success. Furthermore, species with short juvenile periods were more likely to establish than species that started breeding later, as were species with more distant relatives in regional biotas. Average climate match and life form were also important. Of the herpetofaunal groups, frogs and lizards were most likely to establish, while snakes and turtles established at much lower rates, though analysis of all recorded herpetofaunal introductions shows slightly different patterns. Predictions made by the BRT model to independent data were relatively poor, though this is unlikely to be unique to this study and can be partially explained by missing data. Though numerous uncertainties remain in this field, many can be lessened by applying case by case rules rather than generalising across all herpetofaunal groups. The purpose for import and potential trade volume of a species will influence the threat it poses. Considering this in conjunction with a species’ environmental tolerances and previous success of species with similar life histories, should provide a reasonable and defendable estimate of establishment risk. Finally, a brief summary of the potential impacts of introduced alien herpetofauna is provided in the thesis. / AFRIKAANSE OPSOMMING: Indringer spesies hou ‘n al groter bedreiging in vir die biodiversiteit, handel en landbou van Suid- Afrika. Alhoewel uitheemse reptiele en amfibieërs (herpetofauna) tans nie ‘n groot bedreiging in Suid-Afrika is nie, dui groeiende probleme wêreldwyd asook 'n toename in plaaslike handel op moontlike toekomstige probleme. In hierdie tesis, ondersoek ek praktiese metodes vir risikobepaling wat onder nasionale wetgewing toegepas kan word. Ek begin deur die verskille in stoor van rekords en wetgewing tussen provinsies te dokumenteer. Hierdie proses het ernstige tekortkominge uitgewys, wat pogings om akkurate inventarisse saam te stel en invoertendense te bepaal, bemoeilik. Internasionale handelsdata het egter getoon dat daar ‘n eksponensiële toename in die hoeveelheid invoere na Suid-Afrika oor die laaste 30 jaar was. Die hoeveelheid spesies in hierdie handel is belangrik omdat spesies wat in groot hoeveelhede ingevoer word, ‘n hoër vestigingsrisiko het. In Suid-Afrika is ‘n tendens gevind vir handel in giftige en duur spesies teen lae hoeveelhede, terwyl spesies wat maklik teel, maklik hanteer kan word en kleurvol is of mooi patrone het, in groter hoeveelhede mee handel gedryf word. Kalifornië and Florida, in teenstelling met Suid-Afrika, het ‘n hoë aantal goed-gedokumenteerde gevalle van herpetofauna wat in die natuur vrygestel is. Hierdie introduksies was gebruik om die rol van verskeie belangrike faktore in die vestiging van populasies te bepaal. Eerstens het ek die rol van elke faktor apart ondersoek. Ek het verskillende benaderinge vir bioklimatiese model-bou ondersoek, die akuraatheid van verskillende bronne van distribusiedata getoets en drie metodes om ‘n “climate match score” te bereken, voorgestel. Ek bied ook die eerste toets van Darwin se naturalisasie-hipotese vir landwerveldiere aan, deur gebruik te maak van twee nuwe filogenieë wat ek gebou het vir inheemse en ingevoerde reptiele in Kalifornië en Florida. Ek het verder gebruik gemaak van “boosted regression trees” (BRT) om die relatiewe bydrae van elke faktor tot die vestigings-potensiaal van spesies te bepaal. Resultate van hierdie BRTs was ingekorporeerd in ‘n gebruikersvriendelike ontledingstaat wat deur bestuurders, onervare in komplekse modelboutegnieke, gebruik kan word. Invoer-hoeveelheid was die faktor wat die sterktste bygedra het tot suksesvolle vestiging. Verder is spesies met kort jeugperiodes en dié met verlangse familie in streeks-biotas, meer geskik om suksesvol te vestig. Gemiddelde klimaatooreenstemming en lewensvorm was ook belangrik. Paddas en akkedisse was die mees waarskynlikste van die herpetofauna groepe om populasies te vestig, terwyl slange en skilpaaie teen laer tempo’s populasies gevestig het, alhoewel analise van alle gedokumenteerde gevalle van herpetofauna-invoerings wêreldwyd effens verskillende tendense toon. Voorspellings wat deur die BRT-model vir onafhangklike data gemaak is was redelik swak, alhoewel hierdie resultaat onwaarskynlik nie uniek aan die studie is nie, en word gedeeltelik verduidelik deur die gebrek aan data. Alhoewel talle onsekerhede steeds bestaan, kan dié verminder word deur geval-tot-geval reëls toe te pas eerder as om vir herpetofauna as ‘n groep te veralgemeen. Die doel van invoer en potensiële handel-volumes van ‘n spesie, sal die bedreiging wat die spesie toon, bepaal. Hierdie faktore moet saam met omgewingstoleransie en voorafgaande sukses van spesies met soortgelyke lewenswyses oorweeg word, om ‘n aanvaarbare en verdedigbare beraming van vestigingsrisiko te gee. Laastens, word ‘n kort opsomming van die effekte wat uitheemse herpetofauna mag hê, verskaf.

Zahlreiche Studien den Stand der Forschung in Bezug auf die Ökosystemdienstleistungen untersucht. Dennoch wurde die Dimension „Volumen und Höhe“, d.h. die dritte Dimension städtischer Systeme, in den Studien zu Ökosystemdienstleistungen in städtischen Gebieten ignoriert. Die Forschungsziele und Fragestellungen dieser Dissertation lauten: i) Stand der aktuellen Forschung zur dritten Dimension von Ökosystemdienstleistungen im städtischen Raum, ii) Beurteilung des Zusammenhangs von urbanen mehrdimensionalen Indikatoren (zwei- und dreidimensionalen Indikatoren) für die Oberflächentemperatur in der Stadt und iii) Unterschiede zwischen Innen- und Außentemperaturen in urbanen Räumen. Diese Dissertation ist in vier Kapitel gegliedert. Im ersten und zweiten Kapitel werden die Forschungslücken und das Ziel der vorliegenden Untersuchung erläutert. Kapitel 3 enthält die veröffentlichten Artikel. Das letzte Kapitel behandelt die Ergebnisse der veröffentlichten Artikel. Diese Dissertation betont die Bedeutung von dreidimensionalen Studien in urbanen Ökosystemen, um das Konzept der Nachhaltigkeit in Städten voranzutreiben. Deshalb werden kontinentübergreifende Forschungen für weitere Studien empfohlen, die die dreidimensionale Struktur aller städtischen Komponenten und ihre Auswirkungen auf die Außen- und Innentemperatur berücksichtigen. / Among the studies on ecosystem services undertaken in urban areas, a ‎dimension ‘volume and height’, i.e., the third-dimension of urban environment is largely ignored. More specific, three-dimensional spatial models will increase the knowledge of how complex environment ‎shape the micro-climate in urban ‎environment. The research objectives and questions of this dissertation is: i) the status of the current research addressing the third-dimension of ‎ecosystem services in urban area, ii) assessing the association of urban multi-dimensional (two- and three- ‎dimensional) indicators on urban surface temperature and iii) variation of indoor and outdoor urban temperature pattern. This dissertation is organized into four chapters. The ‎first and second chapter explain the gaps in literature and the aim of this research. Chapter 3 holds the published articles. The last chapter discusses the results of the published articles. This dissertation emphasizes the importance of three-dimensional studies in urban ecosystems to advance the concept of sustainability in cities. Therefore, cross-continental studies that consider the three-dimensional structure of all the urban components and its impact on outdoor and indoor temperature is recommended for future research. / به جرات می توان گفت که در مطالعات خدمات اکوسیستم، بخصوص خدمات اکوسیستم شهری ، بعد سوم که شامل "ارتفاع و حجم" می باشد اصلا مورد توجه قرار نگرفته است. هدف از این پایان نامه، تلفیق مفهوم بعد سوم در خدمات اکوسیستم شهری و استفاده از فواید آن می باشد. مطالعه بعد سوم دانش ما را در نحوه شکل گیری اقلیم خُرد شهری افزایش می دهد. هدف این پروژه دکتری پاسخ به سوالات ذیل می باشد: 1) سطح آگاهی تحقیقات از بعد سوم خدمات اکوسیستم شهری، 2) ارزیابی ارتباط شاخص های چندبعدی (دو و سه بعدی) با دمای سطح و 3) ارزیابی الگوی دمای درونی و بیرونی در شهر. جهت پاسخ دادن به سوال های مطرح شده، این پژوهش به چهار فصل تقسیم شده است. فصل اول و دوم، که جایگاه خدمات اکوسیستم را در مطالعات شهری بررسی و جای خالی مفهوم بعد سوم در مطالعات خدمات اکوسیستم شهری را جستجو می کند. فصل سوم، شامل سه مقاله چاپ شده در راستای این پروژه دکتری می باشد. فصل چهارم، که نتایج بدست آمده را تجزیه و تحلیل می کند. نتایج بدست آمده نشان می دهد که مطالعات خدمات اکوسیستم شهری از معنی کلی و بنیادی به سمت سازش پذیری شهرها با پدیده تغییر اقلیم در حال تغییر است. همچنین نتایج نشان می دهد که ساختار متفاوت شهری بر شکل گیری الگوی دمای بیرون و داخل ساختمان ها موثر می باشد. استنتاج نتایج بدست آمده از این پایان نامه دو مورد را پیشنهاد می کند. اول، بررسی نقش ساختار های دو بعدی و سه بعدی بر روی دیگر شهر ها و تاثیر آن بر شکل گیری دمای بیرون و درونی ساختمان ها.

Saltmarshes provide a diverse range of ecosystem services and are protected under a number of international designations. Nevertheless they are generally declining in extent in the United Kingdom and North West Europe. The drivers of this decline are complex and poorly understood. When considering mitigation and management for future ecosystem service provision it will be important to understand why, where, and to what extent decline is likely to occur. Few studies have attempted to forecast saltmarsh morphodynamics at a system level over decadal time scales. There is no synthesis of existing knowledge available for specific site predictions nor is there a formalised framework for individual site assessment and management. This project evaluates the extent to which machine learning model approaches (boosted regression trees, neural networks and Bayesian networks) can facilitate synthesis of information and prediction of decadal-scale morphological tendencies of saltmarshes. Importantly, data-driven predictions are independent of the assumptions underlying physically-based models, and therefore offer an additional opportunity to crossvalidate between two paradigms. Marsh margins and interiors are both considered but are treated separately since they are regarded as being sensitive to different process suites. The study therefore identifies factors likely to control morphological trajectories and develops geospatial methodologies to derive proxy measures relating to controls or processes. These metrics are developed at a high spatial density in the order of tens of metres allowing for the resolution of fine-scale behavioural differences. Conventional statistical approaches, as have been previously adopted, are applied to the dataset to assess consistency with previous findings, with some agreement being found. The data are subsequently used to train and compare three types of machine learning model. Boosted regression trees outperform the other two methods in this context. The resulting models are able to explain more than 95% of the variance in marginal changes and 91% for internal dynamics. Models are selected based on validation performance and are then queried with realistic future scenarios which represent altered input conditions that may arise as a consequence of future environmental change. Responses to these scenarios are evaluated, suggesting system sensitivity to all scenarios tested and offering a high degree of spatial detail in responses. While mechanistic interpretation of some responses is challenging, process-based justifications are offered for many of the observed behaviours, providing confidence that the results are realistic. The work demonstrates a potentially powerful alternative (and complement) to current morphodynamic models that can be applied over large areas with relative ease, compared to numerical implementations. Powerful analyses with broad scope are now available to the field of coastal geomorphology through the combination of spatial data streams and machine learning. Such methods are shown to be of great potential value in support of applied management and monitoring interventions.

Spelifiering definieras som användningen av speldesignelement inom icke-spelsammanhang. Detta är ett koncept vars popularitet har ökat och fortsätter att öka. På senare år har spelifiering tillämpats inom utbildning men även andra områden som: marknadsföring, politik och interaktiva system. Studier har visat märkbar inverkan av spelifiering på användares beteende men trots detta finns det en brist på tillämpningar och forskning av spelifiering på informationssystem och undervisning. Avsikten med denna studie är att redogöra för vilka känslor studenter upplever när de använder sin primära lärplattform samt hur en spelifierad lärplattform skulle påverka studenters känslor och därmed deras studieupplevelse. Detta utförs genom en kvalitativ forskningsansats som baseras på semistrukturerade intervjuer med fem studenter vilket innehar en aktiv utbildning vid Högskolan i Borås. I samband med de semistrukturerade intervjuerna presenterades en interaktiv IT-artefakt i form av en prototyp där spelelement har tillämpats på studenternas primära lärplattform. Prototypen användes för att informanterna skulle kunna få en djupare förståelse kring vad spelifiering innebär och hur det skulle kunna se ut i praktiken tillämpat vid lärplattformen. Slutsatserna som presenteras tyder på att studenters studieupplevelse förbättras till viss del då det framkommer mer positiva känslor i samband med användningen av den spelifierade lärplattformen. Detta till skillnad från vad det gjorde i samband med användningen av den primära lärplattformen där spelifiering inte var tillämpat. De positiva känslor som uppstod bland studenterna var främst en ökad motivation, ett förbättrat självförtroende och en ökad gemenskap. Vissa delar av den spelifierade lärplattformen har framkallat negativa känslor såsom stress och prestationsångest. Slutsatserna tyder även på vad man som utvecklare behöver ta i åtanke för att undvika stress och prestationsångest bland studenterna. Vi finner i övrigt att slutsatserna är väsentliga för utvecklare till följd att lyckas med en praktisk tillämpning av spelifiering på en lärplattform där studenternas studieupplevelse ligger i huvudfokus. / Gamification is defined as the use of game design elements in non-gaming context. This is a concept whose popularity has increased and continues to increase. In recent years, gamification has been applied in education but also other areas such as: marketing, politics and interactive systems. Studies have shown a noticeable impact of gamification on user behavior, but despite this, there is a lack of applications and research of gamification applied on information systems and teaching. The purpose of this study is to describe what feelings students experience when using their primary learning management system and how a gamified learning management system would affect students' feelings and thus their study experience. This is done through a qualitative research assignment that is based on semi structured interviews with five students, which holds an active education at the University of Borås. In connection with the semi structured interviews, an interactive IT artefact was presented in the form of a prototype where game elements have been applied to the students' primary learning management system. The prototype was used to enable the informants to gain a deeper understanding of what gamification involves and what it could look like in practice applied to the learning management system. The conclusions presented indicate that students' study experience is improved to some extent as there are more positive feelings in connection with the use of the gamified learning management system. This is unlike what it did in connection with the use of the primary learning management system where gamification was not applied. The positive emotions that arose among the students were primarily an increase of motivation, improved self-esteem and an increased community. Some parts of the gamified learning management system have caused negative feelings such as stress and performance anxiety. The conclusions also indicate what developers need to keep in mind in order to avoid stress and performance anxiety among the students. We also find that the conclusions are essential for developers to succeed in the practical application of gamification on a learning management system where the students' study experience is the main focus.

Le travail de recherche réalisé au cours de cette thèse s’inscrit dans le contexte de l’expérience ATLAS, l’une des quatre grandes expériences auprès du collisionneur LHC. Il fut principalement dédié à la recherche de nouveaux bosons de jauge lourds chargés, appelé W' et prédits par de nombreuses extensions du Modèle Standard de la physique des particules. Ce manuscrit présente une recherche du boson W' se désintégrant en un quark top et un quark beau à travers une approche de couplage effectif, dans des états finals de désintégrations leptoniques du quark top. Cette recherche fut réalisée avec 20.3 fb−1 de données de collision proton-proton, produits par le LHC à une énergie dans le centre de masse de 8 TeV et collectées par le détecteur ATLAS en 2012. Plusieurs scénarios d’études sont envisagés où le boson W' se couple soit à des fermions de chiralité gauche (W'L) soit de chiralité droite (W'R). Une technique d’analyse multivariée utilisant des arbres de décision boostés (BDT) est utilisée afin de mettre évidence un excès de processus de signal dans les données enregistrées. Aucun excès n’est observé au-delà des incertitudes expérimentales pour la statistique de données analysées jusque-là. Une analyse statistique est réalisée afin d’extraire des limites d’exclusion sur la masse et la section efficace de production de la particule. Des masses inférieures à 1.92, 1.80 et 1.70 TeV furent exclues respectivement pour des bosons W'R et W'L, en tenant compte ou non d’effets d’interférence. Les limites d’exclusion sur les sections efficaces de production sont réinterprétées en matière de limite d’exclusion sur le couplage effectif g'/g de la particule. Les limites d’exclusion les plus basses observées sur le rapport g'/g, respectivement de 0.20 et 0.16 pour les recherches de bosons W'R et W'L, furent obtenues pour une masse de boson W'R/L de 0.75 TeV. Une recherche de bosons de Higgs chargés se désintégrant en un quark top et un quark beau est également présentée dans ce manuscrit. Cette dernière repose sur une approche de couplage effectif décrivant un modèle à deux doublets de Higgs de type II. Cette analyse réutilise l’infrastructure développée pour la recherche du boson W' est complétée d’études phénoménologiques liées au calcul de la section efficace de ce processus ainsi que sur la caractérisation des effets de largeur de la résonance recherchée. Les premiers résultats obtenus sur la limite d’exclusion sur la section efficace de production pp → H+→ tb montrent toutefois que cette analyse ne semble pas être en mesure d’exclure un signal de boson H+ pour l’ensemble des scénarios théoriques considérés, compte tenu des faibles sections efficaces de production prédites. En parallèle de ces activités, des développements ont été réalisés pour la simulation rapide du système de calorimétrie FastCaloSim du détecteur ATLAS afin de pallier ses limitations. En particulier, un nouveau modèle de paramétrisation et de simulation rapide de la réponse en énergie du système de calorimétrie est présenté dans ce manuscrit. Ce modèle, toujours en développement, montre des résultats très encourageant pour la simulation d’événements à pion unique et permet de réduire considérablement l’empreinte mémoire de la paramétrisation en comparaison avec des versions précédentes de FastCaloSim, tout en permettant aux futures reparamétrisations d’être plus rapides et automatisées. / The research work carried out during this Ph.D thesis has been performed in the context of the ATLAS experiment, one of the four major LHC experiments, and was primarily dedicated to the search for a new chaged heavy gauge boson, called W' and predicted by many extensions of the Standard Model of particle physics. This manuscript presents a search for W' boson decaying into a top and a bottom quark through an effective coupling approach, in the lepton plus jets final states. This search is performed with 20.3 fb−1 of proton-proton collision data, produced by the LHC with a center-of-mass energy of 8 TeV and collected by the ATLAS detector in 2012. Several scenarios are considered where the W boson can couple to left-handed (W'L) or right-handed (W'R) fermions. A multivariate techniques based on boosted decision trees is used to search for an excess of W signal process in the recorded data. No excess is observed beyond the experimental uncertainties for the data analysed so far. A statistical analysis is performed in order to extract exclusion limits on the mass and the production cross section of the particle. Masses below 1.92, 1.80 and 1.70 TeV are excluded, respectively for W'R and W'L bosons taking into account or not interference effects. These exclusion limits on the production cross section are also reinterpreted in terms of exclusion limits on the effective coupling g'/g of the particle. The lowest exclusion limits observed on the ratio g'/g are equal to 0.20 and 0.16, respectively, for W'R and W'L searches, and are obtained for a W'R/L mass of 0.75 TeV. A search for charged Higgs boson decaying into a top and a bottom quark is presented in this manuscript. This search is based on an effective coupling approach describing a type II Two Doublet Higgs Model. It reuses the analysis infrastructure developed for the W' search and is completed by phenomenological studies related to the production cross section calculation for the process and the characterisation of the resonance width effects affecting the analysis. Preliminary results on the excluded cross section limits pp → H+→ tb show that the analysis is not able to exclude a signal a H+ boson for all theoretical scenarios considered, due to low production cross sections predicted. In parallel of these activities, several developments have been performed on the fast simulation of the ATLAS calorimeter system in order to overcome its limitations. In particular, a new parametrisation and fast simulation model for the energy response of the calorimeter is presented in this manuscript. This model, still under development, shows encouraging results for simulated single pion event and allows to reduce considerably the memory footprint of the parametrisation compared to previous versions of FastCaloSim, while enabling future reparametrisations to be faster and automated.

Problématique : L’amélioration de l’accessibilité financière aux soins de santé est essentielle pour réduire la morbidité et de la mortalité infantile dans les pays à ressources limitées. Cependant, les preuves disponibles sur la relation entre un accès accru aux soins et l’amélioration la santé infantile, dans le long terme, demeurent insuffisantes et parfois inconnues. Dans le contexte spécifique de la région du Sahel au Burkina Faso où les niveaux élevés de morbidité et de malnutrition coïncident avec un faible recours aux soins, une intervention de santé publique associant la gratuité des soins à l’amélioration de la qualité des soins et à la prise en charge de la malnutrition dans la communauté a été mise en œuvre en septembre 2008. Objectifs : En utilisant des approches statistiques et épidémiologiques appliquées aux données transversales et de séries chronologiques, cette thèse vise à apporter une meilleure compréhension de la façon dont la présence de l’intervention dans les communautés peut augmenter et maintenir l’utilisation des services de santé à long terme et améliorer la santé des enfants de moins de cinq ans. Les objectifs spécifiques sont : 1) évaluer le maintien à long terme des effets de l’intervention sur l’utilisation des services de santé chez les enfants de moins de cinq ans, 2) évaluer l’effet contextuel de l’intervention, quatre ans après le début de sa mise en œuvre, sur la probabilité de survenue d’une maladie et sur la probabilité d’utilisation des services de santé chez les enfants de moins de cinq ans, et 3) évaluer l’effet contextuel de l’intervention, quatre ans après le début de sa mise en œuvre, sur le retard de croissance chez les enfants de moins de cinq ans. Méthodes : Les données proviennent du système national d’information sanitaire, d’une enquête rétrospective sur les services de santé ainsi que d’une enquête de ménages réalisée quatre ans après le début de l’intervention dans 41 villages du district d’intervention et 51 villages du district de comparaison. Nous avons utilisé un plan quasi expérimental à séries temporelles interrompues avec groupe de comparaison pour évaluer les effets immédiats et à long terme de l’intervention sur les taux d’utilisation des services de santé. Ensuite, un plan d’étude transversale post-intervention avec un groupe de comparaison nous a permis d’évaluer l’effet contextuel de l’intervention sur la probabilité de survenue d’une maladie, sur la probabilité d’utilisation des services de santé et sur le retard de croissance chez les enfants de moins de cinq ans. La stratégie analytique a combiné la méthode de pondération par les scores de propension pour équilibrer les covariables entre les deux groupes, la modélisation binomiale négative à effets mixtes, les régressions linéaire et logistique multiniveaux. Résultats : L’intervention de gratuité des soins associée à l’amélioration de la qualité des soins et à la prise en charge de la malnutrition dans la communauté était associée à l’augmentation et au maintien de l’utilisation des services de santé au-delà de quatre ans (ratio des taux d’incidence = 2,33 ; IC 95 % = 1,98 – 2,67). En outre, comparativement aux enfants vivant dans le district de contrôle, la probabilité d’utiliser les services de santé était de 17,2 % plus élevée chez les enfants vivant dans le district d’intervention (IC 95 % = 15,01–26,6) ; et de 20,7 % plus élevée lorsque l’épisode de maladie était sévère (IC 95 % = 9,9–31,5). Ces associations étaient significatives, quels que soient la distance par rapport aux centres de santé et le statut socio-économique du ménage. Par ailleurs, alors que le contexte de résidence expliquait 9,36 % de la variance du retard de croissance (corrélation intraclasse = 9,36 % ; IC 95 % = 6,45–13,38), la présence de l’intervention dans les villages n’explique que 2 % de la variance du retard de croissance. Cependant, nous n’avons pas pu démontrer que la présence de l’intervention dans les communautés était associée à une réduction de la probabilité de survenue d’un épisode de maladie (Différentiel des probabilités = 4.4 ; IC 95% = -1.0 – 9.8), ni à une amélioration significative de l’état nutritionnel des enfants de moins de cinq ans (RC = 1,13 ; IC 95 % = 0,83–1,54). Conclusion : Cette thèse souligne que la gratuité des soins associée à l’amélioration de la qualité des soins et à la prise en charge de la malnutrition dans la communauté est efficace pour augmenter et maintenir l’utilisation des services de santé et réduire les inégalités géographiques de recours aux soins. Cependant, cette intervention n’était pas associée à une amélioration des résultats de santé infantile. Bien que des études longitudinales rigoureuses soient nécessaires pour comprendre pleinement l’influence potentielle de cette intervention sur la morbidité, cette thèse plaide pour la nécessité d’agir simultanément sur les autres déterminants sociaux de la santé et d’intégrer, de manière synergique, des interventions spécifiques à la nutrition pour plus d’impact sur la santé infantile. / Introduction: Improving financial access to health care is believed to be essential for reducing the burden of child morbidity and mortality in resource-limited settings, but the available evidence on the relationship between increased access and health remains scarce and the long-term issues are still unknown. In the specific context of the Sahel region in Burkina Faso where high levels of morbidity and malnutrition coincide with low health care use, a pilot intervention for free health care including quality of care improvement and management of malnutrition at the community level was implemented in September 2008. Objectives: Using statistical and epidemiological approaches applied to cross-sectional and time series data, this thesis aims to provide a better understanding of how the presence of intervention in communities can increase and maintain long-term use of health services and improve the health of children under five years. The specific objectives are: 1) to evaluate the long-term effects of the intervention on the use of health services in children under the age of five, 2) to estimate the contextual effect of intervention on the probability of occurrence of and the likelihood of health services being used by children under five, four years after the start of its implementation, and 3) to evaluate the contextual effect of the intervention on stunting in children under five, four years after the start of its implementation. Methods: The data for the analyses were provided from a variety of sources including the national health information system, a retrospective health services survey, and a household survey conducted four years after the intervention onset in 41 villages in the intervention district and 51 villages in the comparison district. We used a quasi-experimental controlled interrupted time-series design group to analyze the immediate and long-term effects of the intervention on the rate of health services utilization in children under five. Then, a quasi-experimental post-test-only design that included a control group allowed us to evaluate the contextual effect of the intervention on the probability of occurrence of a disease, on the probability of use of health services, and stunting in children under five. The analytic strategy combined the propensity score weighting method to balance the covariates between the two groups, two-level mixed-effects negative binomial, and linear and logistic regression models to account for the hierarchical structure of data. Results: The intervention for free health care including quality of care improvement and management of malnutrition at the community level was associated with an increased and maintained use of health services beyond four years after the onset of intervention (incidence rate ratio = 2.33; 95% CI = 1.98–2.67). In addition, compared to children living in the comparison district, the probability of using health services was 17.2% higher among those living in the intervention district (95% CI = 15.0–26.6); and 20.7% higher when the illness episode was severe (95% CI = 9.9–31.5). These associations were significant regardless of the distance to health centers and the socio-economic status of households. In addition, inequalities in the use of care were less pronounced in the intervention villages compared to those in the control village. Finally, the results also showed that the residence context accounted for 9.36% of the variance in stunting (intra-class correlation = 9.36% ; 95% CI = 6.45–13.38), and only 2% of the variance in stunting was explained by the intervention. However, we could not demonstrate that the intervention in these communities was associated with a reduced probability of an illness occurring (AME=4.4 (95% CI: -1.0 – 9.8), nor with a significant improvement in the nutritional status among children under five (OR = 1.13; 95% CI = 0.83–1.54). Conclusion: This thesis underlines the importance that affordable health care, including quality of care, as well as improving the management of malnutrition at the community level, are effective in increasing and maintaining the use of health services and reduce geographical inequalities in the use of care. However, this intervention was not associated with improved child health outcomes. Although rigorous longitudinal studies are necessary to fully understand the potential influence of this intervention on morbidity, this thesis highlights the need to simultaneously act on other social determinants of health and to synergistically integrate nutrition-specific interventions for greater impact on child health.