企業著眼於國際市場機會進行國際化的同時，面臨到不同的阻礙，過去國際化的理論討論到影響國際化的速度、進入模式、國家選擇等的各種因素，但隨著產業的型態改變，以及進入國家的不同，國際化的歷程或是成功因素可能因而有所差異。因此，本研究欲探討電子商務在國際化的過程中，特別是進入新興市場國家時，由於電子商務尚未成為主要消費模式，電商企業的國際擴張將會受到哪些因素影響，不同於過去生產導向的國際化歷程，這些障礙又能夠如何被克服。過去學者曾討論外來者劣勢在企業國際化中的影響，但並沒有探討是否適用電商產業，由於產業特性的不同，以及母國市場與進入市場的差異，過去學者提出企業外來者的身份在新市場中面對外來者劣勢，然而，隨著電子商務產業的出現，亦有學者提出局外人劣勢才是新型網路企業在國際化中的主要劣勢，因此，本研究針對過去學者提出的從外來者劣勢（Liability of Foreignness）、局外人劣勢（Liability of Outsidership）出發，結合企業專屬優勢（firm-specific advantage）以及創新擴散理論（Diffusion of Innovations Theory），針對國內外共四家電商業者，採用深度訪談法歸納研究結果。研究結果發現雖然電子商務相較於一般企業在進行國際化初期，主要仍受到外來者劣勢影響，方能順利進入市場去處理身為局外人所帶來的劣勢，透過創新擴散理論的資訊溝通方式以及企業本身的專屬優勢，則可以有效降低進入所遇到的障礙，達到企業在東南亞市場成長的目標。 / During internationalization, firms seek growth opportunities in global markets, while being faced with various sources of obstacles and disadvantages. Previous researches and theories discuss the factors that influence the speed of internationalization, mode of entry, and country selection. However, with the change of industry, and the difference types of countries that are entered, the process of internationalization and the factors that influence the success might vary. As a result, the research aims at clarifying the variables that influence the internationalization of ecommerce corporations, especially when entering emerging markets. In the research, structured interviews were conducted to gain deeper understanding of the internationalization of 4 e-commerce firms. Our findings is that in emerging markets, e-commerce has not become the main stream; therefore, firms need to deal with both liability of foreignness and liability of outsidership because of the new technology and the role as a foreigner in the market. With the firm-specific advantages and the usage of online media and opinion leaders in the countries, e-commerce corporations are more likely to offset the liability that stems from foreignness and outsidership. However, the research shows that the liability of foreignness is more important and urgent for firms to overcome than liability of outsidership. Our research conceptualizes the framework for e-commerce internationalization and provides empirical evidence for the entry and growth in emerging markets.

Contexte : La mauvaise qualité et la faible utilisation des services de santé contribuent aux taux élevés de morbidité et de mortalité dans plusieurs pays à faible et à moyen revenu. Face à cette situation, le gouvernement du Burkina Faso a testé une intervention novatrice qui combine le financement basé sur la performance (FBP) à des mesures d'équité en santé. Les formations sanitaires ont reçu des prix unitaires pour des services de santé fournis ainsi que des bonus conditionnels à la qualité des soins. Des comités communautaires ont sélectionné les indigents pour leur octroyer des exemptions de paiements des soins. Malgré le peu d’études sur le sujet, des acteurs en santé mondiale craignent que l’intervention puisse avoir des conséquences non intentionnelles importantes. Objectif : Cette thèse vise à accroître les connaissances scientifiques sur les conséquences non intentionnelles du FBP combiné à des mesures d'équité en santé dans un environnement à faible revenu. Méthodes : Nous avons développé un cadre conceptuel basé sur la théorie de la diffusion des innovations. Une étude de cas multiples a été réalisée avec neuf formations sanitaires au Burkina Faso. Cinq mois sur le terrain ont permis d’effectuer 104 entrevues semi-structurées, 266 séances d'observation et des conversations informelles avec un large éventail d'acteurs incluant les prestataires de soins, les patients et les vérificateurs. Les données qualitatives ont été codées avec QDA miner pour faciliter l’analyse thématique. Nous avons également utilisé des données quantitatives du système de gestion pour décrire l'évolution des services et trianguler les résultats. Résultats : La nature et la mise en œuvre de l'intervention ont interagi avec le système social et les caractéristiques de ses membres pour engendrer des conséquences non intentionnelles importantes, dont la plupart étaient indésirables. Les prestataires de soins ont démontré une fixation sur les mesures de rendement, ont falsifié les registres médicaux et ont enseigné de mauvaises pratiques aux stagiaires pour augmenter leurs subsides et bonus. Comme conséquence non intentionnelle désirable, certaines formations sanitaires ont limité la vente de médicaments sans prescriptions pour encourager les consultations. Les vérifications communautaires, durant lesquelles les patients sont retrouvés pour vérifier les services déclarés, ont entraîné la falsification des données de vérification, la perte de la confidentialité des patients et certaines craintes chez les patients, bien que certains étaient heureux de partager leurs opinions. Enfin, les prestataires de soins ont limité les services offerts gratuitement aux indigents, ce qui a déclenché des conflits. Discussion : Cette thèse contribue au développement des connaissances scientifiques sur la façon dont le FBP, combiné à des mesures d'équité, peut engendrer des conséquences non intentionnelles. Les résultats sont utiles pour affiner ce type d’intervention et éclairer une mise en œuvre efficace dans le secteur du financement de la santé. Plus largement, cette thèse démontre la faisabilité et la valeur ajoutée d'utiliser un cadre conceptuel pour étudier les conséquences non intentionnelles. Elle pourra guider les chercheurs à élargir leur angle d’analyse afin de rendre compte des conséquences intentionnelles et non intentionnelles des interventions complexes en santé. / Background: Poor quality and low utilization of healthcare services contribute to high levels of morbidity and mortality in many low- and middle-income countries (LMICs). In response, the government of Burkina Faso tested an innovative intervention that combines performance-based financing (PBF) with health equity measures. Healthcare facilities received unit fees for targeted services and bonuses conditional upon the quality of care. To reduce inequities in access to care, community-based committees selected indigents, i.e., the poorest segment of the population, to offer them user fee exemptions. Facilities were also paid more for services delivered to indigents. Despite the potential of this type of intervention, many global health actors argue that it could lead to important unintended consequences that influence its overall impact. Yet, little attention has been given to studying the unintended consequences of this complex intervention. Objective: This thesis aims to increase the scientific knowledge on the unintended consequences of PBF combined with health equity measures in a low-income setting. Methods: We developed a conceptual framework based on the diffusion of innovations theory. Using a multiple case study design, we selected nine healthcare facilities in Burkina Faso. Over five months of fieldwork, we collected multiple sources of qualitative data including 104 semi-structured interviews, 266 recorded observation sessions, informal conversations and documentation. Participants included a wide range of stakeholders, such as providers, patients, and PBF verifiers. Data were coded using QDA miner to conduct a thematic analysis. We also used secondary data from the PBF routine management system to describe the evolution of services and triangulate results. Results: Interactions between the nature and implementation of the intervention, the nature of the social system, and its members’ characteristics led to important unintended consequences, most of which were undesirable. Providers were fixated on performance measures rather than on underlying objectives, falsified medical registers, and taught trainees improper practices to increase subsidies and bonuses. As a desirable unintended consequence, we found that some facilities limited the sale of non-prescribed medication to encourage patients to consult. Community verifications, in which patients are traced to verify the authenticity of reported services and patient satisfaction, also led to unintended consequences, such as the falsification of verification data, the loss of patient confidentiality, and fears among patients, although some were pleased to share their views. Lastly, health equity measures also triggered changes that were not intended by program planners. For example, providers limited the free services and medication delivered to indigents, which led to conflicts between parties. Discussion: This thesis contributes to the development of scientific knowledge on how PBF interventions, combined with equity measures, can trigger unintended consequences in a low-income setting. The results are useful to inform effective implementation and refine interventions, particularly in the health financing sector. More broadly, this thesis demonstrates the feasibility and added value of using a conceptual framework to study the unintended consequences of complex health interventions. This thesis can inspire and guide future researchers to broaden their analytical horizons to capture both intended and unintended consequences of health interventions.

In the summer of 2007, a single neighbourhood in downtown Toronto contributed at least 13 percent of all residential grid???tie solar photovoltaic (PV) systems sold in the Canadian province of Ontario. On average, PV purchaser households produced 37 percent as much electricity as they consumed. This research investigates solar energy adoption in a community case study. Specifically, it investigates why some residents who sign up for a solar resource assessment through a community solar energy initiative (CSEI) decide to purchase, and others decide not to purchase in the short???term. Characteristics and perceptions of potential adopters are analyzed to better understand their motivations and barriers to adoption. Community energy projects became an official public policy goal in Ontario, with the passing of the Green Energy and Green Economy Act in 2009. Approximately 80 percent of Ontario???s anticipated generation capacity will need to be built, replaced or refurbished within 15 years. In this context, the Ontario Ministry of Energy, Ontario Power Authority, and Deloitte (one of Canada???s leading professional services firms), have partnered with a ???green benefit??? fund, the Community Power Fund, to help local community groups access resources to develop and establish renewable energy projects. Understanding solar energy adoption in a community context is therefore important to improve the effectiveness of such policies, including the disbursement of multi???million dollar grant funds. Differences between purchasers and non???purchasers in respect of adoption behaviour were found in this study to cluster around two general themes. The first theme concerns differences in compatibility of both the concept of solar energy systems, and their physical attributes, with characteristics of potential adopter households. Some compatibility issues are straightforward, e.g. availability of roof space with a southern orientation. Others are more complex, involving several interrelated perceptual and socio???demographic factors. For instance, while both purchasers and non???purchasers rated cost as a very important barrier, purchasers rated the motivation of solar energy systems to reduce climate change higher relative to the barrier of high financial costs than did non???purchasers. Purchasers were also more likely to possess a graduate degree, while non???purchasers were more likely to hold a professional degree. The second general theme relates to potential adopters??? trust and stake in the ability of the community???based initiative to reduce barriers in the adoption process. Since two types of solar energy systems are considered in the case study???PV and thermal (hot water)???differences are explored between each of three respondent groups: solar PV purchasers, solar hot water (SHW) purchasers, and non???purchasers. iv Surveys were used to gather data on adopter perceptions and characteristics. A participatory research design helped identify the research topic. Two main bodies of literature???community???based social marketing (CBSM) and diffusion of innovations theory???were drawn upon to conceptualize the adoption process and interpret the survey findings. These include five models of human behaviour that can be used to guide the design of CBSM campaigns. Diffusion theory was used as a basis for discussing ???perceived innovation attributes???. The study takes an integrated approach by considering both social and technical aspects of solar energy adoption, together with the issues of fuel substitution and household electricity demand.