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              <p>Depuis quelques années, le champ de l’évaluation des interventions en santé mondiale a vu resurgir le concept de « configuration » à travers le déploiement d’une approche ancrée dans le réalisme critique. Pourtant, ce concept est très ancien et a été largement mobilisé en sociologie, notamment grâce aux travaux de Norbert Elias. Dans ce texte de nature méthodologique et réflexif, nous essayons de montrer, d’une part, ses usages multiples, et, d’autre part, sa pertinence pour l’évaluation des interventions de santé mondiale. Après une analyse de la manière dont la configuration est abordée dans les domaines de la sociologie de la santé, de la sociologie des organisations et de l’évaluation réaliste, nous explicitons son apport heuristique à partir de trois exemples empiriques en santé mondiale. Le texte permet de rendre compte de la myriade d’usages mais aussi des défis de l’approche configurationnelle dans le débat récurrent de la généralisation et de la causalité en évaluation.</p>
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