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Archive for the ‘decentralisation’ Category
Thursday, January 12th, 2012
Andrew Foster
As the title of this initiative suggests, the notions of rural governance and inclusive growth are often paired in discussions of fiscal and political reform in India and around the world. It is suggested that rural governance and decentralization more generally may be a critical element in ensuring that the benefits of national economic growth are shared broadly across the economy, both between rural and urban areas, and among different groups within rural areas. But while there appears to be some level of consensus about what increasing rural governance means in the context of India, it is less clear what is meant by inclusive growth. This distinction is important because different elements of inclusive growth may be differentially served by increased democratization of rural governance and by fiscal decentralization.
One element of inclusive growth is the notion that the expansion in public resources made possible by higher productivity ought to be widely shared across the population. Even if the primary source of growth is in particular pockets of the economy, concerns of both equity and efficiency would suggest it is not desirable for all public resources to be targeted towards those pockets. Individuals in less rapidly growing areas should also benefit at least in part in terms of better quality health and schooling, functional roads, and access to reliable street lightsy and clean drinking water. Moreover, within rural areas it is important that these benefits be available to all. While fair and equitable distribution of public resources within rural areas is not a necessary implication of rural democratization and fiscal decentralization, increasing evidence from this initiative as well an emerging body of research elsewhere suggests that it in fact can play that role. Rural governance introduces some level of accountability both in terms of stewardship of resources and in terms of ensuring that the interests of numerically large (but poor in terms of social standing or economic resources) groups are accommodated.
But there is another element of inclusive growth, that which is related to whether the benefits of overall productivity expansion result in higher private earnings for all groups within the economy. In short, to what extent will individuals in rural areas and, within rural areas, those not endowed with substantial land or other physical resources, benefit from expanding productivity through access to better paying and more secure employment? This is an active and growing area of research that is also of substantial interest to policy makers. While some would argue that ensuring that new agricultural technologies are in the hands of smaller farmers is sufficient, others place emphasis on the growth of the non-farm sector as a source of employment in rural areas. It has been argued, for example, that in a setting in which villages are relatively isolated, agricultural productivity enhancement increases both land rents and wages and thus results in benefits to both rich and poor. On the other hand as a village becomes more integrated this may no longer be the case. Because land does not move but workers and investment capital do move, the local wage may respond slowly if at all to local agricultural productivity increases and thus most benefits of such growth will accrue to land-owning households. Moreover increased mechanization may displace workers as well as decrease the cost advantage of small farms that rely primarily on family labor, thus lowering wages and the financial viability of small farms. From this perspective investment and support of employment that is not intensive in the use of land can be a key mechanism to reduce rural inequality. Investment in particular in non-farm activities that make use of local agricultural inputs may be particularly helpful as it ensures that expanding agricultural productivity (which will depress local non-labor input costs) translates into better rural jobs.
The role of fiscal decentralization and rural governance reform in expanding rural earnings growth is less clear. Certainly such things as providing better schools increase the potential for good-quality employment both within the village and as a result of migration to urban areas. Migration also may have favorable effects on those not moving by reducing labor supply and through remittances that expand local incomes and increase the demand for local services. Also an adequate and fair basis for policing and dispute resolution can help to ensure that property rights are secure and thus increase the scope for the efficient allocation of financial assets towards non-farm activities. But many things that might otherwise promote growth in employment in rural areas such as more competitive financial markets, reliable power for businesses, and better access to markets appear to be beyond the scope of the governance of single villages. If the rural areas are to be successful in this latter regard, it is through working together to ensure that the interests of the rural poor are met in terms of promoting the competitiveness of rural economic activity. But if so, rural governance must be thought of as an integral part of a larger political system rather than an isolated entity that serves to ensure that the spoils of wider economic growth are equitably distributed.
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Andrew Foster is the Professor and Chair of the Department of Economics and Professor of Community Health at Brown University.
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Tags: Decentralization, Fiscal Reforms, Inclusive Growth, Inclusive Growthin India, Rural Economy, Rural Governance
Posted in decentralisation, government, Inclusive Growth, Inclusive Growth in India, Rural Development, Rural Economic growth, Rural Governance | 10 Comments »
Tuesday, July 26th, 2011
Sohini Paul
The world has never yet seen a truly great and virtuous nation because in the degradation of woman the very fountains of life are poisoned at their source. ~Lucretia Mott
Gender discrimination is a devastating reality in developing countries. Women are oppressed at home, at shops, and at the workplace. India is no exception. Women are dependent on family and kinship to access social goods and economic opportunities. The Government of India has passed several laws to protect women’s constitutional rights including the Hindu Succession Act (1956) and the Dowry Prohibition Act (1961). In addition, the government has provided several welfare measures to empower women that include the Indira Mahila Yojana (1995), the DWACRA Plan (1997) and Balika Samriddhi Yojana (1997). Monitoring the implementation and effectiveness of these programs at the national level is not an easy task. In such a scenario, the process of decentralisation would be a good solution for women particularly when they are linked to democratisation. Local institutions should have a better understanding of the problems of women at the village level compared to institutions at the central level. Thus, decentralisation has the potential to address the interests of women.
The Indian government has introduced a quota for women within the local government system, ideally to break down the traditional and cultural inequities working as barriers against women. The conjecture is the following: elected women leaders may have immense potential to encourage the women of the village to raise their voices and demand their rights in a direct or indirect manner. They may approach village women actively as a friend/neighbour or village women may be inspired by the boldness of the woman leader. This would empower local women. Though it is difficult to quantify empowerment, prioritising women issues and voicing them through political participation are important indicators of empowerment.
In 1992, the 73rd and 74th constitutional amendments were enacted, leading the way for democratic grassroots governance. Thirty-three per cent of the seats at the local government level are reserved for women. It is important to note that the process of allocating reserved constituencies is random. After the women quota system was introduced in village councils (panchayats), approximately one million women have joined the elected local government bodies. However, the effective participation of women in local governance is ambiguous. It is argued that elected women may be proxies for their husbands, families or male leaders of political parties. They may get hardly any opportunity to work due to their lack of political experience and traditional social barriers. On the contrary, empirical studies have found that political participation among women has improved through their active participation in ‘gram-Sabha’ meetings. A study by Deininger, Jin and Nagarajan has pointed to increased willingness to contribute to the provision of local public goods in reserved villages. The question now is whether “women issues” receive priority in the ‘reserved’ villages.
Political reservation may have a stronger impact on women-centric issues, especially on the use of birth control measures as well as the health of girl children. In a ‘discriminating’ society, the onus of contraceptive use often falls on the women of the family. For example, the proportion of male contraceptive use in developing countries is significantly lower than the proportion of female contraceptive use. Approximately 70% of the contraceptive couples depend on female methods in poor countries. The ratio of female to male sterilization was 3 to 1 in China and 4 to 1 in Latin America (UN Report 2004, World Population Prospects). The use of contraceptives or non-use of any measure takes a huge toll on women’s health. High levels of fertility cause many of the health problems women face. Repeated termination of unwanted pregnancies through abortions also has a negative impact on her health. Does the pattern of use of contraception change in the ‘reserved’ villages?
Data collected by the National Council of Applied Economic Research in the Rural Economic and Demographic Survey suggests that the mode of contraceptive use changed towards male methods over time and varied across reserved vs. unreserved villages. The proportion of males using condoms is higher by 7 points in ‘reserved’ villages compared to ‘unreserved’ ones. In contrast, the proportion of women going for sterilisation is 53% in the ‘unreserved’ villages while it is 44% in the reserved villages. There is, therefore, a more equitable distribution of males and females in the adoption of contraceptive use when the village Panchayat leadership is ‘reserved’ for women.
Trends over time suggest that the use of contraceptives has increased after political reservation. However, there is a sharp decline in the use of women-centric methods of birth control. The pattern is not uniform across different ‘disadvantaged’ groups. For instance, women belonging to scheduled caste households increasingly share the burden of using contraceptives relative to women from other castes.
To summarise, there is enough empirical evidence to suggest that political reservation for women has a positive impact on diversification of fertility control choices. The process of change, however, may be slow as changes in any behaviuoral pattern are usually slow.
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Dr. Sohini Paul is a Fellow at NCAER, New Delhi.
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Tags: decentralisation, Gender discrimination, Political Reservation, The Hindu Succession (Amendment) Act, Women Empowerment in Rural India
Posted in Gender discrimination, government, panchayat, People, Political Reservation, Reservation, Rural Development, Rural Governance, Rural Health Service | 10 Comments »
Monday, May 2nd, 2011
Sonalde Desai
Studies of social capital have emphasised the subjective beliefs necessary to support strong networks of social ties and organisational memberships. Higher levels of confidence in the system’s institutions and trust in one’s fellow citizens facilitate the social interactions that build a strong civil society. The India Human Development Survey, a nationwide survey of 41,554 households conducted in 2004-2005 by researchers from University of Maryland and NCAER asked respondents how much confidence they had in 10 important institutions in Indian society (“a great deal of confidence,” “only some confidence,” or “hardly any confidence at all”). The analysis revealed that the principal division was between households that responded that they had “a great deal of confidence” and households that responded otherwise.
The most confidence was reported for banks (90%) and the military (87%), followed by schools (69%), hospitals/doctors (63%), courts (55%), newspapers (38%), panchayats and nagarpalikas (34%), the state government (27%), police (23%), and politicians (11%).
Low level of confidence in political institutions is striking but within that, respondents have far greater confidence in systems closest to them, i.e. the panchayats and nagarpalikas compared state governments. Politicians, when referred to in abstract, seem to enjoy the lowest level of confidence. This suggests a great potential for panchayats to serve as a nucleus for civil society.
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 Dr. Sonalde Desai is a Senior Fellow at NCAER, New Delhi.
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Tags: confidence, government, Political Institution, trust
Posted in decentralisation, government, People, Rural Governance, trust | 16 Comments »
Wednesday, February 9th, 2011
Hans P. Binswanger-Mkhize
The vision: During the immediate post-independence period, India developed the theory of ARD decentralization that is still valid today. It includes four key elements that contribute to positive agricultural and rural development: (i) community participation, (ii) decentralization, (iii) autonomous institutions at local and community level, and (iv) the application of modern agricultural technology. Global evidence shows that the vision has tremendous value in revitalizing the rural sector.
Positive international experience: Decentralization and increased popular participation are desirable not as ends in themselves, but because it has been observed that decentralization results in a wide spectrum of benefits. Among the benefits are: (i) enhanced transparency, (ii) enhanced government responsiveness as a result of increased accountability, (iii) reduced absenteeism, (iv) improved services at no extra cost, and (v) an improved quality of government outputs because local preferences are considered.
In the Philippines and Uganda, citizens perceive more corruption at central levels rather than at the local levels where peoples’ participation is wider (Azfar et al, 2000). Panel data of 30 countries shows clearly that entrenched, centralized political and bureaucratic cultures are the most significant determinants of corruption (Ivanyna and Shah ,2010). In a number of countries decentralization and community participation has led to quality improvements, costs savings, and the more timely completion of infrastructure projects, in particular. There are many types of examples from all parts of the world that support this general observation (Binswanger et al. 2010, Sud, 2010, and Bardhan, 2002).
In India decentralization and participation are still lagging after sixty years: In 1992/93, India’s central government took a major step towards greater decentralization, with the passage of the 73rd and 74th Amendments to the Constitution. Nearly two decades after their passage, progress has been very slow, with half-hearted and very partial actions by most state governments. The delegation of increased responsibilities at lower levels of government has often not been accompanied by the granting of any significant autonomy. The fiscal system devolves less than five percent of the overall fiscal resources to local governments; and almost no revenue generation and functionaries; the design of India’s central and centrally sponsored schemes centralizes power in the ministries at the national and state level, effectively clawing back the powers that were to be devolved.
While community participation is advocated in most programs, full transfer of functions and funds to communities occurs rarely, and most programs, in design or practice, also claw back powers to higher level administrators. Therefore local governments and communities cannot function as intended, and their lack of performance, and even lack of interest, is then cited as a reason to continue to manage things for them. As a result, agricultural and rural development remains deeply centralized, with sectoral silos that have led to serious difficulties in service delivery. The plethora of centrally-sponsored schemes in India has rendered local governments and their citizens into chasers of grants and favours, and created a generalized system of bribes to access them that is so well described in the movie “Well done, Abba.”
Reforming dysfunctional rural development institutions involved a return to the four principles above:
India has been a pioneer in articulating a strong vision for decentralization and people’s participation in agricultural and rural development. It is time for India to finally translate its own vision into reality. The Second Administrative Reforms Commission, the Finance Commission, and the Planning Commission provide a full set of recommendations on how to move from decentralization as an intention to decentralization in reality. A key reform agenda would include:
1. Centrally-sponsored schemes need to be consolidated into block grants, as long recommended. Block grants should be directed at local governments, not line agencies, with sharing rules among levels of local government and with communities.
2. Further decentralization would include the transformation of local governments to independent tiers of government; strengthening of administrative decentralization and of horizontal and downwards accountability; and increasing revenue-raising and co-financing at all levels; otherwise efforts are likely to neither promote efficiency nor good governance.
3. A clear plan of action is needed. It will have to include practical ways to implement the already available recommendations of the various commissions, as well as political tactics to overcome resistance from central and state politicians and agencies. Advocacy from the highest level and a training program are needed to change the attitudes of the IAS officers and other central and state cadres to decentralization. The plan needs to involve the Interstate Council, local governments, progressive chief ministers, and members of civic society.
There are few prior conditions for success of decentralization: Decentralization has occurred in the presence AND the absence of a variety of conditions. For example, decentralization has occurred both with and without: (i) a strong middle class; (ii) prior land redistribution; (iii) a high human development index; and (iv) a strong civil society. It has occurred in countries that are ethnically diverse oe homogeneous, strife-torn or quiescent; and in countries where social hierarchies and patriarchies are strong or weak. There are few areas of the world in which inequalities are so extreme that decentralization is a dangerous option that should not be considered (Manor, 2009).
Necessary elements for success include: (i) a state that has some minimal capacity; (ii) devolution of substantial powers onto elected bodies at lower levels along with substantial resources; (iii) accountability mechanisms that ensure the horizontal accountability of bureaucrats to elected representatives, and the downward accountability of elected representatives to ordinary people (Manor, 2009). A widely shared consensus is that success depends on the details of implementation and rigorous follow through.
Conclusion :
India has been a pioneer in formulating a strong vision for decentralization and increased people’s participation in agricultural and rural development. The vision is over sixty years old and in many countries has proven to be of tremendous value to revitalizing lagging agricultural and rural development sectors. It is essential for India that now the vision be translated into reality.
References :
- Azfar, Omar, Satu Kahkonen and Patrick, Meagher. 2000. “Conditions for Effective Decentralized Governance: A Synthesis of Research Findings.” IRIS Center Working Paper, University of Maryland
- Bardhan, Pranabh, 2002, Decentralization of Governance and Development, Journal of Economic Perspectives, Volume 16, Number 4: 185–205
- Binswanger-Mkhize, Hans P., Jacomina de Regt, and Stephen Spector, 2010, “Local and Community-Driven Development: Moving to Scale in Theory and Practice,” New Frontiers in Social Policy, Washington DC, World Bank
- Ivanyna, Maksym and Anwar Shah, 2010, Decentralization (Localization) and Corruption: New Cross-country Evidence, The World Bank, Policy Research Working Paper 5299
- Manor, James, 2010, Perspectives on Decentralization, Keynote Address at the IFPRI-University of Kiel Workshop on Government Decentralization Research, Washington DC, February 3-4
- Sud, Inder. 2010 “Governance for a modern society: Combining smarter government, decentralization and accountability to people” in Kohli and Sood (eds). 2010. India 2039: An affluent society in one generation. Manila: Asian Development Bank.
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1 The highest shares of public resources controlled by local governments in the developing world are: China (51%), Poland (38%), South Africa (28%), Uganda (25%), Indonesia (23%), and Brazil (20 %). These numbers stand in marked contrast to most sub-Saharan African countries (an average of around 5%), and India (3-4%).
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Hans P. Binswanger-Mkhize is Professor Extraordinaire at the Institute for Economic Research on Innovation, Tshwane University of Technology, South Africa and a Senior Fellow of Amsterdam Institute for Development.
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Tags: Rural Development, Rural India, Rural Policy of India Govt.
Posted in decentralisation, panchayat, People, Rural Development, Rural Governance | 25 Comments »
Thursday, January 13th, 2011
Shashanka Bhide
Rural housing has attracted considerable attention in the recent years just as much as the rural markets in general have. In a policy sense, recognition of housing deficiencies was at the centre of several rural development programs. After all, rural India accommodates over 700 million people today. There is of course heterogeneity within the ‘rural areas’; some are fairly large and close to the urban centres. Some are small and remote. There are many in between the spectrum. Some villages are ‘rich’ as the average farm holdings may be large and there is irrigation. Likewise the rural housing needs are also varied depending on the needs of cultivators: e.g space for storage of output and space for livestock. There is no question of rural housing demand not rising as the overall economic growth is taking place. It is also well recognised that improvement and expansion in the rural housing stock would lead to gains in labour productivity and positive health benefits. There are, however, constraints to faster improvements. There are indeed policy measures to relax some of the constraints such as subsidies to the poor or support to drinking water supply schemes; there are also market developments such as innovations that help bring down the cost of house construction. But there is also a central role that the village panchayats ought to play to make a positive difference to the quality of life in rural habitations.
It is now fairly well recognised that demand for rural housing is constrained, among other factors, surprisingly by availability of land for building houses. The rising requirement of land for livelihood over time has meant that there is hardly any ‘common panchayat land’ available for non-agricultural uses, including for housing. Also most government land and forest land in the countryside has also been fairly extensively encroached. Besides the physical availability of land in rural areas for housing, the land problem has yet another dimension: the legal ownership rights to village land are often undefined and unclear. All this essentially means market for land for rural housing is also thin and ineffective. Paradoxically, there are indeed hot land markets in the villages close to the large cities and metros as the urban requirements for land have also increased in the recent years. But this is not the bulk of the rural areas. Housing in rural India is still largely for own use rather than for sale and resale. And one important reason for this again is associated among other things with the problem of transferring ownership rights.
A distinctive aspect of rural housing, which is seldom recognised, is the lack of planning of rural habitations. They probably were planned at some point of time keeping in mind the security aspect besides their being less suitable for cultivation or having better drainage. But growth of population and other economic activities have led to deterioration of the quality of local environment. The problem is particularly acute in low rainfall and unirrigated areas.
The poor state of habitations is an economic problem. Barring some exceptional cases, with community initiatives as in the case of Ralegan Sidhi, or some of the ‘model villages’ there is lack of collective action to improve the overall rural habitat conditions. There are indeed many other civil society initiatives for building better rural houses. The Rural Building Centres fashioned on the success of the initiatives in Kerala have not quite succeeded elsewhere. The rural infrastructure programs do bring in roads, electricity, drinking water and sanitation. But convergence of these various programs with housing and habitation plan is largely missing. The role that panchayats can play in this respect as units of self-government is indeed huge. But as with municipalities, this is largely an issue of capacity and institutional strengths.
To re-iterate, what the rising demand for rural housing has meant is also that village panchayats may have a chance to encourage the kind of housing plans that may improve quality of life for the millions of rural Indians. Financiasl resources for the panchayats are obviously constrained. Village panchayats have not been able to raise adequate revenues from property taxes and therefore not able to do much on improving the quality of habitation. The separation of land record and land revenue functions from the panchayats has meant that the panchayats have taken the state of the habitation as given and whatever improvements have occurred are mainly the outcome of the schemes planned from government bodies above. The prosperity of rural areas has meant better houses for only a few individuals and has not necessarily resulted in better habitation as a whole. The overall income of the panchayats from grants and own resources is still too meager to bring about any significant changes on their own.
There are two directions in which the village panchayats can play a more active role in rural housing development. In one direction, there is a need to strengthen the governance role of panchayats: influencing construction of better houses and in a manner so that the village infrastructure is optimally utilised; the land and property records are improved. This in turn would catalyse the other services- particularly finance- that helps in turning some of the latent demand into effective demand. The second dimension in which the panchayats can play an important role is bringing greater convergence of many of the rural development programs for greater impact. There is a need to develop habitation plan for the villages that sets out the land use and construction guidelines. The latter activity would certainly require making new capacity available. The partnership with the NGOs, private sector and other civil society organisations will remain imperative as in many other rural development programs.
The experience of involvement of the panchayats at different levels in facilitating the implementation of Indira Awas Yojana is important. The role of panchayats has been mainly limited to identifying the beneficiaries who receive the subsidy and then certifying completion of construction so that the final installment of the subsidy is released. In some cases the panchayats also help in identifying land for construction of these houses as many of the beneficiaries are landless. As land is not available in contiguous pieces or blocks, the houses are built wherever land is available. Obviously this is not most efficient in terms of providing infrastructure services. The panchayats also play a major role in facilitating the implementation of drinking water supply and sanitation programs (such as the accelerated rural water supply scheme and the total sanitation program) in the villages; they also facilitate building of rural roads as well as the execution of many other programs of rural development. The housing development perspectives actually provide greater convergence to many of these services as location of houses or new houses can be planned with reference to the various services.
The village panchayats have yet another responsibility in modernising rural habitations. Their intimate knowledge of local needs, people and local conditions make them pre-eminently credible facilitators. The property tax on houses should become a major source of own revenue for the panchayats over time. As it is often said, it may be easier to collect the taxes if the tax payers see the benefits- in the form of better amenities. The PRIs should levy property taxes to improve the quality of habitations.
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 Shashanka Bhide is the Senior Research Counsellor and a Senior Fellow at the NCAER, New Delhi.
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Tags: decentralisation, Role of Panchayat in Housing Problem, Rural Housing, Rural Housing Problem in India, Rural India
Posted in decentralisation, panchayat, Role of Panchayat in Rural Housing, Rural Governance, Rural Housing, Rural housing problem, Rural Housing Problem in India, service delivery in rural India | 33 Comments »
Monday, May 17th, 2010
D.B.Gupta
A major problem currently engaging the attention of health professionals concerns the low efficiency and poor quality of health service delivery in the health sector in rural India. This is despite a fairly well developed rural health infrastructure. Highly centralised health services with very little local autonomy either over programmes or over resources is regarded as one of the major contributory factors for poor service delivery owing to the following two typical problems:
(a) the unresponsiveness of health services to local needs, and
(b) staff assigned – rotated and paid with little relationship to output of services and/or patient satisfaction – are often inadequately or under-trained, ill-equipped and frequently, as a consequence indulging in private practice.
In order to improve the quality of health service delivery in publicly run health care facilities and to mitigate the problems associated with centralisation two significant initiatives of the government are worth mentioning: (a) Increasing reliance on user fees with varying degrees of control over the utilisation of revenues generated through user fees. This is usually done to provide greater flexibility to health care functionaries in funds utilisation for emergent or other similar needs, not otherwise provided in the budget, and (b) Devolution of central responsibilities to lower levels of government (district, block, village levels) such as the Panchayati Raj Institutions.
Although the Panchayati Raj has been the system of democratic representation of the community at three levels (the village, block, and district) almost since the late 1950s, it was only in 1993 that the PRIs were incorporated into the Constitution, and health, sanitation, and family welfare at the local level fell under their jurisdiction. Thus local self-government became the main vehicle for community participation in the delivery of services.
Linking of the health sector with the Panchayati Raj system is a complex chain process involving numerous stakeholders. Our experience in this context so far is mixed. The PRIs have often been dominated by the local elite, obstructed by the politicians at the state level, and have mostly been seen as advisory rather than decision making. Allocated financial resources, often inadequate, are usually governed by tied budget lines, leaving little flexibility at the local level to meet the specific needs of the local populations. However, based on a recentl a review of Union health budget, a new budget line was introduced which provides flexibility in the use of at least a part of the health budget (pattern of funding in the recently launched NRHM).
The PRIs and the Health sector – Working and the lessons learned
There are a number of studies that help us get some idea of what has worked and what has not worked. A recent study, using the empirical evidence from India shows that fiscal decentralisation plays a significant role in reducing infant mortality rate in India. The study further shows that the effectiveness of fiscal decentralisation can be affected by other complementary factors such as the level of political decntralisation. States which have good fiscal and political decentralisation index are twice more effective in reducing IMRs than states with high fiscal but low political decentralisation index.
A study of Karnataka experience found that creation of elected councils (at local level) have helped in reducing absenteeism and in enhancing employees’ work rate when they were on the job, although they felt that these achievements sometimes tend to be exaggerated. It si also suggested that moral pressure from councils at both district and block levels have been more important than formal disciplinary action. The power of district councils to move formally against civil servants was limited in that they could suspend but not dismiss. A study of West Bengal shows that the panchayats have helped, among other things, in efficient and cost effective implementation of several rural development programmes including the construction of health centres.
In yet another field based study linking primary health care and PRIs in the states of Gujarat, Maharashtra, Karnataka, and West Bengal it is seen that there is a definitive role for PRIs in improving the quality of health care services. It shows that PRIs have a significant role in improving the functioning of the health care system at the local level.
All evidence clearly suggests the positive role of PRIs in improving the quality of health care services, especially through ensuring better attendance of health care functionaries at the local level, as well as exerting moral pressure on health staff not to shirk from work. Also watchful participation of local communities has contributed in some measure in improving the supplies of drug and equipment by assisting the local health staff by bringing the deficiencies in the supplies to the attention of higher authorities. In addition the PRIs can play a significant role by assuming responsibilities of monitoring and supervision in preventive health care. The PRIs have yet another role which they are capable of playing; this concerns participation in programmes of health education and awareness creation.
There is however a serious concern in a situation where different political parties have control over the state administration and the administration of the PRIs. Thus, some amount of caution is needed in devolving powers to the PRIs. Another serious issue is related to financial resources with the PRIs. As is well know the PRIs have very limited financial resources of their own, and hence hugely dependent on grants, etc. Until the PRIs are empowered with financial resources, their involvement in strengthening health service delivery will remain only supplementary rather than decisive.
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 Prof. D.B.Gupta, a PhD from University of Birmingham, UK has been an active development economist for more than 40 years. He has taught at a number of universities and institutions in India and abroad and has worked extensively with the World Bank, UNICEF, WHO, Institute of Economic Growth, NIPFP, NCAER and similar organisations.
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Tags: decentralisation, Health Services
Posted in decentralisation, Health Services, panchayat, Resources, Rural Governance, Rural Health Service | 73 Comments »
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