Bottom's up: to the role of Panchayati Raj Institutions in health and health services (original) (raw)
India is currently witness to two trends that have the potential to significantly improve the health of its people. The first is the growing recognition that the system of public delivery of health services is in crisis. The second trend is India's bold efforts to strengthen the voice of the rural poor through decentralization to local governments. This paper argues that these two ostensibly separate trends can converge to generate real reform in the health sector in India through the potential for increased accountability that local governments can provide. The paper is structured as follows: Section I begins with some prefatory remarks setting the context for discussion of health, health care and health policy in India, which is necessary to understand the role that decentralized decisionmaking can play. To make the policy options concrete we briefly review two broad categories of health policy; Section II addresses the problem from the view of standard economic analysis; Sect...
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