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Political agency and public healthcare: Evidence from India

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  • Joan Costa-Font
  • Divya Parmar

Abstract

The development of institutions of self-governance in India, and specifically the 2005 reform—the National Rural Health Mission that introduced village health and sanitation committees—provide a unique opportunity to study the effects of the strengthening of the political agency on collective healthcare decision-making in rural areas. We use data from the District Level Household Survey and take advantage of the heterogeneity of maternal and child healthcare use, before and after the introduction of village health and sanitation committees. Specifically, we examine the effect of village health and sanitation committees on use of both public and preventive healthcare among children. Our results suggest that local democracy has increased access to preventive child healthcare services. Part of the effect is driven by an increase in the utilization of the public healthcare network. We find some evidence of an effect of village residence heads of a Panchayat on preventive healthcare use.

Suggested Citation

  • Joan Costa-Font & Divya Parmar, 2016. "Political agency and public healthcare: Evidence from India," WIDER Working Paper Series 135, World Institute for Development Economic Research (UNU-WIDER).
  • Handle: RePEc:unu:wpaper:wp2016-135
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    References listed on IDEAS

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    1. Betancourt, Roger & Gleason, Suzanne, 2000. "The Allocation of Publicly-Provided Goods to Rural Households in India: On Some Consequences of Caste, Religion and Democracy," World Development, Elsevier, vol. 28(12), pages 2169-2182, December.
    2. Nickell, Stephen J, 1981. "Biases in Dynamic Models with Fixed Effects," Econometrica, Econometric Society, vol. 49(6), pages 1417-1426, November.
    3. Timothy Besley & Rohini Pande & Vijayendra Rao, 2005. "Participatory Democracy in Action: Survey Evidence from South India," Journal of the European Economic Association, MIT Press, vol. 3(2-3), pages 648-657, 04/05.
    4. Singh, Nirvikar, 2008. "Decentralization and Public Delivery of Health Care Services in India," MPRA Paper 7869, University Library of Munich, Germany.
    5. Pranab Bardhan, 2002. "Decentralization of Governance and Development," Journal of Economic Perspectives, American Economic Association, vol. 16(4), pages 185-205, Fall.
    6. Jishnu Das & Alaka Holla & Aakash Mohpal & Karthik Muralidharan, 2016. "Quality and Accountability in Health Care Delivery: Audit-Study Evidence from Primary Care in India," American Economic Review, American Economic Association, vol. 106(12), pages 3765-3799, December.
    7. Santosh Kumar & Nishith Prakash, 2012. "Political Decentralization, Women's Reservation and Child Health Outcomes: A Case Study of Rural Bihar," Working papers 2012-18, University of Connecticut, Department of Economics.
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    More about this item

    Keywords

    decentralization; direct democracy; India; immunization; maternal healthcare; public;

    JEL classification:

    • H70 - Public Economics - - State and Local Government; Intergovernmental Relations - - - General
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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