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Governance of communicable disease control services : a case study and lessons from India

  • Das Gupta, Monica
  • Khaleghian, Peyvand
  • Sarwal, Rakesh

The authors study the impact of governance and administrative factors on communicable disease prevention in the Indian state of Karnataka using survey data from administrators, frontline workers, and elected local representatives. They identify a number of key constraints to the effective management of disease control in India, in misaligned incentives, and the institutional arrangements for service delivery. The authors discuss these under five headings: administrative issues; human resource management; horizontal coordination; decentralization, community involvement, and public accountability; and implementation of public health laws and regulations. They find that India's public health system is configured to be highly effective at top-down reactive work, such as bringing disease outbreaks under control, but not for the more routine collaborations required for proactive disease prevention. The authors conclude with policy recommendations that take into account the complexity of India's system of public administration and the need for simple reforms that can be easily implemented.

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Paper provided by The World Bank in its series Policy Research Working Paper Series with number 3100.

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Date of creation: 31 Jul 2003
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Handle: RePEc:wbk:wbrwps:3100
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  1. Samuel H. Preston & Michael R. Haines, 1991. "Fatal Years: Child Mortality in Late Nineteenth-Century America," NBER Books, National Bureau of Economic Research, Inc, number pres91-1, August.
  2. McMillan, Della E. & Meltzer, Martin I., 1996. "Vector-borne disease control in sub-Saharan Africa: A necessary but partial vision of development," World Development, Elsevier, vol. 24(3), pages 569-588, March.
  3. Gauri, Varun & Khaleghian, Peyvand, 2002. "Immunization in Developing Countries: Its Political and Organizational Determinants," World Development, Elsevier, vol. 30(12), pages 2109-2132, December.
  4. Tendler, Judith & Freedheim, Sara, 1994. "Trust in a rent-seeking world: Health and government transformed in Northeast Brazil," World Development, Elsevier, vol. 22(12), pages 1771-1791, December.
  5. Samuel H. Preston, 1980. "Causes and Consequences of Mortality Declines in Less Developed Countries during the Twentieth Century," NBER Chapters, in: Population and Economic Change in Developing Countries, pages 289-360 National Bureau of Economic Research, Inc.
  6. McGuire, James W., 2001. "Social Policy and Mortality Decline in East Asia and Latin America," World Development, Elsevier, vol. 29(10), pages 1673-1697, October.
  7. Filmer, Deon & Pritchett, Lant, 1999. "The impact of public spending on health: does money matter?," Social Science & Medicine, Elsevier, vol. 49(10), pages 1309-1323, November.
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