Publication: Flies without Borders: Lessons from Chennai on Improving India's Municipal Public Health Services
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Published
2020-05
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0022-0388
Date
2020-04-28
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India’s cities face key challenges to improving public health outcomes. First, unequally distributed public resources create insanitary conditions, especially in slums – threatening everyone’s health, as suggested by poor child growth even among the wealthiest. Second, devolving services to elected bodies works poorly for highly technical services like public health. Third, services are highly fragmented. This paper examines the differences in the organisation and management of municipal services in Chennai and Delhi, two cities with sharply contrasting health indicators. Chennai mitigates these challenges by retaining professional management of service delivery and actively serving vulnerable populations − while services in Delhi are quite constrained. Management and institutional issues have received inadequate attention in the public health literature on developing countries, and the policy lessons from Chennai have wide relevance.
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It's main focus in on helping Kenya manage a delicate transition.Publication Governance of Communicable Disease Control Services : A Case Study and Lessons from India(World Bank, Washington, DC, 2003-07)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. 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