Governance of Communicable Disease Control Services : A Case Study and Lessons from India
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World Bank, Washington, DC
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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.
Palabras clave
ADMINISTRATIVE CAPACITY, ADMINISTRATIVE FRAMEWORK, ADMINISTRATIVE SYSTEM, ADULT MORTALITY, AGRICULTURAL PRODUCTION, AUTHORITY, BLINDNESS, BUDGETARY ALLOCATIONS, CADRES, CENTRAL GOVERNMENT, CENTRAL GOVERNMENTS, CHILD DEVELOPMENT, CITIES, CITIZENS, COLONIES, CONSTITUTION, CONTAGIOUS DISEASES, CONTRACEPTIVES, CORRUPTION, DECENTRALIZATION, DECISION MAKING, DEVELOPMENT INDICATORS, DISCIPLINARY PROCEDURES, DISEASE CONTROL, DISTRICTS, DRAINAGE, ELECTED REPRESENTATIVES, EMBEZZLEMENT, EPIDEMICS, EXERCISES, EXPENDITURE, EXTENSION, FAMILY PLANNING, FINANCIAL MANAGEMENT, FISCAL, FISCAL CONTROL, GOVERNMENT DEPARTMENTS, GOVERNMENT EXPENDITURES, HEALTH ADMINISTRATION, HEALTH CENTERS, HEALTH INTERVENTIONS, HEALTH OUTCOMES, HEALTH POLICIES, HEALTH POLICY, HEALTH PROGRAMS, HEALTH REGULATIONS, HEALTH SECTOR, HEALTH SERVICES, HEALTH SYSTEM, HEALTH SYSTEMS, HEALTH WORKERS, HOSPITALS, HOUSING, HUMAN RESOURCE, HUMAN RESOURCE MANAGEMENT, HUMAN RESOURCES, HYGIENE, IMMUNIZATION, INCOME, INFANT MORTALITY, INFANT MORTALITY RATE, INNOVATION, INSTITUTIONAL ARRANGEMENTS, ISOLATION, JUDICIARY, LABORATORIES, LACK OF AUTONOMY, LAWS, LEVELS OF GOVERNMENT, LIFE EXPECTANCY, LIVING CONDITIONS, LOW-INCOME COUNTRIES, MALARIA, MANAGERIAL AUTONOMY, MANAGERS, MEDICAL EDUCATION, MORTALITY, MOTIVATION, NATIONS, NUTRITION, PARTNERSHIP, PESTS, POLICY RESEARCH, POLIO, PRIVATE SECTOR, PUBLIC ACCOUNTABILITY, PUBLIC ADMINISTRATION, PUBLIC AGENCIES, PUBLIC FUNDS, PUBLIC GOVERNANCE, PUBLIC HEALTH, PUBLIC HEALTH SERVICES, PUBLIC SECTOR, PUBLIC SECTOR MANAGEMENT, PUBLIC SERVICE, PUBLIC SERVICES, QUALITATIVE RESEARCH, QUARANTINE, REPRESENTATIVES, RESOURCE ALLOCATION, SERVICE DELIVERY, SERVICE DELIVERY MECHANISMS, SOCIAL INFRASTRUCTURE, STATE GOVERNMENT, UNIVERSITIES, WASTE, WASTE DISPOSAL, WATER SUPPLY, WORKERS, WORKING CONDITIONS COMMUNICABLE DISEASES, COMMUNICABLE DISEASES PREVENTION, CASE STUDIES, GOVERNANCE, SURVEY DATA, ADMINISTRATIVE CONSTRAINTS, SERVICE DELIVERY, HUMAN RESOURCES DEVELOPMENT, DECENTRALIZATION, COMMUNITY PARTICIPATION, POLITICAL ACCOUNTABILITY, PUBLIC HEALTH CARE, HEALTH LEGISLATION, REGULATORY FRAMEWORK, DISEASE PREVENTION, DISEASE CONTROL, PUBLIC ADMINISTRATION, HEALTH POLICY, HEALTH REFORM, WORKING CONDITIONS, COMMUNICABLE DISEASES