Parallel Systems and Human Resource Management in India's Public Health Services : A View from the Front Lines

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dc.creatorLa Forgia, Gerard
dc.creatorRaha, Shomikho
dc.creatorShaik, Shabbeer
dc.creatorMaheshwari, Sunil Kumar
dc.creatorAli, Rabia
dc.date2014-07-30T14:09:18Z
dc.date2014-07-30T14:09:18Z
dc.date2014-06
dc.date.accessioned2026-07-01T00:53:34Z
dc.descriptionThere is building evidence in India that the delivery of health services suffers from an actual shortfall in trained health professionals, but also from unsatisfactory results of existing service providers working in the public and private sectors. This study focusses on the public sector and examines de facto institutional and governance arrangements that may give rise to well-documented provider behaviors such as absenteeism, which can adversely affect service delivery processes and outcomes. The paper considers four human resource management subsystems: postings, transfers, promotions, and disciplinary practices. The four subsystems are analyzed from the perspective of front line workers, that is, physicians working in rural health care facilities operated by two state governments. Physicians were sampled in one post-reform state that has instituted human resource management reforms and one pre-reform state that has not. The findings are based on quantitative and qualitative measurement. The results show that formal rules are undermined by a parallel modus operandi in which desirable posts are often determined by political connections and side payments. The evidence suggests an institutional environment in which formal rules of accountability are trumped by a parallel set of accountabilities. These systems appear so entrenched that reforms have borne no significant effect.
dc.formatapplication/pdf
dc.formattext/plain
dc.identifierhttp://documents.worldbank.org/curated/en/2014/06/19737148/parallel-systems-human-resource-management-indias-public-health-services-view-front-lines
dc.identifierhttps://hdl.handle.net/10986/19065
dc.identifierhttps://doi.org/10.1596/1813-9450-6953
dc.identifier.urihttp://hdl.handle.net/123456789/412560
dc.languageEnglish
dc.languageen_US
dc.publisherWorld Bank, Washington, DC
dc.relationPolicy Research Working Paper;No. 6953
dc.rightsCC BY 3.0 IGO
dc.rightshttp://creativecommons.org/licenses/by/3.0/igo/
dc.subjectABILITY TO PAY
dc.subjectACCOUNTABILITIES
dc.subjectACCOUNTABILITY
dc.subjectACCOUNTABILITY MECHANISMS
dc.subjectAGED
dc.subjectANTI-CORRUPTION
dc.subjectASSETS
dc.subjectAUDITOR
dc.subjectAUDITORS
dc.subjectBASIC SERVICES
dc.subjectBULLETIN
dc.subjectCAPACITY BUILDING
dc.subjectCITIZEN
dc.subjectCITIZENS
dc.subjectCIVIL SERVANT
dc.subjectCIVIL SERVANTS
dc.subjectCIVIL SOCIETY
dc.subjectCOLLUSION
dc.subjectCOMMUNITY HEALTH
dc.subjectCONFIDENCE
dc.subjectCORRUPTION
dc.subjectCOUNSELING
dc.subjectCRIMINAL
dc.subjectCRIMINAL LAW
dc.subjectDECISION MAKING
dc.subjectDELIVERY OF HEALTH CARE
dc.subjectDELIVERY OF HEALTH SERVICES
dc.subjectDELIVERY SYSTEM
dc.subjectDELIVERY SYSTEMS
dc.subjectDEMOCRACY
dc.subjectDEVELOPING COUNTRIES
dc.subjectDEVELOPMENT POLICY
dc.subjectDISEASES
dc.subjectDOCTORS
dc.subjectECONOMIC PERSPECTIVES
dc.subjectECONOMIC POLICIES
dc.subjectECONOMIC REVIEW
dc.subjectEVALUATION TECHNIQUES
dc.subjectFAMILY WELFARE
dc.subjectFEMALE LITERACY
dc.subjectFINANCIAL RESOURCES
dc.subjectFOCUS GROUP DISCUSSIONS
dc.subjectGOOD GOVERNANCE
dc.subjectGOVERNMENT AGENCIES
dc.subjectGOVERNMENT OFFICIALS
dc.subjectHEALTH AFFAIRS
dc.subjectHEALTH CARE
dc.subjectHEALTH CARE DELIVERY
dc.subjectHEALTH CARE FACILITIES
dc.subjectHEALTH CARE SERVICES
dc.subjectHEALTH CARE SYSTEM
dc.subjectHEALTH CARE UTILIZATION
dc.subjectHEALTH CENTERS
dc.subjectHEALTH CENTRES
dc.subjectHEALTH COMMITTEES
dc.subjectHEALTH DELIVERY
dc.subjectHEALTH DELIVERY SYSTEM
dc.subjectHEALTH FINANCING
dc.subjectHEALTH INFRASTRUCTURE
dc.subjectHEALTH INSURANCE
dc.subjectHEALTH INSURANCE SCHEME
dc.subjectHEALTH INSURANCE SCHEMES
dc.subjectHEALTH OFFICIALS
dc.subjectHEALTH OUTCOMES
dc.subjectHEALTH PLANS
dc.subjectHEALTH PROFESSIONALS
dc.subjectHEALTH SECTOR
dc.subjectHEALTH SERVICE
dc.subjectHEALTH SERVICE DELIVERY
dc.subjectHEALTH SERVICES
dc.subjectHEALTH SERVICES RESEARCH
dc.subjectHEALTH SYSTEM
dc.subjectHEALTH SYSTEM PERFORMANCE
dc.subjectHEALTH SYSTEMS
dc.subjectHOSPITAL
dc.subjectHOSPITALS
dc.subjectHOUSEHOLD SURVEYS
dc.subjectHR
dc.subjectHUMAN RESOURCE MANAGEMENT
dc.subjectHUMAN RESOURCES
dc.subjectHUMAN RESOURCES MANAGEMENT
dc.subjectIMMUNIZATION
dc.subjectINCOME
dc.subjectINCOME DISTRIBUTION
dc.subjectINFORMAL SECTOR
dc.subjectINPATIENT CARE
dc.subjectINSURANCE SCHEMES
dc.subjectINTERMEDIARIES
dc.subjectINTERNAL MIGRATION
dc.subjectKICKBACKS
dc.subjectLEADERSHIP
dc.subjectLOCAL COMMUNITY
dc.subjectLOW-INCOME COUNTRIES
dc.subjectMANAGEMENT SYSTEMS
dc.subjectMARITAL STATUS
dc.subjectMEDICAL SCHOOL
dc.subjectMIGRATION
dc.subjectMINISTER
dc.subjectMINISTRIES OF HEALTH
dc.subjectMINISTRY OF HEALTH
dc.subjectMINORITY
dc.subjectMORBIDITY
dc.subjectMORTALITY
dc.subjectNATIONAL HEALTH
dc.subjectNATIONAL HEALTH SYSTEMS
dc.subjectNURSE
dc.subjectNURSES
dc.subjectNURSING
dc.subjectNUTRITION
dc.subjectOUTPATIENT CARE
dc.subjectPATIENT
dc.subjectPATIENT CHOICE
dc.subjectPATIENTS
dc.subjectPATRONAGE
dc.subjectPEDIATRICS
dc.subjectPENSIONS
dc.subjectPHYSICIAN
dc.subjectPHYSICIANS
dc.subjectPLACE OF RESIDENCE
dc.subjectPOLICY DISCUSSIONS
dc.subjectPOLICY MAKERS
dc.subjectPOLICY RESEARCH
dc.subjectPOLICY RESEARCH WORKING PAPER
dc.subjectPOLITICAL CHANGE
dc.subjectPOLITICAL CORRUPTION
dc.subjectPOLITICAL LEADER
dc.subjectPOLITICAL LEADERS
dc.subjectPOLITICAL PARTIES
dc.subjectPOLITICAL SUPPORT
dc.subjectPOLITICIAN
dc.subjectPOLITICIANS
dc.subjectPOLLUTION
dc.subjectPOOR HEALTH
dc.subjectPOPULAR SUPPORT
dc.subjectPRIMARY CARE
dc.subjectPRIVATE CARE
dc.subjectPRIVATE HEALTH SERVICES
dc.subjectPRIVATE SECTOR
dc.subjectPRIVATE SECTORS
dc.subjectPROBABILITY
dc.subjectPROGRESS
dc.subjectPSYCHOLOGY
dc.subjectPUBLIC ADMINISTRATION
dc.subjectPUBLIC HEALTH
dc.subjectPUBLIC HEALTH CARE
dc.subjectPUBLIC HEALTH SERVICES
dc.subjectPUBLIC HEALTH SYSTEM
dc.subjectPUBLIC HEALTH WORKERS
dc.subjectPUBLIC HOSPITALS
dc.subjectPUBLIC OFFICIALS
dc.subjectPUBLIC OPINION
dc.subjectPUBLIC PROVIDERS
dc.subjectPUBLIC SECTOR
dc.subjectPUBLIC SERVICE
dc.subjectPUBLIC SERVICES
dc.subjectPUBLIC SPENDING
dc.subjectQUALITY CARE
dc.subjectQUALITY OF CARE
dc.subjectQUANTITATIVE RESEARCH
dc.subjectREFORM EFFORT
dc.subjectRESEARCH METHODS
dc.subjectRURAL AREAS
dc.subjectRURAL HEALTH CARE
dc.subjectSANCTIONS
dc.subjectSANITATION
dc.subjectSENSITIVE ISSUES
dc.subjectSENSITIVE TOPICS
dc.subjectSERVICE PROVIDERS
dc.subjectSERVICE PROVISION
dc.subjectSOCIAL DEVELOPMENT
dc.subjectSOCIAL INFRASTRUCTURE
dc.subjectSPOUSE
dc.subjectSPOUSES
dc.subjectSTATE GOVERNMENT
dc.subjectSTATE GOVERNMENTS
dc.subjectSURGERY
dc.subjectTHEFT
dc.subjectTRANSPARENCY
dc.subjectURBAN AREAS
dc.subjectURBAN CENTERS
dc.subjectVICTIMS
dc.subjectWORKERS
dc.titleParallel Systems and Human Resource Management in India's Public Health Services : A View from the Front Lines

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