Objectives
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To understand the status of decentralization in the health sector, in particular the range of choice that local authorities are able to exercise over different functions and sub- functions (e.g., financing, service delivery and organization, human resources, governance).
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Assessing the existing capacities at different levels of local government to execute responsibilities pertaining to health care decisions.
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To understand the extent of responsiveness of local governments to local interests and demands.
Geographical spread
10 districts of Orissa
Key areas/components
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A tentative sample plan was developed and sample districts, blocks and gram panchayats to be covered under the study were identified in consultation with health department officials at state and district levels.
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A two-day initial orientation workshop was organized for the group of potential interviewers on the approach and methodology to be adopted during the study, survey instruments and data collection and quality management aspects.
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The survey instruments were translated into Oriya language for better facilitation of the interview process and the Oriya version of the survey instruments were retranslated into English to know the gap or loss of information through the translation process.
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Interviews conducted with panchayati raj and health/government functionaries at various levels and performance data available at the local level also collected.
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The coded state level data, collected through interview process, was analysed and a report prepared based on the findings of the study.
Key outputs
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The actual status of decentralization in the health sector (the difference between acts and practice) documented.
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Measures that can be adopted to improve choices by panchayati raj institutions over decisions as well as to improve capacities of the panchayat head to take decisions.
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Areas for future intervention indentified to increase participation and power of panchayati raj institutions in decisions about health care needs of the community.
Year/period
October 2006-January 2007
Client
Health, Nutrition and Population Unit, World Bank and Harvard School of Public Health
