Managing health outcomes through local governance

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dc.contributor.authorBinswanger-Mkhize, Hans P.
dc.contributor.authorNagarajan, Hari K.
dc.contributor.authorPradhan, Kailash C.
dc.date.accessioned2014-03-06T16:34:11Z
dc.date.available2014-03-06T16:34:11Z
dc.date.issued2012-05
dc.description.abstractHas the devolution of responsibilities and finances to local governments in India produced positive impacts on health status and incomes of men and women? Using a national data set with details on health, health seeking behavior and local governance, we estimate a system of simultaneous equations to analyze the incidence of illness via a health production function and show that health care expenditures at the household level, choice of health care provider by members, and the incidence of illness will jointly impact individual incomes. The incidence of illness is significantly reduced by better access to drinking water, clean surroundings and awareness about health campaigns. Discussions of health issues in the Gram Sabha reduce illnesses for both men and women and their private health expenditures. Reserving the position of the village head to women leads to greater participation in Gram Sabha meetings; better problem resolution in water supply, sanitation and health; greater village health expenditures; and greater satisfaction with access to health. The increased expenditures of Panchayats on health care reduce the incidence of illness three times more for women than for men, but reduce their private health care expenditures about equally. It also shifts the choice of health care providers from private to public facilities, more so for women than for men. Family inheritance increase the use of private health care for both genders, while a woman’s individual land inheritance increases her use of both public and private health care. While women do not have lower access to health care or are discriminated within the household in terms of access to different providers, their earnings are adversely affected to a greater degree by illness compared to that of men. Women’s private health expenditures tend to improve their incomes more compared to that of men.en
dc.formatTexten
dc.format.extent1 digital file (39 p.)en
dc.format.mimetypeApplication/pdf
dc.identifier.urihttp://hdl.handle.net/10625/52481
dc.identifier.urihttp://www.ruralgov-ncaer.org/images/product/doc/2_1979802213_Health.pdf
dc.language.isoen
dc.publisherNational Council of Applied Economic Research (NCAER), New Delhi, INen
dc.relation.ispartofNCAER working papers on decentralisation and rural governance in India; no. 5, May 2012en
dc.subjectPOLITICAL AGENCYen
dc.subjectGENDERen
dc.subjectHEALTHen
dc.subjectHEALTH ADMINISTRATIONen
dc.subjectDECENTRALIZATIONen
dc.subjectLOCAL GOVERNMENTen
dc.subjectHOUSEHOLD INCOMEen
dc.subjectHEALTH EXPENDITUREen
dc.subjectRURAL AREASen
dc.subjectGENDER ROLESen
dc.subjectINDIAen
dc.titleManaging health outcomes through local governanceen
dc.typeWorking Paperen
idrc.dspace.accessIDRC Onlyen
idrc.project.componentnumber105223001
idrc.project.number105223
idrc.project.titleBuilding Policy Research Capacity for Rural Governance and Growth in Indiaen
idrc.recordsserver.bcsnumberIC01-1339-20
idrc.rims.adhocgroupIDRC SUPPORTEDen

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