IJRM Past Issues

The maternal and child healthcare programmes have made a responsibility of village Panchayat, local agents/community in India. Under the decentralized process, the funds, functions and functionary powers have been devolved to village Panchayat and local community/agents to achieve equity and efficiency in health sector. This paper examines whether a properly implemented decentralized policy, degree of community participation (CP), reservation of women and minority groups in politics lead to equitable access to healthcare use and in influencing the health seeking behaviour for maternal and child health. The filed data collected at households, health and Panchayat functionaries’ level from twelve villages of Haryana. The results show that reservation of women and minority groups and degree of CP turned less likely in effective services delivery in Haryana where dominant class/caste/male captures most of the decentralization powers. Rather, properly implemented decentralized policy turns significant in promoting equity in healthcare use and influencing the choice of cost-effective care. The gains from decentralization increase with the increase in devolution of health functions, funds, management and regulation of functionaries, health policy making powers to Panchayat. The magnitude of Panchayat support & priorities and co-ordination between local agents and health functionaries add in materializing greater gains from decentralization.