Citation

Mishra A, Banati B. Health Millions 1993; 1(5): 21-23.

Copyright

(Copyright © 1993, Health for the Millions Trust)

DOI

unavailable

PMID

12288801

Abstract

The 1993 annual meeting of the Voluntary Health Association of India included a panel discussion on decentralization and community participation. Panel participants included politicians and health planners. The objective of Health for All by the Year 2000 was considered unlikely. Only 1% of the world's health budget is spent in India, which had 16-17% of the world's population. Active community participation will be required if greater numbers are to benefit from health services. Historically, administrative systems have been removed from the population served. Officials should be held accountable at all levels of government. Reporting systems should reflect this accountability. The Panchayati Raj Act provides for the decentralization process, but the act must be made operational and the present system of governance dismantled at the political, financial, and administrative levels. Development is better assured with a greater number of smaller decision-making units. The Block Development Office, as the local administrative unit, was replaced by the Panchayat. In West Bengal, there was a strong peasant movement, and the rich and powerful were not elected to Panchayat offices. Today, 70% of Panchayat members are from the rural poor, 26% from the middle class, and 4% from the elite. In Karnataka, the Panchayat has empowered women. The power of women was used to facilitate delivery of government services within villages, and teachers and health personnel were not paid unless they showed up for work. Tribal areas received health services and safe drinking facilities. Nongovernmental organizations were used to plan and implement the changes and to strengthen the power of the Panchayats. The greatest obstacles to successful Panchayat administration were identified as the vested interests of MLAs and an entrenched bureaucracy.

Language: en