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首页> 外文期刊>International Journal of Rural Management >Effectiveness of Local Government and Community Participation in Health Service Delivery in Rural Haryana
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Effectiveness of Local Government and Community Participation in Health Service Delivery in Rural Haryana

机译：哈里亚纳邦农村卫生服务提供中地方政府和社区参与的有效性

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The recent health sector reform initiatives argue that health service delivery mechanism can be made effective through the participation of local governments and community in policy making, planning and services delivery. We believe that the gain fromsuch initiatives to the large extent depends on how these initiatives are implemented at the ground level. In order to evaluate their effectiveness, this study first captures the degree of local agent's participation and extent of decentralization in health, and then measures their impact on health service access and health-seeking behaviour of rural households, controlling for socio-economic, demographic and political factors, such as reservation of women/minority groups in politics. This exercise islargely based on field survey data collected from 12 villages of Haryana. The results show that the degree of community participation and women/minority groups' reservation in politics hardly matters for promoting the equity in access to health care. This may be because dominant class/caste/male captures most of the decentralization powers in Haryana. A properly designed and implemented decentralized policy however turns effective in promoting the health care use from public facilities. The study arguesthat the gains from decentralization can be enhanced by devolving more health-related functions, funds, management, regulation and policy making powers to local Panchayat and community. The magnitude of Panchayat support and priorities to health and coordination between local agents and health functionaries is a value addition for materializing the greater gains from such decentralized initiatives.
机译：最近的卫生部门改革举措认为，可以通过地方政府和社区参与决策，规划和服务提供来使医疗服务提供机制有效。我们认为，从这些倡议中获得的收益在很大程度上取决于如何在地面一级实施这些倡议。为了评估他们的有效性，本研究首先了解了当地代理人在卫生中的参与程度和权力下放的程度，然后测量了它们对农村居民获得卫生服务和寻求健康行为的影响，控制了社会经济，人口和健康状况。政治因素，例如妇女/少数民族在政治上的保留。此练习主要基于从哈里亚纳邦12个村庄收集的实地调查数据。结果表明，社区参与程度和妇女/少数群体对政治的保留对促进公平获得医疗保健几乎没有关系。这可能是因为统治阶级/种姓/男性占据了哈里亚纳邦的大多数权力下放权力。但是，经过适当设计和实施的权力下放政策将有效地促进公共设施的医疗保健使用。该研究认为，通过将更多与健康相关的职能，资金，管理，法规和决策权下放给当地的Panchayat和社区，可以增强权力下放的收益。 Panchayat的大量支持以及对卫生的优先考虑以及地方工作人员与卫生工作人员之间的协调，是实现这种分散举措的更大收益的附加值。

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