Panchayati Raj and Rural Health Care Delivery System in Karnataka

Abstract

It is commonly opined that decentralisation through Panchayati Raj Institutions (PRIs) can help in creating greater accountability in the Indian healthcare system. Health decentralisation is specially meant for peoples’ participation, increased transparency and a higher degree of accountability to provide comprehensive and quality health services at the grassroots level. The National Rural Health Mission (NRHM) visualises the provision of decentralised healthcare at the grassroots level. However, this scheme has some lacunas in reaching the needy, especially in the rural parts of India because of an ineffective and non-participatory role of PRIs in decision making. This has been ascribed to a malfunction in creating healthcare awareness and making the procedures complicated and chaotic for the local Panchayats. The article is based on the Indian Council of Medical Research-funded study in the state of Karnataka. It seeks to find out how PRIs are managing the public healthcare system and its success and failure through a qualitative study. The study has shown that some amount of caution is needed in devolving requisite powers to the PRIs within the NRHM. The coordination between Public Health Institute officials and those of PRIs is completely absent and most of the PRI members do not even know about various health schemes.