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The book undertakes a critical examination of health service development in India and provides an explanation of its underdevelopment. It analyzes the trajectory of health services development in India and dissects the roles of various actors which shape that process viz. the State, civil society, and the people. It helps you to arrive at a less ambiguous analytical paradigm regarding a complex scenario discernible in a country like India where diversities across regions and states make it difficult to advance a pan Indian framework, strategy, or theory.
World Development Report 1994 examines the link between infrastructure and development and explores ways in which developing countries can improve both the provision and the quality of infrastructure services. In recent decades, developing countries have made substantial investments in infrastructure, achieving dramatic gains for households and producers by expanding their access to services such as safe water, sanitation, electric power, telecommunications, and transport. Even more infrastructure investment and expansion are needed in order to extend the reach of services - especially to people living in rural areas and to the poor. But as this report shows, the quantity of investment cannot be the exclusive focus of policy. Improving the quality of infrastructure service also is vital. Both quantity and quality improvements are essential to modernize and diversify production, help countries compete internationally, and accommodate rapid urbanization. The report identifies the basic cause of poor past performance as inadequate institutional incentives for improving the provision of infrastructure. To promote more efficient and responsive service delivery, incentives need to be changed through commercial management, competition, and user involvement. Several trends are helping to improve the performance of infrastructure. First, innovation in technology and in the regulatory management of markets makes more diversity possible in the supply of services. Second, an evaluation of the role of government is leading to a shift from direct government provision of services to increasing private sector provision and recent experience in many countries with public-private partnerships is highlighting new ways to increase efficiency and expand services. Third, increased concern about social and environmental sustainability has heightened public interest in infrastructure design and performance.
Full of data on various sectors and issues--among them finance, tourism, foreign trade, agriculture, and governance--this report on the state of Kerala is designed to benefit businesses, NGOs, and policy makers. While Kerala has a strong economy and is India's most literate state, areas such as human rights and the treatment of women and minorities leave room for improvement. This extensive reference discusses the constraints and challenges faced by Kerala and provides a blueprint for its socioeconomic progress.
Kerala, a state in southwestern India, has implemented radical reform as a development strategy. As a result, Kerala now has some of the Third World's highest levels of health, education, and social justice. Originally published in 1989, this book traces the role that movements of social justice played in Kerala's successful struggle to redistribute wealth and power. A 21-page introduction updates the earlier edition. This book underlines the following positive lessons that the Kerala experience offers to developing countries: Radical reforms deliver benefits to the poor even when per capita incomes remain low. Popular movements and militant progressive organizations with dedicated leaders are necessary to initiate and sustain reform. Despite their other benefits, radical reforms cannot necessarily create employment or raise per capita income. Local reformers are restricted by national politics. Public distribution of food is a highly effective policy in poor agrarian economies. Devoting significant resources to public health can bring about low infant mortality, high life expectancy, and low birth rates even when incomes are low. Widespread literacy and educational opportunities can help create a more just and open social order. Meaningful land reform can reduce inequalities and give resources to the poor. Wage and working-condition laws can help effect more equitable resource distribution even in a poor economy. Greater socioeconomic equality can lead to lower levels of violence and a healthier social and political environment. Women can benefit from radical reforms not aimed at them, but special attention must eventually be given to their needs. Progressive forces, including Communist parties, can play a major positive role in benefiting very poor Third World citizens. Radical reforms can shield the poor against recessions. Contains over 200 references. (TD)
The economic activity that drives growth in developing countries is heavily concentrated in cities. Catchphrases such as “metropolitan areas are the engines that pull the national economy” turn out to be fairly accurate. But the same advantages of metropolitan areas that draw investment also draw migrants who need jobs and housing, lead to demands for better infrastructure and social services, and result in increased congestion, environmental harm, and social problems. The challenges for metropolitan public finance are to capture a share of the economic growth to adequately finance new and growing expenditures and to organize governance so that services can be delivered in a cost-effective way, giving the local population a voice in fiscal decision making. At the same time, care must be taken to avoid overregulation and overtaxation, which will hamper the now quite mobile economic engine of private investment and entrepreneurial initiative. Metropolitan planning has become a reality in most large urban areas, even though the planning agencies are often ineffective in moving things forward and in linking their plans with the fiscal and financial realities of metropolitan government. A growing number of success stories in metropolitan finance and management, together with accumulated experience and proper efforts and support, could be extended to a broader array of forward-looking programs to address the growing public service needs of metropolitan-area populations. Nevertheless, sweeping metropolitan-area fiscal reforms have been few and far between; the urban policy reform agenda is still a long one; and there is a reasonable prospect that closing the gaps between what we know how to do and what is actually being done will continue to be difficult and slow. This book identifies the most important issues in metropolitan governance and finance in developing countries, describes the practice, explores the gap between practice and what theory suggests should be done, and lays out the reform paths that might be considered. Part of the solution will rest in rethinking expenditure assignments and instruments of finance. The “right” approach also will depend on the flexibility of political leaders to relinquish some control in order to find a better solution to the metropolitan finance problem.