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This book is an analytical examination of financing and public service delivery challenges in a decentralized framework. It also provides critical insights into the effectiveness of public expenditure, through benefit incidence analysis of education and healthcare services in India. The benefits of decentralization always come with conflicts and trade-offs. By unpacking the process of decentralization, the authors identify that 'unfunded mandates', arising from the asymmetry between finances and functions at local levels, are a major challenge. The analysis is carried out by distilling the existing studies in this area, and through an empirical investigation of public finance data at different public sector levels in India, as well as in some selected developing countries. Using the household survey statistics of consumption expenditure, an analysis of utilization or benefit incidence of public spending on social sectors in India is achieved, covering education and health sectors. This title is available as Open Access on Cambridge Core.
Locus of decision-making: Understanding a decentralized flagship programme on health in India
Nearly all countries worldwide are now experimenting with decentralization. Their motivation are diverse. Many countries are decentralizing because they believe this can help stimulate economic growth or reduce rural poverty, goals central government interventions have failed to achieve. Some countries see it as a way to strengthen civil society and deepen democracy. Some perceive it as a way to off-load expensive responsibilities onto lower level governments. Thus, decentralization is seen as a solution to many different kinds of problems. This report examines the origins and implications decentralization from a political economy perspective, with a focus on its promise and limitations. It explores why countries have often chosen not to decentralize, even when evidence suggests that doing so would be in the interests of the government. It seeks to explain why since the early 1980s many countries have undertaken some form of decentralization. This report also evaluates the evidence to understand where decentralization has considerable promise and where it does not. It identifies conditions needed for decentralization to succeed. It identifies the ways in which decentralization can promote rural development. And it names the goals which decentralization will probably not help achieve.
"This book describes the transition in Indian healthcare system since independence and contributes to the ongoing debate within development and institutional economics on the approaches towards reform in the public health system. The institutional reform perspective focuses on examining the effective utilisation of allotted resources and improvements in delivery through decentralisation in governance by ensuring higher participation of elected governments and local communities in politics, policymaking and delivery of health services. It discusses the economic (resource) reforms to explain the relevance and expansion of state interventionism along with its influence on the health sector, accountability and allocative efficiency. The author also explores the connections between neoliberal thought and privatisation in health sector, and examines the greater role of insurance-based financing and their implications for health service access and delivery. The book offers ways to address long-standing systemic and structural problems that confront the Indian healthcare system. Based on large-scale surveys and diverse empirical data on the Indian economy, this book will be of great interest to researchers, students and teachers of health economics, governance and institutional economics, political economy, sociology, public policy, regional studies and development studies. This will be useful to policymakers, health economists, social scientists, public health experts and professionals, and government and nongovernment institutions"--
Is decentralisation good for development? This book explains when the answer is 'Yes' and when it is 'No'. It shows how decentralisation can be designed to drive development forward, and focuses on the institutional incentives that can strengthen democracy, boost economies, and improve public sector performance.
Bulgaria has made solid progress in its territorial governance and socio-economic development. Yet, it has not been able to counteract large and increasing territorial disparities. Doing so will require addressing remaining structural challenges that may be limiting further transformation, government performance and regional resilience.
This book analyzes decentralisation, regional development paths and success factors in different governance sectors in Ghana, the Philippines, Tanzania and Chile, and discuss overarching aspects of relevance. Decentralisation, which refers to the delegation of administrative responsibilities, political decision-making and fiscal powers to lower levels of government, is now considered one of the most efficient engines of development. In Sub-Saharan Africa decentralised states have made more progress in reducing poverty than those states with lower decentralisation scores. But in many countries, decentralisation is still considered a ‘work in progress’ with unsatisfactory results. From a spatial point of view, the link between decentralisation and regional and district development is particularly interesting. Both in the North and in the South, regional or district development is seen as holding the potential for advancing social and economic development, and even more so in decentralised political settings. Space-based networks at the regional or district level are considered instrumental for responding to locally specific challenges, e.g. in areas lagging behind economically.
Over the last decades, and in line with the adoption of the Sustainable Development Goals (SDGs) in 2015, cities and regions have played an important part in helping to implement global agendas at local level through their Decentralised Development Cooperation (DDC) activities.
Exploring the capacity and impact of decentralization within European health care systems, this book examines both the theoretical underpinnings as well as practical experience with decentralization.
Demystifies the process of sovereign wealth fund creation and examines the policy and economic issues surrounding them, updated for a post-Covid world