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Health outcomes in rural India UPSC NOTE

 Importance of panchayat autonomy for improving health outcomes in rural India

  • The Data Point published on Monday had highlighted how panchayats earn only 1% of their income through taxes.

  • The rest being sourced from Central and State grants. 

  • The Reserve Bank of India study, based on which the report was written, had called for greater autonomy for panchayats and empowerment of local leaders

  • This Data Point aims to show that greater autonomy of panchayats results in better governance and leads to superior outcomes.

  • Panchayats collaborate with health departments to maintain clinics and dispensaries in rural areas. 

  • By encouraging institutional deliveries and ensuring prenatal and postnatal check ups.

  • They help reduce maternal and infant mortality rates (IMR). 

  • They also provide clean water and sanitation facilities. 

  • The RBI study uses two datasets to show that panchayats which scored high on the health, nutrition, and sanitation parameters also had lower rural IMRs.

  • The State-wise average of panchayat-level health, nutrition, and sanitation scores calculated by the Ministry of Panchayati Raj (MoPR) on the vertical axis. 

  • The scores of all the panchayats in a State were averaged to present the State’s overall score on these parameters. 

  • In general, as shown by the trend line, the higher the score on health, nutrition, and sanitation parameters, the lower the IMR.

  • Major States including Kerala, Tamil Nadu, Himachal Pradesh, Punjab, Jammu and Kashmir (before it became a Union Territory), Karnataka, Maharashtra, and West Bengal all feature on the top left. 

  • That is, they have a high score and a low IMR. Madhya Pradesh, Uttar Pradesh, Assam, Rajasthan, Odisha, and Chhattisgarh can be seen on the bottom right — they have a low score and a high IMR.

  • Given that panchayats play a vital role in health management and some States outperform others.

  • Whether these better-performing States also have greater autonomy at the panchayat level.

  • For this, the RBI study uses the devolution index prepared by MoPR using independent agencies

  • First, the transfer of subjects, that is, how many functions including drinking water, rural housing, family welfare, and women and child development are under the control of panchayats. 

  • Second, transfer of functionaries, that is, how many positions were filled by panchayats on their own

  • Third, transfer of finances, that is, what share of funds are raised by panchayats on their own and what share can they spend based on their decisions. 

  • The States on the right — Kerala, Karnataka, Maharashtra, and Tamil Nadu — have higher devolution scores. 

  • The States on the left — Assam, Odisha, Chhattisgarh, Madhya Pradesh and Uttarakhand — have lower devolution scores. 

  • Together shows that panchayat autonomy plays a vital role in better health outcomes in rural areas.

Map 3 which shows the percentage shortfall of primary health facilities in rural areas also concurs with this conclusion as States which perform better on the index have a surplus, with a few exceptions

  • Uttar Pradesh, Bihar, Jharkhand, Madhya Pradesh and West Bengal have very high levels of shortage. 

  • On the other hand, Kerala, Tamil Nadu, Karnataka and Himachal have none.

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Learnerz IAS | Concept oriented UPSC Classes in Malayalam: Health outcomes in rural India UPSC NOTE
Health outcomes in rural India UPSC NOTE
Learnerz IAS | Concept oriented UPSC Classes in Malayalam
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