Flies Without Borders
India's fast-growing cities face three key challenges in improving public health outcomes. The first is the persistence of weak links in the chain -- notably, slums badly underserved with basic civic services -- that can pose public health threats to all. Richer residents corner public resources, such as water and sanitation services, but their children's health indicators suggest they are deeply affected by contagion from the broader urban environment. The second challenge relates to devolution of services to elected bodies. Devolution works poorly for intangible and highly technical services, such as public health, where success is measured by the lack of (adverse) events. The third challenge is high fragmentation of services that directly affect health outcomes. In India, some cities have addressed these challenges more effectively than others have. This paper explores the management of municipal public health services in two major Indian metropolises with sharply contrasting health and sanitation indicators. The paper explains how Chennai mitigates these challenges through active service outreach to vulnerable populations, and a considered approach to devolution that distributes responsibilities appropriately between line agencies, technical personnel, and elected representatives. Services in Delhi are quite constrained. These policy lessons are pertinent to other Indian cities and beyond.
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| Format: | Working Paper biblioteca |
| Language: | English en_US |
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World Bank, Washington, DC
2017-09
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| Subjects: | PUBLIC HEALTH, SANITATION, URBANIZATION, LOCAL GOVERNMENT, GOVERNANCE, SLUMS, WATER AND SANITATION, CONTAGION, |
| Online Access: | http://documents.worldbank.org/curated/en/561701505760347121/Flies-without-borders-lessons-from-Chennai-on-improving-Indias-municipal-public-health-services https://hdl.handle.net/10986/28375 |
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dig-okr-10986283752024-07-28T08:18:00Z Flies Without Borders Lessons from Chennai on Improving India's Municipal Public Health Services Das Gupta, Monica Dasgupta, Rajib Kugananthan, P. Rao, Vijayendra Somanathan, T.V. Tewari, K.N. PUBLIC HEALTH SANITATION URBANIZATION LOCAL GOVERNMENT GOVERNANCE SLUMS WATER AND SANITATION CONTAGION India's fast-growing cities face three key challenges in improving public health outcomes. The first is the persistence of weak links in the chain -- notably, slums badly underserved with basic civic services -- that can pose public health threats to all. Richer residents corner public resources, such as water and sanitation services, but their children's health indicators suggest they are deeply affected by contagion from the broader urban environment. The second challenge relates to devolution of services to elected bodies. Devolution works poorly for intangible and highly technical services, such as public health, where success is measured by the lack of (adverse) events. The third challenge is high fragmentation of services that directly affect health outcomes. In India, some cities have addressed these challenges more effectively than others have. This paper explores the management of municipal public health services in two major Indian metropolises with sharply contrasting health and sanitation indicators. The paper explains how Chennai mitigates these challenges through active service outreach to vulnerable populations, and a considered approach to devolution that distributes responsibilities appropriately between line agencies, technical personnel, and elected representatives. Services in Delhi are quite constrained. These policy lessons are pertinent to other Indian cities and beyond. 2017-09-21T21:09:48Z 2017-09-21T21:09:48Z 2017-09 Working Paper Document de travail Documento de trabajo http://documents.worldbank.org/curated/en/561701505760347121/Flies-without-borders-lessons-from-Chennai-on-improving-Indias-municipal-public-health-services https://hdl.handle.net/10986/28375 English en_US Policy Research Working Paper;No. 8197 CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo World Bank application/pdf text/plain World Bank, Washington, DC |
| institution |
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| collection |
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| country |
Estados Unidos |
| countrycode |
US |
| component |
Bibliográfico |
| access |
En linea |
| databasecode |
dig-okr |
| tag |
biblioteca |
| region |
America del Norte |
| libraryname |
Biblioteca del Banco Mundial |
| language |
English en_US |
| topic |
PUBLIC HEALTH SANITATION URBANIZATION LOCAL GOVERNMENT GOVERNANCE SLUMS WATER AND SANITATION CONTAGION PUBLIC HEALTH SANITATION URBANIZATION LOCAL GOVERNMENT GOVERNANCE SLUMS WATER AND SANITATION CONTAGION |
| spellingShingle |
PUBLIC HEALTH SANITATION URBANIZATION LOCAL GOVERNMENT GOVERNANCE SLUMS WATER AND SANITATION CONTAGION PUBLIC HEALTH SANITATION URBANIZATION LOCAL GOVERNMENT GOVERNANCE SLUMS WATER AND SANITATION CONTAGION Das Gupta, Monica Dasgupta, Rajib Kugananthan, P. Rao, Vijayendra Somanathan, T.V. Tewari, K.N. Flies Without Borders |
| description |
India's fast-growing cities face
three key challenges in improving public health outcomes.
The first is the persistence of weak links in the chain --
notably, slums badly underserved with basic civic services
-- that can pose public health threats to all. Richer
residents corner public resources, such as water and
sanitation services, but their children's health
indicators suggest they are deeply affected by contagion
from the broader urban environment. The second challenge
relates to devolution of services to elected bodies.
Devolution works poorly for intangible and highly technical
services, such as public health, where success is measured
by the lack of (adverse) events. The third challenge is high
fragmentation of services that directly affect health
outcomes. In India, some cities have addressed these
challenges more effectively than others have. This paper
explores the management of municipal public health services
in two major Indian metropolises with sharply contrasting
health and sanitation indicators. The paper explains how
Chennai mitigates these challenges through active service
outreach to vulnerable populations, and a considered
approach to devolution that distributes responsibilities
appropriately between line agencies, technical personnel,
and elected representatives. Services in Delhi are quite
constrained. These policy lessons are pertinent to other
Indian cities and beyond. |
| format |
Working Paper |
| topic_facet |
PUBLIC HEALTH SANITATION URBANIZATION LOCAL GOVERNMENT GOVERNANCE SLUMS WATER AND SANITATION CONTAGION |
| author |
Das Gupta, Monica Dasgupta, Rajib Kugananthan, P. Rao, Vijayendra Somanathan, T.V. Tewari, K.N. |
| author_facet |
Das Gupta, Monica Dasgupta, Rajib Kugananthan, P. Rao, Vijayendra Somanathan, T.V. Tewari, K.N. |
| author_sort |
Das Gupta, Monica |
| title |
Flies Without Borders |
| title_short |
Flies Without Borders |
| title_full |
Flies Without Borders |
| title_fullStr |
Flies Without Borders |
| title_full_unstemmed |
Flies Without Borders |
| title_sort |
flies without borders |
| publisher |
World Bank, Washington, DC |
| publishDate |
2017-09 |
| url |
http://documents.worldbank.org/curated/en/561701505760347121/Flies-without-borders-lessons-from-Chennai-on-improving-Indias-municipal-public-health-services https://hdl.handle.net/10986/28375 |
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