Flies Without Borders : Lessons from Chennai on Improving India's Municipal Public Health Services

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 thr...

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Main Authors: Das Gupta, Monica, Dasgupta, Rajib, Kugananthan, P., Rao, Vijayendra, Somanathan, T.V., Tewari, K.N.
Format: Working Paper
Language:English
en_US
Published: World Bank, Washington, DC 2017
Subjects:
Online Access:http://documents.worldbank.org/curated/en/561701505760347121/Flies-without-borders-lessons-from-Chennai-on-improving-Indias-municipal-public-health-services
http://hdl.handle.net/10986/28375
id okr-10986-28375
recordtype oai_dc
spelling okr-10986-283752021-06-08T14:42:48Z 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 http://documents.worldbank.org/curated/en/561701505760347121/Flies-without-borders-lessons-from-Chennai-on-improving-Indias-municipal-public-health-services http://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 World Bank, Washington, DC Publications & Research Publications & Research :: Policy Research Working Paper South Asia India
repository_type Digital Repository
institution_category Foreign Institution
institution Digital Repositories
building World Bank Open Knowledge Repository
collection World Bank
language English
en_US
topic 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
Das Gupta, Monica
Dasgupta, Rajib
Kugananthan, P.
Rao, Vijayendra
Somanathan, T.V.
Tewari, K.N.
Flies Without Borders : Lessons from Chennai on Improving India's Municipal Public Health Services
geographic_facet South Asia
India
relation Policy Research Working Paper;No. 8197
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
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 : Lessons from Chennai on Improving India's Municipal Public Health Services
title_short Flies Without Borders : Lessons from Chennai on Improving India's Municipal Public Health Services
title_full Flies Without Borders : Lessons from Chennai on Improving India's Municipal Public Health Services
title_fullStr Flies Without Borders : Lessons from Chennai on Improving India's Municipal Public Health Services
title_full_unstemmed Flies Without Borders : Lessons from Chennai on Improving India's Municipal Public Health Services
title_sort flies without borders : lessons from chennai on improving india's municipal public health services
publisher World Bank, Washington, DC
publishDate 2017
url http://documents.worldbank.org/curated/en/561701505760347121/Flies-without-borders-lessons-from-Chennai-on-improving-Indias-municipal-public-health-services
http://hdl.handle.net/10986/28375
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