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

29 Pages Posted: 20 Sep 2017

See all articles by Monica Das Gupta

Monica Das Gupta

World Bank - Development Research Group (DECRG)

Rajib Dasgupta

Calcutta University

P. Kugananthan

Chennai Municipal Corporation

Vijayendra Rao

World Bank - Development Research Group (DECRG)

T.V. Somanathan

Government of India

K.N. Tewari

Municipal Corporation of Delhi

Date Written: September 18, 2017

Abstract

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.

Keywords: Health and Sanitation, Sanitary Environmental Engineering, Social Accountability, City to City Alliances, Regional Urban Development, Urban Economics, Environmental Engineering, Town Water Supply and Sanitation, Urban Economic Development, Regional Governance, Urban Communities, Small Private Water Supply Providers, National Urban Development Policies & Strategies, Water and Human Health, Sanitation and Sewerage, Water Supply and Sanitation Economics, Local Government

Suggested Citation

Das Gupta, Monica and Dasgupta, Rajib and Kugananthan, P. and Rao, Vijayendra and Somanathan, T.V. and Tewari, K.N., Flies Without Borders: Lessons from Chennai on Improving India's Municipal Public Health Services (September 18, 2017). World Bank Policy Research Working Paper No. 8197. Available at SSRN: https://ssrn.com/abstract=3039218

Monica Das Gupta (Contact Author)

World Bank - Development Research Group (DECRG) ( email )

1818 H. Street, N.W.
MSN3-311
Washington, DC 20433
United States

HOME PAGE: http://econ.worldbank.org/staff/mdasgupta

Rajib Dasgupta

Calcutta University ( email )

Senate House, 87/1 College Street
Bagnan
Kolkata, 700073
India

P. Kugananthan

Chennai Municipal Corporation ( email )

Chennai
India

Vijayendra Rao

World Bank - Development Research Group (DECRG) ( email )

1818 H. Street, N.W.
MSN3-311
Washington, DC 20433
United States
202-458-8034 (Phone)
202-522-1153 (Fax)

HOME PAGE: http://vijayendrarao.org

T.V. Somanathan

Government of India ( email )

India

K.N. Tewari

Municipal Corporation of Delhi ( email )

New Dehli
India

Here is the Coronavirus
related research on SSRN

Paper statistics

Downloads
17
Abstract Views
189
PlumX Metrics