Scholarlink

<p>Kerala has long been distinguished among Indian states for its robust healthcare infrastructure, underpinned by strong local governance mechanisms and institutional frameworks such as Self-Help Groups (SHGs). Against the backdrop of the COVID-19 pandemic, which revealed vulnerabilities in the state’s health system, this study investigates the association among local government expenditure patterns, district-level economic performance, and key health indicators in the 14 districts of Kerala. The health indicators used are the Infant Mortality Rate (IMR), the Maternal Mortality Ratio (MMR), the Death Rate (DR), and the Stillbirth Rate (SBR). Employing descriptive statistics, trend analysis, and an unbalanced panel data regression framework, the analysis draws on data from all 1200 urban and rural Local Government Institutions (LGIs) in the state, ensuring both comprehensive coverage and empirical rigour. The findings suggest that in a relatively high-performing state like Kerala, differences in LGI expenditure and district economic performance are not significantly associated with changes in key health indicators during the period of study. Due to the unavailability of consolidated district-level data before 2017–18, the temporal scope of the analysis is limited to recent years. This study addresses a critical gap in the literature as it examines the interlinkage between decentralised governance and public health outcomes and contributes to a nuanced understanding of the limits of decentralisation in improving health performance in a developing country’s context.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Can Local Governance Deliver Better Health? Insights from Kerala’s Decentralization Model

  • 期刊论文

  • 发表日期：

    2026年6月26日

查看全文
  • Megha Jacob,
  • Sukanya Das

摘要

Kerala has long been distinguished among Indian states for its robust healthcare infrastructure, underpinned by strong local governance mechanisms and institutional frameworks such as Self-Help Groups (SHGs). Against the backdrop of the COVID-19 pandemic, which revealed vulnerabilities in the state’s health system, this study investigates the association among local government expenditure patterns, district-level economic performance, and key health indicators in the 14 districts of Kerala. The health indicators used are the Infant Mortality Rate (IMR), the Maternal Mortality Ratio (MMR), the Death Rate (DR), and the Stillbirth Rate (SBR). Employing descriptive statistics, trend analysis, and an unbalanced panel data regression framework, the analysis draws on data from all 1200 urban and rural Local Government Institutions (LGIs) in the state, ensuring both comprehensive coverage and empirical rigour. The findings suggest that in a relatively high-performing state like Kerala, differences in LGI expenditure and district economic performance are not significantly associated with changes in key health indicators during the period of study. Due to the unavailability of consolidated district-level data before 2017–18, the temporal scope of the analysis is limited to recent years. This study addresses a critical gap in the literature as it examines the interlinkage between decentralised governance and public health outcomes and contributes to a nuanced understanding of the limits of decentralisation in improving health performance in a developing country’s context.