Decentralisation and social sector schemes: a study of the performance of national rural health mission-RCH II scheme

Abstract

This paper studies the effect of centralisation on a social sector scheme performance in India. Starting with the premise that decentralisation is desirable for the country, the paper seeks to find evidence that decentralisation improves performance of a government scheme, specifically designed for decentralised functioning. This paper studies the patterns between the RCH-II scheme performance with the level of decentralisation at the sub-state and Local Body levels across States. The Decentralisation Debate is set out in terms of its theoretical underpinnings and the practical discourse in the form of debate among the national and international community. The decentralisation scenario in India is outlined especially focussing on the developments since the 73rd and 74th Amendments in the constitution which ushered formal political Decentralisation in India beyond the traditional concept of federalism between the strong centre and the states. The political, fiscal and administrative decentralisation in India is studied from a perspective of the implementation of social sector schemes rather than de-concentration of powers from the centre or state capitals. The level of functional and financial Devolution in the major States of India is mapped in terms of the Devolution Index and its three components which is taken as an indicator of the level of decentralisation among different States. A description of the Reproductive and Child Health (RCH II) component of the National Rural Health Mission follows as the scheme design itself emphasises decentralisation. An evaluation of the scheme performance over its first two years 2005-6 and 2006-7 is studied with reference to their decentralisation levels to see whether there are any patterns discernable among higher decentralisation and better scheme performance. There is no clear pattern seen between higher levels of decentralisation measured in terms of the Devolution Index and better performance of RCH-II scheme.