Political and Programmatic Health Decentralisation in Karnataka State: An Evidence-based Rural Participatory Decision-making

Health decentralisation is a dynamic tool for providing quality and inclusive healthcare. The effectiveness of the administration of an institutional-quality healthcare delivery system focusing on health decentralisation has been under question for the last three decades. Also, examining the successes of decentralisation and the correlation between autonomy, decision space (degree of decentralisation) and health outcomes is gaining momentum today. The major aim of this research study is to assess the effectiveness of Panchayati Raj Institutions (PRIs) in managing the rural healthcare system in the state of Karnataka (South India). The study has used mixed methods, drawing samples from PRIs and Public Health Institutions. The study has found some notable issues in rescheduling decentralised health administrative structures, reducing benefaction and political meddling and implementing performance-based resource distribution. It is concluded that structural, dynamic and geographically specific reforms in age-old administrative procedures are very essential in the administrative and financial management systems of PRIs for effective health decentralisation in India.