Gloria Benny, Jaison Joseph, Hari Sankar, Devaki Nambiar
Abstract Background Palliative care needs are increasing in India, but access remains limited. Kerala is a notable exception, with a widely developed community-based, home-based palliative care approach. Its development coincided with governance reforms, particularly the People’s Planning Campaign (PPC) in 1996, which decentralisation by transferring planning responsibility, decision space, and financial authority to Local Self-Governments (LSGs), while expanding participation in priority-setting. Although Kerala’s palliative care outcomes are well documented, less is known about how decentralised institutions, political priorities, and local histories supported the model’s emergence and scale-up. This study examines how LSG-level decentralisation created conditions for initiatives, what mechanisms sustained them, and how they gained policy legitimacy, from those who witnessed and shaped these developments. Methods We used Witness Seminar (WS) methods, an oral-history approach bringing together people who witnessed or influenced a historical development to reconstruct events and create an archival record. Three WS were held in 2021 with 22 participants from the health department, LSGs, bureaucracy, civil society, and PPC policy spaces. Inductive thematic analysis was applied to English transcripts using ATLAS.ti 9, followed by realist analysis to develop Context–Mechanism–Outcome (CMO) explanations linking decentralisation processes with the evolution of palliative care in Kerala. Results CMO configurations showed how decentralisation created contexts and mechanisms through which palliative care emerged as a community movement and later gained system-level support. The PPC enabled local planning, participation, and ownership, while community-based, volunteer-led home-care programmes developed across several panchayats. LSGs implemented these programmes through government Primary Health Centres transferred under decentralisation. As the value of the model became evident, the state health department scaled up palliative care, with finance and HRH support from the National (Rural) Health Mission proving critical. Conclusion Palliative care came to be viewed by stakeholders as central to health service delivery in Kerala, contributing to the State Palliative Care Policy in 2008. Decentralisation and sustained community participation can generate legitimacy and political commitment to embed such programmes within services. However, durable implementation also requires system-level enablers such as financing, human resources, and administrative support, alongside local relational foundations including trust, leadership, and shared ownership.
The constitutionalising of local self-government through the 73rd and 74th Constitutional Amendments marked a significant moment in India’s democratic and federal evolution. These reforms sought to deepen democracy by devolving powers, responsibilities and resources to local governments. More than three decades later, decentralization in India has produced institutions that are electorally vibrant but administratively constrained. This paper examines the paradox of extensive formal devolution coexisting with persistent state control. Using the analytical framework of finance, functions, and functionaries (the “3Fs”), it argues that decentralization in India has unfolded as a managed and politically conditioned process rather than a comprehensive transfer of authority. While fiscal transfers and functional assignments have expanded unevenly, control over administrative personnel has remained firmly centralized. The retention of authority over functionaries emerges as the central mechanism through which state governments preserve power over local governance. The paper contributes to decentralization scholarship by shifting attention from constitutional design to political economy, highlighting personnel control as the key constraint on substantive local self-government in India.
The foundation of rural local self-governance in India was laid post-independence, inspired by Mahatma Gandhi's vision of Swaraj. The Indian Constitution institutionalized this vision through provisions like the 73rd Amendment Act, which established the Panchayati Raj system as a three-tier structure for decentralized governance. Articles 243G and 40 emphasize empowering Panchayati Raj Institutions (PRIs) for economic development and social justice, while Articles 243D, 243E, and 243I provide for reservation, periodic elections, and financial autonomy.Despite these constitutional provisions, challenges persist in rural governance. Villagers often lack awareness about government schemes and their legal rights, leading to underutilization of available resources. Administrative inefficiencies, limited participation in decision-making bodies, and issues of transparency undermine the effectiveness of rural governance. Additionally, inadequacies in the selection and training of government personnel hinder productive interactions with elected representatives and villagers.Reforms are needed to address these issues and enhance rural governance. Strengthening awareness campaigns, reforming recruitment and training of personnel, and institutionalizing mechanisms for greater villager participation are essential steps. Leveraging technology through e-governance can promote transparency and accessibility, while robust financial empowerment through State Finance Commissions can ensure PRIs have the resources necessary for development. Accountability mechanisms, such as social audits, can further improve trust and performance in rural governance.The role of new actors like civil society organizations and private sector collaborations is also crucial in bridging gaps in service delivery and promoting participatory governance. While India has achieved significant milestones in its 75 years of independence, consistent efforts and structural reforms are vital to realizing the constitutional vision of Swaraj and ensuring effective rural governance that empowers communities and fosters inclusive development.
Changing the formal structure of Indian federalism may have been difficult, given that altering the Indian constitution requires super-legislative majorities which are harder to mobilize in a fragmented party system than in a one party dominant one. The dynamics of Indian federalism underwent significant change due to the transformation of the Indian party system and economic liberalization. Decentralized spending with centralized financing through grants, from a public finance perspective, serves to help central governments implement redistributive programs. The effect of party politics on federalism is felt most intensely in those sectors of government which are open to direct party political influence. Economic liberalization built on central deregulation and party system fragmentation is likely to generate centrifugal tendencies. With it comes the expectation of more policy divergence across the states.
The passage of the constitution (Seventy-third Amendment) Act, 1992 marked a watershed in the history of Modern India. With this amendment, a uniformity structure of Panchayats emerged throughout the country. Similarly, the passage of the constitution (Seventy-Fourth Amendment) Act, 1992 was a land mark in the history of municipal administration in India. As a result of these amendments, Panchayats and Municipalities are now constitutional bodies forming third tier of the federal policy of India.1 India’s decentralization initiative in the form of seventy-third and seventy fourth Amendments poses challenges and offers opportunities. Tenth Finance Commission onwards every Finance Commission allocated the grants funds to Panchayati Raj Institutions (PRIs).
India adopted an ambitious reform policy of rural and urban decentralization in 1992, under which powers and finance are transferred to new local and regional bodies. These are governed by elected councils, in which women and members of disadvantaged groups/castes have a fixed quota of seats. While the legislation is still relatively new, some states have been able to make fast progress in decentralizing tasks, power and funds, while others have been much slower. This article presents an initial review of the decentralization efforts, exploring administrative, fiscal and political dimensions, and the implementation problems at central, state and local levels. Most emphasis is given to development at the local level: the panchayats in rural areas and the ward committees in urban areas, which is where the impact of decentralization should be felt. This article assesses whether increased proximity between citizens and government leads to increased transparency, accountability and participation.
In the early twentieth century British colonial authorities continued their efforts to decentralize the governance and financial system of British India by providing greater administrative and financial authority to provincial governments, which required delineation of powers and the financing of the government of British India and the provincial governments. Governor-General of India, Lord Curzon tried to escape the disadvantages of the "Ripon scheme" and introduced a scheme of "quasi-permanent nature", based on three principles. The basic idea of the scheme was to raise the interest of the provinces to increasing of their income. The lack of success of the reforms led to the establishing by Edward VII in September 1907 of "Royal Commission on Decentralization of India", which was to examine the situation on the ground and then to make suggestions. In February 1909 the Commission submitted a report, which laid out the arguments both in favor of centralization of governance and in favor of decentralization. In order to enhance the decentralization they proposed measures for increasing of the powers of provincial governments and authorities subordinate to administrative units, governance of public services on a wide range of issues, primarily "provincial" and "subordinate" parts of the Indian Civil Service, the police, as well as medical, sanitation and so on. Particular emphasis was placed on the need to develop local government throughout India, particularly in rural areas. The most important role among them was assigned to panchayati. They envisaged the establishment of self-government at the district level and at the lowest level - a village or a group of villages. Accordingly, the proposed redistribution of competences between different levels of government and self-government. To implement the changes, the commission recommended to redistribute sources of financing government bodies at each level and discussed specific taxes thoroughly enough. They also mentioned some situations when the income did not cover the costs of provinces, districts and villages. The report revealed the need for changes in the cost structure of different levels of authorities. The article suggests some measures for implementation of recommendations of the Commission, the assessment of its activities by a number of researchers and sources, and makes a brief conclusion.
Open access
Social and Economic Development in India
Politics and Conflicts in Afghanistan, Pakistan, and Middle East
Krishna M. Singh, Meena Meena, Burton E. Swanson, M.N. Reddy · 5 authors
This In-Depth Study of the Pluralistic Agricultural Extension System in India is a full analysis of the pluralistic extension system in India, how it has changed over many years and the direction it is currently moving. \n \nChapter-1 outlines the Evolution of the Pluralistic Agricultural Extension System in India and the changes that have occurred since about 1871, including the establishment of the Department of Agriculture in 1882. Following independence in 1947, many changes have happened as outlined in this first chapter, including the Community Development Program (CDP), the Intensive Agricultural District Program (IADP), including dissemination of high-yielding varieties during the Green Revolution, the Training and Visit (T&V) approach and then the move to the decentralized, farmer-led and market driven approach influenced by the Agricultural Technology Management Agency (ATMA) model. \n \nChapter-2 gives an Overview of the Public Extension System within the Ministry of Agriculture (MoA), the State Departments of Agriculture and then provides more detailed information about the Krishi Vigyan Kendra (KVK) and the public extension system in India. It starts with an overview of the organizational structure at the national level, including the Department of Agricultural Research and Extension (DARE), then into the Department of Agriculture and Cooperation (DAC) and Directorate of Extension within DAC. Then, it moves into the KVKs, which are a critical linkage at the district level between research, extension and farmers. In short, KVKs focus on the specific agro-ecological conditions within each district and then, after conducting research on these different crops, livestock and other farming systems. Then it moves into the development of the ATMA model through two World Bank projects, which is now expand across all Indian districts. \n \nChapter-3 outlines the Directorates of Extension Education within each State Agricultural Universities (SAUs). India is unique in having Extension units established within each SAU, since this extension approach was first introduced by selected US Land Grant Universities into these SAUs in the late 1950s and early 1960s. This chapter outlines the historical development of the extension within each SAU and then outlines the mandate, organizational structure, human resources and methods used within these SAUs and their relationship with the public extension system. \n \nChapter-4 outlines the Private Sector Advisory Services being provided in India, especially in the provision of good advisory services through private Agri-Business Companies through the sale of inputs to farmers. In India, there are over 280,000 input supply firms, but many do not have sufficient knowledge and experience in providing good advisory services to farmers. At first, the public and private sector did not want to work together but through the ATMA approach, the public and private sector started working together and then, in 2004, the National Institute of Agricultural Extension Management (MANAGE) started training and giving diplomas to the participants from these private sector firms, especially in Andhra Pradesh (see: http://www.manage.gov.in/daesi/daesi.htm). \n \nChapter-5 summarizes the role and activities of the different Commodity Boards currently operating in India, including: Central Silk Board (CSB), Coconut Development Board (CDB), Coffee Board, Coir Board, Rubber Board, Spices Board, Tea Board, Tobacco Board, National Dairy Development Board (NDDB), National Horticulture Board (NHB), Cashew Export Promotion Council (CEPC), National Jute Board (NJB), and the National Federation of Cooperative Sugar Factories (NFCSF) and how each of these boards carry out extension and advisory services to the farmers being served. \n \nChapter-6 outlines the Institutional Mechanism for Capacity Building to strengthen the pluralistic extension system in India. This chapter starts with an overview of the National Institute of Agricultural Extension Management (MANAGE), which is an autonomous organization that has had the most impact on strengthening the extension system in India. Next, it discusses the paradigm shift within the National Institute of Agricultural Marketing (NAIM) in India; and then outlines the role of the Extension Education Institutes (EEIs). Finally, it moves to outline the role and structure of the State Agricultural Management and Extension Training Institutes (SAMETIs), especially in strengthening the ATMA model in India. \n \nChapter-7 is the conclusion chapter that outlines the Strengths and Weaknesses of India’s Pluralistic Extension System. It starts by outlining the Policy Framework and Reforms for strengthening the pluralistic extension system in India. Next, it outlines how to strengthen research-extension linkages as well as capacity building among extension workers. Next, it addresses how to empower farmers, including women farmers. It also outlines the use of Information Technology (IT) and how to strengthen it through different approaches. This chapter also outlines the changing role of government in extension and how the ATMA model can be strengthened following very specific details. The other issue is how to strengthen the SAMETIs, since they still need to be strengthened in providing service to district and block level extension workers. This chapter ends with a brief summary the key role that the public extension system can play in India.
Emerging economies are building up their education systems by overcoming the major challenges of finance, infrastructure and planning and control of resources and internal processes through ‘school-based management’ reforms. To achieve relative competitiveness, school management must deal with these challenges. Governments consider decentralization as an indispensable step in efforts to provide quality education. Many successful schools set up committees and undertake improvements in planning. The Indian school education sector is not an exception. This study sought to explore the nature of planning function being practiced at the school level as a source of competitive advantage. A sample of 188, among the population of 557 secondary schools in Krishna district of Andhra Pradesh in India, was selected through stratified sampling. The primary responses were collected through a structured questionnaire administered to the respective school heads and analyzed with chi-square and simple descriptives. Decentralization is a management strategy which demands flexible implementation with a balance between the autonomy and the characteristics of its beneficiaries. Improvement of the quality of education needs the functioning and management of schools to improve. The findings indicate that the planning framework is either nonexistent or inactive in a majority of public sector schools. The inclusion of community members in school management is comparatively better in the public sector schools run by the State government of Andhra Pradesh than those run by private managements. The academic, infrastructure and financial planning activities are highly centralized, giving no scope for innovation and autonomy at the school level.
The paper has two main objectives. The first is to trace the progress in the process of decentralisation in the provision of public services in India. The second is to test the hypothesis that decentralisation in the system of public service delivery in primary health care and education led to improved outcomes for the rural Indian population. Before 1992, with few exceptions, there was little movement towards decentralisation. Rural local bodies functioned primarily as program executing agents for government line departments, with little control over finances, administration, or the pattern of expenditure. The only decentralisation that existed was in the importance of state governments vis-à-vis the centre. After the 1992 Constitutional Amendments, significant progress has taken place in the form of the passing of conformity legislation by state governments, the setting up of State Finance Commissions to examine the distribution of resources from states to local bodies, and accelerated moves towards transfer of planning and expenditure responsibilities to village bodies. The paper used data from the 1994 NCAER survey to test the hypothesis that increased decentralisation/democratisation positively influences enrolment rates and child mortality once the influence of socioeconomic circumstances, civil society organisations, the problem of capture of local bodies by elite groups, and so on are controlled for. Our main empirical findings are that indicators of democratisation and public participation, such as frequency of elections, presence of non-governmental organisations, parent-teacher associations and indicator variables for decentralised states generally have the expected positive effects, although these are not always statistically indistinguishable from zero.
Given the increasing demand pressure on water resources coupled with supply holdups and institutional failures, fresh-water resources are increasingly susceptible to depletion and could potentially add to water stress in India. A vast demand-supply gap necessitates water conservation, including recycling measures. India has a great potential in wastewater treatment, and one of the ways to address it is decentralisation of wastewater treatment given its environmental benefits. Based on the Contingent Valuation Method (CVM), this study assesses Delhi urban households’ willingness to pay for the Operation & Maintenance (O&M) costs of a local Wastewater Treatment Plants (WWTP) that supplies residential complexes treated water for toilet-flushing. The study found that if freshwater prices rise sufficiently for consumers, they may be willing to subsidise a decentralized WWTP to cover at least their non-potable water uses. In addition, the co-provision of such public goods can become an important supplement to urban municipal finance.