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Urban governance and health care provision in Delhi

Abstract : This paper considers how changes in urban governance in Delhi over the last two decades have influenced the provision of health care services. It begins by describing the introduction of, or return to, elected governments for the National Capital Territory of Delhi and for the Municipal Corporation of Delhi. It then discusses public health care, which in effect serves low-income groups as most higher-income groups now use private services, and how this has changed, drawing on interviews and direct observations of elected representatives and officials at state and municipal levels, political cadres, NGOs, members of residential welfare associations and public health care users. The research focused on four municipal wards that included a middle-class area, a mixed-income area, a ward where many slum communities had been relocated and an “urban village”. The research also included an analysis of the priority given to health care issues (and what those issues are) in the Legislative Assembly and in the Municipal Health Department and Municipal Health Committee. The paper suggests that the opening by state government of new invited spaces for resident welfare associations meant that the elected members of the Legislative Assembly and of the municipal government were by-passed. It increased the influence of resident welfare associations, but these are a feature of middle-class areas whose inhabitants use private health care. It avoided contestation, as the state could decide who was invited. The role of NGOs as advocates for the urban poor also diminished, as many were drawn into becoming implementers of government programmes. In effect, this increase in participation can be seen as a new form of centralization, strengthening the position of senior bureaucrats and by-passing the elected politicians.
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Contributor : Stéphanie Tawa Lama <>
Submitted on : Tuesday, October 20, 2020 - 5:55:51 PM
Last modification on : Saturday, November 28, 2020 - 3:28:39 AM

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Stéphanie Tawa Lama-Rewal. Urban governance and health care provision in Delhi. Environment and Urbanization, SAGE Publications, 2011, 23 (2), pp.563-581. ⟨10.1177/0956247811416433⟩. ⟨halshs-02973006⟩



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