Parallel Systems and Human Resource Management in India's Public Health Services: A View from the Front Lines

La Forgia, Gerard ; Raha, Shomikho ; Shaik, Shabbeer ; Maheshwari, Sunil Kumar ; Ali, Rabia

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Lizenz: Creative Commons LizenzvertragParallel Systems and Human Resource Management in India's Public Health Services: A View from the Front Lines von La Forgia, Gerard ; Raha, Shomikho ; Shaik, Shabbeer ; Maheshwari, Sunil Kumar ; Ali, Rabia underlies the terms of Creative Commons Attribution-ShareAlike 3.0 Germany

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Abstract

There is building evidence in India that the delivery of health services suffers from an actual shortfall in trained health professionals, but also from unsatisfactory results of existing service providers working in the public and private sectors. This study focusses on the public sector and examines de facto institutional and governance arrangements that may give rise to well-documented provider behaviors such as absenteeism, which can adversely affect service delivery processes and outcomes. The paper considers four human resource management subsystems: postings, transfers, promotions, and disciplinary practices. The four subsystems are analyzed from the perspective of front line workers, that is, physicians working in rural health care facilities operated by two state governments. Physicians were sampled in one post-reform state that has instituted human resource management reforms and one pre-reform state that has not. The findings are based on quantitative and qualitative measurement. The results show that formal rules are undermined by a parallel modus operandi in which desirable posts are often determined by political connections and side payments. The evidence suggests an institutional environment in which formal rules of accountability are trumped by a parallel set of accountabilities. These systems appear so entrenched that reforms have borne no significant effect.

Document type: Working paper
Publisher: The World Bank
Place of Publication: Washington, D.C.
Date: 2014
Version: Secondary publication
Date Deposited: 5 February 2016
Number of Pages: 34
Faculties / Institutes: Miscellaneous > Individual person
DDC-classification: Medical sciences Medicine
Controlled Subjects: Indien, Öffentliches Gesundheitswesen
Uncontrolled Keywords: Indien, Öffentliches Gesundheitswesen, Beschäftigte / India, Public Health System, Employers
Subject (classification): Medicine
Countries/Regions: India
Additional Information: © World Bank. https://openknowledge.worldbank.org/handle/10986/19065 License: CC BY 3.0 IGO
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