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Two Cheers for Decentralisation: Unpacking Mechanisms, Politics and Accountability in the ICDS, Central India.

Devanshi Chanchani
Published in: The European journal of development research (2022)
From long-term qualitative research this paper argues that Chhattisgarh's decentralised mechanisms in implementation of the Integrated Child Development Services (ICDS) foster increased stake of local communities and local politics, and that these work to enhance accountability and programme quality. A larger number of actors with financial interests in the scheme at the level of the sub-block ICDS 'sector' and down to the village leads to wider distribution of financial gains from delivery of ICDS Services, thereby increasing local competition and political interest from lower tiers of governance. Decentralised mechanisms work to enhance checks and balances via formal and informal routes to governance and accountability. Chhattisgarh's ICDS represents a 'hybrid model' between the short and long routes to accountability. While competing interests from local politics and institutions of governance work to improve ICDS accountability, they also work to appropriate the programme for political gain, or unfairly target ICDS workers. The paper unpacks mechanisms by which local politics relate with decentralised prescriptions in ICDS implementation. It gives the decentralised mechanisms a qualified two cheers.
Keyphrases
  • primary care
  • healthcare
  • mental health
  • clinical trial
  • global health
  • public health
  • randomized controlled trial
  • affordable care act
  • health insurance