Kerala People’s Campaign for

Decentralised PlanningDr. Joy ElamonDr. B. Ekbal

People’s Campaign forDecentralised Planning:

Objectives

• Strengthen the Local Governments• Solve Developmental Crisis• Initiate a New Development Culture

Local Self Government Institutions:1214

• Grama (Village) Panchayaths– 991: Population: 20,000

• Block Panchayaths– 152: Population:150,000

• District Panchayaths– 14: Population:2 Million

• Urban Bodies– Municipalities (54) Population:100,000– Corporations(3) Population:1 Million

Peoples PlanningStrategy

Plan Allocation Peoples Movement Rules and Regulation

World Bank Peoples Plan Campaign

Downsize GovernmentInvolvement in development

Involve local selfgovernment in localdevelopment

Market Centered Local planning andSocial Control

Resource mobilization insocial sectors: User Fees

Devolution ofresources from thecentralized agenciesto local bodies

Peoples Participation:Individuals, NGOs,Apolitical

Involvement of Classand Massorganization:Political Movement

Peoples Campaign for Decentralised Planning

Gramasabha(Village Assembly

Development SeminarReport

Task Forces

Projects

Plan Document

Gramasabha

Implementation

Peoples Campaign for Decentralised Planning

Massive Devolution of Resources and Power

Achievements

• Participatory Planning and Development

• Devolution of Resources and Power

• Empowerment of Women• Transparency in governance• Physical achievements

ALL-K ERALA TRENDS IN ATTENDANCE AT GRAMA SABHAS

HELD IN AUGUST–OCTOBER 1996 (GRAMA SABHA 1), DECEMBER–MARCH 1997 (GRAMA SABHA 2) J ULY -SEPTEMBER 1997

(GRAMA SABHA 3)

Percent of Voting AgeAdults

Female % ofAttendees

SC/ST as % ofAttendees

GS 1

N=972

GS 2N=712

GS 3N=901

GS 1

N=925

GS 2N=673

GS3N=901

GS1

N=408

GS2N=673

GS3N=866

11.4 10.1 11.9 26.2 30.3 38.3 8.8 18.3 17.5

Kerala Model of Health

High Health Status Low Economic Development

Kerala Model of Health

Good Health at Low CostGood Health with Social

Justice

Kerala Health ModelFrom Success to Crisis

• Low Mortality High Morbidity Syndrome

• Resurgence of Infectious Diseases• Rise in Life Style Diseases• Stagnation of Public Health System• Rising Health Expenditure• Marginalisation of the Poor

Kerala Health Reform: Goals

• Control of Infectious Diseases• Control of LSD• Revamping of Public Health System• Social Control of Private Sector• Control of Health Expenditure• Protection of the poor

Community involvement in Health

Decentralisation and Health

• Health Care institutions to local bodies• Power and resources transferred• Mandate to plan and implement locally• Human resource development

Decentralisation and Health Sector: Achievements

• Integrated Disease control programmes• Specific disease detection camps• School health programmes• Nutrition programmes• Geriatric care• Rural Sanitation• Water Supply• Health Survey• Strengthening Hospital Infrastructure

Kerala Experiment : Uniqueness

• Thrust on preventive and promotive health

• Innovative health programmes• Better working partnership health

workers and the people• Reallocation and availability of Health

Resources• Improvement of Primary and Secondary

Health Systems

Peoples Campaign: Health

Case Studies

Erattupettah: Grama PanchayathIntegrated Health Development

• Healthy Village Project• Drinking Water• Sanitation• School Health Programme• Health Cards to citizens• Healthy Hotels• Primary Health Centre Strengthening

Ponnani: Block PanchayathCommunity Mental Health

Programme

• School Mental Health Programme• Teenage Marriage Prevent ion• Mental Health Survey• Suicide Prevention• Dementia Care• Pain and Palliative Care

Nedumangad: MunicipalityModel Hospital Development

• Infrastructure • Blood Bank and Mortuary• Fair price medical shop• Hospital Sanitation

Chembilod: Grama PanchayathStudy on Gender Status in

Health Local Women’s Health Cell

• Sex Ratio • Education Status• Sanitation, Toilet and Bathing

Facilities• Household work burden• Health Care Facilities• Health and Sex Education