Managing Healthcare Provision and Health Outcomes Through Local Governance

This paper examines the impact of devolution of responsibilities and finances to local governments in India on the health status and incomes of men and women. Using a national dataset with details on health, health-seeking behaviour and local governance, we estimate a system of simultaneous equations to show that healthcare expenditures at the household level, choice of healthcare provider, and the incidence of illness will jointly impact individual incomes. We find positive impacts of participation in local governance, reserving the position of village head for women, and family inheritance for women on health outcomes, choice of healthcare provider, and expenditure on healthcare.