Role of local self-governments in control of COVID-19 in Kerala: an exploratory study

Radha, D. Aso Mahmood; Kumaran, Jayasree A.; Nair, Mayamol Thekkel Raghavan

doi:10.18203/2394-6040.ijcmph20205180

Cited by 4 publications

(2 citation statements)

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“…The local government at the appropriate level had given special attention to the ailing patients (Radha et al, 2020). They were offered free and regular transportation for their treatment.…”

Section: Role Of the Village-level Governmentmentioning

confidence: 99%

Public Service Delivery in Turbulent Times Where Convergence Matters: Lessons from the Management of Covid-19 in Kerala

Datta

2022

Indian Journal of Public Administration

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In turbulent times, the state is charged with three-fold core responsibilities, namely, to reduce or arrest the impact of the crisis on the lives and property of the citizens, to ensure effective and quicker service delivery, and to maintain stateÐsociety relations. In this article, an attempt has been made to analyse how the government of Kerala, which is regarded as one of the best performing states in India, fought the battle of the first wave of Covid-19 in rural areas. An attempt is made to capture and examine the role of the local government institutions and civil society groups, more particularly Kudumbashree groups and to explore how the state government coordinated and facilitated the work of the different state and non-state actors for the convergence of the services delivered by them and for the maintenance of conducive stateÐsociety relations.

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Section: Role Of the Village-level Governmentmentioning

confidence: 99%

Public Service Delivery in Turbulent Times Where Convergence Matters: Lessons from the Management of Covid-19 in Kerala

Datta

2022

Indian Journal of Public Administration

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“…Community Health Workers (CHW) have implemented measures to better contain the spread of the pandemic. LSGs have steered the coordination of efforts and activities by volunteers [24]. There is journalistic and anecdotal information suggesting that Kerala's COVID response included formal and informal mechanisms comprising a host of players including Kudumbashree (Kerala's government-run women's SHG program), voluntary organisations, youth associations as well as new formations like the Rapid Response Team (RRT) at the ward level set up during the pandemic [25].…”

Section: Introductionmentioning

confidence: 99%

On the forms, contributions and impacts of community mobilisation involved with Kerala’s COVID-19 response: Perspectives of health staff, Local Self Government institution and community leaders

et al. 2023

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Background Kerala, a south Indian state, has a long and strong history of mobilisation of people’s participation with institutionalised mechanisms as part of decentralisation reforms introduced three decades ago. This history formed the backdrop of the state’s COVID-19 response from 2020 onwards. As part of a larger health equity study, we carried out an analysis to understand the contributions of people’s participation to the state’s COVID-19 response, and what implications this may have for health reform as well as governance more broadly. Methods We employed in-depth interviews with participants from four districts of Kerala between July and October, 2021. Following written informed consent procedures, we carried out interviews of health staff from eight primary health care centres, elected Local Self Government (LSG, or Panchayat) representatives, and community leaders. Questions explored primary health care reforms, COVID responses, and populations left behind. Transliterated English transcripts were analysed by four research team members using a thematic analysis approach and ATLAS.ti 9 software. For this paper, we specifically analysed codes and themes related to experiences of community actors and processes for COVID mitigation activities. Results A key feature of the COVID-19 response was the formation of Rapid Response Teams (RRTs), groups of lay community volunteers, who were identified and convened by LSG leaders. In some cases, pre-pandemic ‘Arogya sena’ (health army) community volunteer groups were merged with RRTs. RRT members were trained and supported by the health departments at the local level to distribute medicine and essential items, provided support for transportation to health facilities, and assisted with funerary rites during lockdown and containment period. RRTs often comprised youth cadres of ruling and opposition political parties. Existing community networks like Kudumbashree (Self Help Groups) and field workers from other departments have supported and been supported by RRTs. As pandemic restrictions eased, however, there was concern about the sustainability of this arrangement as well. Conclusion Participatory local governance in Kerala allowed for the creation of invited spaces for community participation in a variety of roles as part of the COVID 19 response, with manifest impact. However, the terms of engagement were not decided by communities, nor were they involved more deeply in planning and organising health policy or services. The sustainability and governance features of such involvement warrant further study.

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Nurturing transformative local structures of multisectoral collaboration for primary health care: qualitative insights from select states in India

Singh,

Miller,

Closser

2024

BMC Health Serv Res

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Background Multisectoral collaboration is essential for advancing primary health care (PHC). In low- and middle-income countries (LMICs), limited institutional capacities, governance issues, and inadequate stakeholder engagement impede multisectoral collaboration. India faces similar challenges, especially at the meso-level (districts and subdistricts). Owing to its dependence on context, and insufficient evidence, understanding “How” to improve multisectoral collaboration remains challenging. This study aims to elicit specific recommendations to strengthen meso-level stewardship in India for multisectoral collaboration. The findings from this study may offer lessons for other LMICs. Methods Using purposive, maximum variation sampling, the study team conducted semi-structured interviews with 20 diverse participants, including policymakers, implementers, development agency representatives, and academics experienced in multisectoral initiatives. The interviews delved into participants’ experiences, the current situation, enablers, and recommendations for enhancing stakeholder engagement and capacities at the meso-level for multisectoral collaboration. Results Context and power are critical elements to consider in fostering effective collaboration. Multisectoral collaboration was particularly successful in three distinct governance contexts: the social-democratic context as in Kerala, the social governance context in Chhattisgarh, and the public health governance context in Tamil Nadu. Adequate health system input and timely guidance instil confidence among local implementers to collaborate. While power plays a role through local leadership’s influence in setting agendas, convening stakeholders, and ensuring accountability. To nurture transformative local leaders for collaboration, holistic, equity-driven, community-informed approaches are essential. The study participants proposed several concrete steps: at the state level, establish “central management units” for supervising local implementers and ensuring bottom-up feedback; at the district level, rationalise committees and assign deliverables to stakeholders; and at the block level, expand convergence structures and involve local self-governments. Development partners can support data-driven priority setting, but local implementers with contextual familiarity should develop decentralised plans collaboratively, articulating rationales, activities, and resources. Finally, innovative training programs are required at all levels, fostering humility, motivation, equity awareness, leadership, problem- solving, and data use proficiency. Conclusion This study offers multiple solutions to enhance local implementers’ engagement in multisectoral efforts, advocating for the development, piloting, and evaluation of innovative approaches such as the block convergence model, locally-led collaboration efforts, and novel training methods for local implementers.

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Role of local self-governments in control of COVID-19 in Kerala: an exploratory study

Cited by 4 publications

References 0 publications

Public Service Delivery in Turbulent Times Where Convergence Matters: Lessons from the Management of Covid-19 in Kerala

Public Service Delivery in Turbulent Times Where Convergence Matters: Lessons from the Management of Covid-19 in Kerala

On the forms, contributions and impacts of community mobilisation involved with Kerala’s COVID-19 response: Perspectives of health staff, Local Self Government institution and community leaders

Nurturing transformative local structures of multisectoral collaboration for primary health care: qualitative insights from select states in India

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