ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

K K DattaSubscribe to K K Datta

How Might India's Public Health Systems Be Strengthened? Lessons from Tamil Nadu

The central government's policies have inadvertently de-emphasised environmental health and other preventive public health services in India since the 1950s. Diseases resulting from insanitary conditions impose high costs even among the more affluent, and rapid urbanisation increases the potential for disease spread. We analyse the central government's policies and then describe Tamil Nadu's public health system, which offers basic principles for strengthening public health within the administrative and fiscal resources available to most states. We suggest establishing a public health focal point in the health ministry, and revitalising the states' public health managerial and grassroots cadres. There needs to be phased progress in four areas: (1) enactment of public health acts to provide the basic legislative underpinning for public health action; (2) establishment of separate public health directorates with their own budgets and staff; (3) revitalisation of public health cadre; and (4) health department engagement in ensuring municipal public health.

Impact Assessment of Drainage Investment

Land damaged due to salinity can be reclaimed through sub-surface drainage (SSD) systems thereby increasing productivity and preserving natural resources. SSD has not been very successful so far due to cost-related problems, conflicts in resource sharing and poor implementation at the state level.

Problems and Prospects of Co-Operatives in Managing Degraded Lands-Case of Saline and Water-Logged Soils

The article identifies problems and prospects of community approach in the form of co-operatives in curing or preventing saline and water-logged soils in Haryana and Gujarat. The technology of subsurface drainage as a measure to control salinity and water-logging is technically and financially feasible. In the absence of an appropriate organisational set-up, the technology could not be widely adopted because its viability would be questionable. The management of saline and water-logged soils needs a community approach and collective vigilance. In this context, co-operatives may play a significant role. However, several factors will determine the success of drainage coroperatives. These are: (i) the problem of free-riders, (ii) disparity in benefits from drainage, (iii) varia- lion in assets, caste and religion of members, (iv) participation of beneficiaries, (v) conflicting objectives between headand tail-enders, and (vi) perception of the programme objectives. The participation score in managing saline and water-logged soils was found higher amongst poor farmers. Differential persuasion and education strategies may bring about the necessary participation to facilitate managing problem soils through co-operatives.
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