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Constraints to scaling-up health programmes: a comparative study of two Indian states

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  • Shreelata Rao Seshadri

    (Consultant Social Development Specialist)

Abstract

This paper analyses constraints to scaling-up successful health interventions and opportunities for relaxing such constraints in Tamil Nadu and Karnataka states. The analytical framework used in the paper categorizes constraints by the level at which they operate. A comparison of the implementation of selected health programmes in Karnataka and Tamil Nadu is appropriate since there are good chances of replicating each others' successes. The case study indicates that in order to scale-up interventions, a combination of actions is required, including: adequate community involvement; clear focusing of objectives and information systems for measuring achievements against them; good technical design; and specific measures to address constraints at the policy and strategic management level. Copyright © 2003 John Wiley & Sons, Ltd.

Suggested Citation

  • Shreelata Rao Seshadri, 2003. "Constraints to scaling-up health programmes: a comparative study of two Indian states," Journal of International Development, John Wiley & Sons, Ltd., vol. 15(1), pages 101-114.
    • Handle: RePEc:wly:jintdv:v:15:y:2003:i:1:p:101-114
    DOI: 10.1002/jid.968
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    References listed on IDEAS

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    1. Valeria Oliveira-Cruz & Kara Hanson & Anne Mills, 2003. "Approaches to overcoming constraints to effective health service delivery: a review of the evidence," Journal of International Development, John Wiley & Sons, Ltd., vol. 15(1), pages 41-65.
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    Cited by:

    1. M. Kent Ranson & Kara Hanson & Valeria Oliveira-Cruz & Anne Mills, 2003. "Constraints to expanding access to health interventions: an empirical analysis and country typology," Journal of International Development, John Wiley & Sons, Ltd., vol. 15(1), pages 15-39.
    2. repec:unu:wpaper:wp2012-69 is not listed on IDEAS
    3. Arnab Acharya & Melisa Martínez-Álvarez, 2012. "Aid Effectiveness in the Health Sector," WIDER Working Paper Series wp-2012-069, World Institute for Development Economic Research (UNU-WIDER).
    4. Valeria Oliveira-Cruz & Christoph Kurowski & Anne Mills, 2003. "Delivery of priority health services: searching for synergies within the vertical versus horizontal debate," Journal of International Development, John Wiley & Sons, Ltd., vol. 15(1), pages 67-86.
    5. Acharya, Arnab & Martínez-Álvarez, Melisa, 2012. "Aid Effectiveness in the Health Sector," WIDER Working Paper Series 069, World Institute for Development Economic Research (UNU-WIDER).
    6. Kara Hanson & M. Kent Ranson & Valeria Oliveira-Cruz & Anne Mills, 2003. "Expanding access to priority health interventions: a framework for understanding the constraints to scaling-up," Journal of International Development, John Wiley & Sons, Ltd., vol. 15(1), pages 1-14.
    7. Guinness, Lorna, 2011. "What can transaction costs tell us about governance in the delivery of large scale HIV prevention programmes in southern India?," Social Science & Medicine, Elsevier, vol. 72(12), pages 1939-1947, June.

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