Examining decentralization and managerial decision making for child immunization program performance in India.

ABSTRACT: Despite widespread adoption of decentralization reforms, the impact of decentralization on health system attributes, such as access to health services, responsiveness to population health needs, and effectiveness in affecting health outcomes, remains unclear. This study examines how decision space, institutional capacities, and accountability mechanisms of the Intensified Mission Indradhanush (IMI) in India relate to measurable performance of the immunization program. Data on decision space and its related dimensions of institutional capacity and accountability were collected by conducting structured interviews with managers based in 24 districts, 61 blocks, and 279 subcenters. Two measures by which to assess performance were selected: (1) proportion reduction in the DTP3 coverage gap (i.e

SUBMITTER: Feldhaus I 

PROVIDER: S-EPMC9870749 | biostudies-literature | 2023 Jan

REPOSITORIES: biostudies-literature