Socio-Managerial Framework of Health Governance: Empirical Evidence from India’s National Sanitation Program (SBM-G)

Abstract

Given that citizen participation is considered the main pillar of ‘Development’, the political economy behind its practice (behaviour and utilisation) remains a question. To disentangle the complex web of relationships that the governance shares with the citizens’ interface, it would be worthwhile to examine the whole phenomenon at the grass root level. A review of issues surrounding democracy has led different schools of thought to realise the need for adopting a holistic development approach for ensuring citizens’ participation in development processes. One such school believes that it is only through addressing governance bottlenecks and ensuring spaces for participation in policy design, programme formulation and implementation supplemented with proper monitoring, that ‘real’ development can be achieved. It is also universally accepted that governance is an enabler for socio-economic transformation and this can help in the improvement of lives through the eradication of structural inequality. Hence, strengthening the local governments is critical for ensuring citizen empowerment, civic participation and better service delivery. Furthermore, governance is measurable and can be monitored; thus can ensure a measurable implementation, accountability and monitoring framework (Global Thematic Consultation on Governance and the Post-2015 Development Framework, 2013). Against these backdrops, the current study endeavours to unearth plausible factors influencing the health behaviour of rural people examining a case of India’s National Sanitation Program—Swachh Bharat Mission in Odisha villages. Analysis of primary data collected from six districts across different regions of the Odisha state shows that various managerial, governance and social factors have a significant effect on the health behaviour of people and present more insightful results.