| | Since the early 1990s, “decentralisation” and “integration” seem to be the buzz words
underlying the implementation of various social development programmes in India,
especially the reproductive and child health programme. Analysis reveals that the state-level
effects of various RCH services are significantly higher than those at the district level.
The pace of annual progress after 1998 in many RCH indicators is slower than before and a
few indicators (e g, child-immunisation) have worsened, despite the expenditure on the
programme being doubled. Decentralisation and integration of basic healthcare
services may not be effective unless monitored centrally and backed by full time health
(medical/paramedical) professionals at the delivery level.
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