Role of the Elected Panchayat Samity Members in National Health and Family Welfare Programs: A Case Study

Introduction The experiment in economic and political decentralization was introduced in the late seventies in the Indian state of West Bengal. West Bengal is predominantly rural with 72 percent of its population living in villages. Being the most populous state in India, its population size was 82 million in 2001, accounting for about 2.7 percent of the country's area (88,752 square km), but about 7.8 percent of the national population. The state ranks first in terms of density of 904 persons per sq. km. Previously, the provision and maintenance of local public goods and implementation of major public projects was discharged by the bureaucrats of central and state governments. Later, the responsibilities of these functions were handed over to formally elected village councils (Gram Panchayats). There is ample evidence that poor performance of local public services in India relates to the centralized and non-participatory nature of their management. Besides, there is little scope for people to voice their demands and criticism in the formal institutional structure (Dreze & Sen, 1995). To continue the development process of the country, the government of India initiated several measures to organize people locally by self-government or self-administration. The objective was to create an atmosphere, so that the rural people could take proper initiatives to institute social change themselves. Efforts in this direction were the 73rd and 74th amendment of the Constitution in 1992, which made it compulsory to form Gram Panchayats in the rural areas and municipalities in the urban areas in each state of the country (Directorate of Panchayat and Rural Development, 1999). The state legislature provides all opportunities to make the Panchayats complete self-government organizations. They are given legal power to formulate plan proposals for economic development and social justice (Article 243 G of the Constitution). A study by Srivastava, Ram, Paswan, and Nagdeve (2004), studied the linkages between activities of the health and family welfare programs and Panchayati Raj Institutions (PRI). The specific objectives were to study the functions and roles of the members of the PRI with regard to health and family welfare activities. The involvement of the PRI members in health and family welfare programs is certainly a good endeavor for the multi-dimensional rural development, and this novel approach may yield better results at the grassroots level. The study advocates better understanding and co-ordination between the PRI members, and health and family welfare personnel, which they believe would result in improved health and family welfare services addressing the needs of the masses in the country. The involvement and participation of the rural people in health and family welfare programs has led to a dramatic improvement as compared to the earlier state, where all the developmental projects were discharged by the bureaucrats of the government (Ghatak & Ghatak, 2002). Child morbidity and mortality is higher in developing countries. The major causes of child death are lack of safe drinking water and proper sanitation as well as poor hygiene. They are generally responsible for the transmission of many communicable diseases like diarrhea, malaria, cholera, polio, and many other parasitic infections. The diseases related to water and sanitation remains the biggest killers in developing countries like India. In the developing countries, around 90 percent of all avoidable mortality in almost all age/sex groups is from communicable diseases, most notably malaria, TB, cholera, and to a lesser extent HIV/AIDS (Mills & Shillcut, 2004). A major portion of the Indian rural population lack basic sanitation and safe drinking water. In rural areas, pond and river water were the prime sources of drinking water. The people belonging to comparatively better financial conditions have installed hand pumps, tube wells, and wells for their sources of drinking water and household use. …