take place only every few years − and public health takes a back seat among election issues in most countries, especially where citizens have little experience of healthier environments.

Under these circumstances, devolution to local bodies can diminish technical /professional inputs into service delivery. This can be very discouraging to staff performance. Even in a country like Sri Lanka, where citizens have come to expect good public health services, the 1987 devolution to the province level made it harder for line agency staff to maintain professional standards.<sup>28</sup>

- b) Some areas of service delivery are highly technical in nature, and require management by trained professionals rather than lay politicians.<sup>29</sup> Public health requires a high level of technical expertise, to assess evolving threats and design effective responses to them. Professionalization of the sector is important for sustaining institutional capacity. And as Mansuri and Rao (2012:177) note: “When externalities are significant, it is particularly important that standards and rules be set at a higher level”.

Interestingly, two small privileged enclaves of Delhi rejected such devolution. The New Delhi Municipal Council (NDMC), home to the central government that had promoted devolution, explicitly stated that such arrangements would be inefficient: <mark>‘Efficient function of the Municipal services in this area is critical for the internal image of the country.... it was felt that any scheme for the governance of this area based on conventional pattern of representative local self-government, would be unworkable and out of place since the pre-eminent character of this area is that of the seat of the Central Government.’</mark><sup>30</sup> The NDMC Council is managed by Indian Administrative Service (IAS) officers nominated by the Central Government, with some inputs from local elected representatives and civilian professionals.<sup>31</sup> The Delhi Cantonment area is run by the Army, with some inputs from local elected representatives. These small enclaves of Delhi are well-resourced, which certainly helps, but their governance structure is critical for achieving good outcomes. The NDMC and Delhi Cantonment rank very high in the urban sanitation surveys, while the MCD that serves 96% of Delhi’s population languishes far behind (Table 1).

Devolution has been carried out in both the MCD and the CMC, with elected representatives formally in charge, while IAS officers manage the staff. However, their governance and accountability arrangements differ substantially, with the CMC retaining far more professional control of service delivery.

In the MCD, the elected representatives (Councilors) take charge at every level, from the headquarters down to the ward where grassroots service delivery takes place. At each of these levels, they take all the major decisions while the technical and field staff work under them. There are few accountability mechanisms within the MCD, and scant checks on the Councilors’ powers. A randomized control trial in Delhi slums found faint evidence that politicians respond to citizens’ reporting of problems with sanitary services.<sup>32</sup> With enough political pressure, Councilors can have IAS officers transferred,<sup>33</sup> so the latter are constrained in monitoring and supporting their staff. The MCD’s technical staff is thus left to adjust as best they can to the wishes of the elected politicians.

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