Political decentralisation, women’s reservation and child health outcomes: A case study of rural Bihar

  • Research has shown that political decentralisation and female leadership at the local governance level can influence policy decisions in favour of women and children.
  • This study analyses how decentralisation and women’s reservation (or quotas) at local levels of governance can improve health outcomes.
  • The 73rd and 74th Amendments to the Constitution of India devolved more power to the local governments, i.e., Panchayati Raj Institutions (PRIs). In its second panchayat election in 2006, Bihar became the first state that reserved 50 percent of panchayat seats for women.
  • The study shows decentralisation and gender quotas for women in Bihar have increased institutional births, thus increasing the safety of child delivery.
  • It also shows that women’s reservation policy has, on average, no significant effect on child mortality. However, it did find child mortality was reduced in richer households but found no such effect in middle-income or poor households.
    The study suggests that empowering local bodies and supporting female leadership may improve public health facilities and child health outcomes at the local level in Bihar.