000			01905pab a2200181 454500
008			180718b2015 xxu||||| |||| 00| 0 eng d
100			_aForgia, Gerard La et al
245			_aParallel systems and human resource management in India's public health services: a view from the front lines
260			_c2015
300			_ap.372-389.
362			_aDec
520			_aThere is building evidence in India that the delivery of health services suffers both from an actual shortfall in trained health professionals and from unsatisfactory results of existing service providers working in the public and private sectors. This study focuses on the public sector and examines de facto institutional and governance arrangements that may give rise to well-documented provider behaviors such as absenteeism that can adversely affect service delivery processes and outcomes. We analyze four human resource management (HRM) subsystems: postings, transfers, promotions and disciplinary practices from the perspective of front-line workers - physicians working in rural healthcare facilities operated by two state governments. We sampled physicians in one post-reform state that has instituted HRM reforms and one pre-reform state that has not. The findings are based on both quantitative and qualitative measurements. The results show that formal rules are undermined by a parallel modus operandi in which desirable posts are often determined by political connections and side payments. The evidence suggests an institutional environment in which formal rules of accountability are trumped by a parallel set of accountabilities. These systems appear so entrenched that reforms have borne no significant effect. - Reproduced.
650			_aHuman resources development - India
650			_aHealth services - India
650			_aHealth services
773			_aPublic Administration and Development
909			_a110322
999			_c110317 _d110317