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February 23, 2023 06:36 am | Updated 07:00 am IST

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Findings of the survey also indicate that those who have benefited from a Central government health scheme do give due credit to the Central government and those who have benefited from a State government health scheme, give credit to the State government.

Electoral accountability for the delivery of services requires responsibility. If voters do not think that a government is responsible for the functioning of a particular service, then they have no incentive to hold them accountable for whether that service is delivered well or not.

Providing health facilities, whether it is good hospitals, medicines or availability of doctors and other medical facilities is the responsibility of the State government. Findings from the survey indicate that most citizens are also aware that the provision of health facilities is the responsibility of the State government, even if many States do not fulfil the requirement of spending 8% of the total budget on health as laid down by the National Health Policy drafted in 2017. But the survey also indicates that a sizeable number of people think health services are the responsibility of the Central government and some believe that it is the responsibility of all levels of government. This may potentially blur lines of electoral accountability.

However, when it comes to specific health programmes a clearer picture emerges. This suggests a level of awareness that different schemes originate at different levels of government. Large numbers of Indians give credit to the Central government for the Pradhan Mantri Jan Arogya Yojana popularity known as Ayushman Bharat — the flagship national health insurance policy initiative which is funded by both the Central and State governments. People also give credit to the State government for State-run health insurance schemes. Yet opinion was divided on where responsibility lay for the mission Indradhanush Yojana.

Findings of the survey also indicate that those who have benefited from a Central government health scheme do give due credit to the Central government and those who have benefited from a State government health scheme, give credit to the State government for having availed the benefits. This indicates that Indian voters appear to carefully assess the role of the government for providing or improving existing public health facilities. This careful watch by citizens may put pressure on various governments as well as on the Central government to pay attention to the issue of public health.

Sanjay Kumar is Professor and Co-director of Lokniti-CSDS

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