India has embarked on a substantialprogram of decentralization following the 73rd and 74thAmendment Acts to the Constitution, which call forestablishing and significantly empowering Panchayati RajInstitutions (PRIs) at district, sub-district (block), andvillage and urban local levels. The World Bank's Indiaprogram is interested in these developments and isconsidering how it should support the Government of India(GoI) objectives in these governance reforms. A wide rangeof support mechanisms is possible, including lending andanalytical work, and focusing on national- or state-levelactivities and direct support for local governments oractions through specific sectors, such as the health sector.The study focused on five functional areas of decisionsabout health systems, strategic and operational planning,budgeting, human resources, service organization ordelivery, and monitoring and evaluation. Prior studies inother countries and Indian states had found thatdecentralization of decisions, capacities and accountabilityvaried considerably among these functional areas. In WestBengal, the formal decision space allowed for a significantrange of choice over planning, service organization,monitoring and evaluation and less range over budgeting andhuman resources. The survey questionnaire asked specificquestions about what choices the respondents had actuallymade within the possible choices granted by the formal rangeof choices.
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