Flies without Borders: Lessons from Chennai on Improving India’s Municipal Public Health Services
比较印度金奈和德里两市市政服务组织管理差异，发现金奈通过保留专业管理和服务弱势群体改善了卫生指标，为发展中国家公共卫生政策提供借鉴。
India's cities face key challenges to improving public health outcomes. First, unequally distributed public resources create insanitary conditions, especially in slums - threatening everyone's health, as suggested by poor child growth even amongst the wealthiest. Second, devolving services to elected bodies works poorly for highly technical services like public health. Third, services are highly fragmented. This paper examines the differences in the organisation and management of municipal services in Chennai and Delhi, two cities with sharply contrasting health indicators. Chennai mitigates these challenges by retaining professional management of service delivery and actively serving vulnerable populations - while services in Delhi are quite constrained. Management and institutional issues have received inadequate attention in the public health literature on developing countries, and the policy lessons from Chennai have wide relevance.