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Background: Given India's high patient load on the existing healthcare setup, as well as political, social, and organizational challenges, the nursing sector is facing various problems, therefore leading to substandard nursing experiences leading to poor patient care at the parallel healthcare setups, specifically homecare. This paper presents self-managed organizations (SMOs) characterized by a horizontal management structure as an effective alternative to existing hierarchical management structures overladen with bureaucracy. Therefore, we are exploring the strategies at self-managed homecare organizations that can make nursing a better and more productive experience. Method: This study utilized Constructivist Grounded Theory (CGT), employing semi-structured interviews to explore nursing dynamics in horizontal organizational structures. It delved into crucial aspects like finances, organizational structure, value systems, information flow, and conflict resolution within SMOs. The methodology involved theoretical sampling, prioritizing expert self-management knowledge over mere representativeness. Seven nurses, twelve management members, and fifteen patients from self-managed homecare organizations contributed to the examination of nursing experiences. Constant comparative analysis of data led to the identification of the Qualitative Success Enablers (QSEs), revealing three themes: Insightfulness, Enhancing Nursing Experience through Job Enrichment, and Autonomy-Enabled Intrapreneurship. Results: The findings indicate that the horizontal management structure represented by the studied organization in India has shown considerable success in times laden with uncertainties during the COVID-19 pandemic, especially during the delta wave, which revealed the frailty of existing healthcare infrastructure. The organization successfully maintained a better nursing experience and gained patient and employee satisfaction, as revealed by in-depth semi-structured interviews and constant comparative analysis. Conclusion: In a world of unique challenges, we stand on the brink of significant transformations. SMOs are vital in India's homecare sector for enhancing nursing experiences and overall organizational performance. Fostering a trust-based environment within SMOs is integral to delivering effective services. The autonomy to design nursing jobs, insightfulness, and innovativeness in the nursing job through suitable training activities, various job enrichment methods, and finding meaningfulness in a job through softer aspects of caregiving result in an enhanced nursing experience at SMOs. This groundbreaking approach can be extended to other homecare organizations in India, relieving the strain on the existing healthcare system. [ABSTRACT FROM AUTHOR]

Due to the workload and lack of a critical mass of trained operational researchers within their ranks, health systems and programmes may not be able to dedicate sufficient time to conducting operational research (OR). Hence, they may need the technical support of operational researchers from research/academic organisations. Additionally, there is a knowledge gap regarding implementing differentiated tuberculosis (TB) care in programme settings. In this 'how we did it' paper, we share our experience of implementing a differentiated TB care model along with an inbuilt OR component in Tamil Nadu, a southern state in India. This was a health system initiative through a collaboration of the State TB cell with the Indian Council of Medical Research institutes and the World Health Organisation country office in India. The learnings are in the form of eleven tips: four broad principles (OR on priority areas and make it a health system initiative, implement simple and holistic ideas, embed OR within routine programme settings, aim for long-term engagement), four related to strategic planning (big team of investigators, joint leadership, decentralised decision-making, working in advance) and three about implementation planning (conducting pilots, smart use of e-tools and operational research publications at frequent intervals). These may act as a guide for other Indian states, high TB burden countries that want to implement differentiated care, and for operational researchers in providing technical assistance for strengthening implementation and conducting OR in health systems and programmes (TB or other health programmes). Following these tips may increase the chances of i) an enriching engagement, ii) policy/practice change, and iii) sustainable implementation. [ABSTRACT FROM AUTHOR]

This paper examines decentralized reform initiatives in the Indian rural water sector from a policy perspective as well as from a political perspective focused on institutional design and implementation at the local level. It argues that normative economic prescriptions regarding decentralization are not very useful. The paper finds that the institutional architecture for decentralized reforms is highly contested and requires a better understanding of power and the role of micro-politics in shaping decentralization designs and outcomes. It also suggests that greater devolution in the water sector can lead to greater decentralization and democratization across sectors. [ABSTRACT FROM AUTHOR]

In this paper, we investigate the impacts of political decentralization and women reservation in local governance on institutional births and child mortality in the state of Bihar, India. Using the difference-in-differences methodology, we find a significant positive association between political decentralization and institutional births. We also find that the increased participation of women at local governance led to an increased survival rate of children belonging to richer households. We argue that our results are consistent with female leaders having policy preference for women and child well-being. [ABSTRACT FROM AUTHOR]

Summary: This paper attempts to quantify the impact of fiscal decentralization in India on its social infrastructure and on rural development. Overall, the results in this paper indicate that Government of India within a federal framework has been fostering development equitably across its states, particularly through health and education expenditures aimed at improving human capital development. In this context, the importance of the two tier centre-states decentralization should be noted. However, the third tier of local governance, particularly the state-rural local bodies decentralization has been dismal and has not achieved significant results across states, which warrant the attention of the central and state governments. [ABSTRACT FROM AUTHOR]

In India, the pressing concern in education is with bringing in at least 32 million children estimated to be out of school, to meet the goal of Universal Elementary Education (UEE). Support for decentralisation of public services is widespread because of the equity and efficiency benefits associated with it. In particular, decentralisation is seen to facilitate the matching of services with local preferences, thus increasing the chances for policy goals to be met. This proposition is examined in the context of research carried out in a village of Raichur district in India, where poor households' 'preferences' with reference to school timings are analysed with a view to reflecting on their implications for education policy and management. The paper attempts to address the following concerns: how homogeneous are local preferences? What if these run counter to policy interests? Can aspects of services be selectively decentralised, or does the 'production' of the sector as a whole require to be rethought? The paper concludes with some thoughts on the importance of processes of 'preference' articulation, and the need to recognise preferences implicit within policy intentions. [ABSTRACT FROM AUTHOR]

The state of Kerala in India is known for its active civil society and the massive decentralization campaign launched in 1996. However marginalization of tribal communities hampers the state's decentralized environmental management strategies. The proposed construction of a dam along the Chalakkudy River will displace two colonies of the Kadar tribe in Chalakkudy and Athirapilly towns, destroy habitats of local wildlife and devastate unique riverine vegetation endemic to the region. This brings to light issues of social and environmental justice as well as a wider responsibility to protect and preserve unique flora and fauna. The state's decentralization strategies, as they relate to tribal communities, lack consideration of local power distribution and cultural conditioning. This raises questions about the state's role in social justice as well as biodiversity conservation. In 2010 and 2011, the author's interviews in Chalakkudy and Athirapilly towns reveal that tribal communities perceive that their place in society restricts their contribution regarding natural resource management and use. The paper suggests that unless the culture of planning and decision making in the state are changed, decentralized strategies will be ineffective, resulting in a predominately top-down approach towards natural resource management, and will negate Kerala's goal of democratic decentralization. [ABSTRACT FROM AUTHOR]

The present paper is based on a field study, on the role of Community Participation in School Education, conducted in the two villages of Haryana State, India. The study shows that interaction between Village Education Committee, community and certain social economic condition has led to major improvement in educational performance in one village. Special focus is on the relevance of community participation and cooperative action at the ground root level. But in second village, the social conditions, local politics and lack of mobilisation etc. are different factors which have made the concept of community participation a failure. Social exclusion in form of gender discrimination and caste hierarchy remain the common hindrances in both villages in community participation. [ABSTRACT FROM AUTHOR]