Delivering Basic Services through Local Governments in Rural
Visiting Professor-Rural Development & Decentralized Governance
National Institute of Advanced Studies
Bangalore 560 012, India
1.1 Efficient delivery of key public services in disadvantaged rural areas has been a
major problem worldwide. In India, key public services are generally failing rural areas
and where they are delivered, the quality is low. Most Indian States are characterized by
regional disparities in development and social indicators, with rain-fed, forest and waste
lands where the rural poor are concentrated, ending up on the losing side. The source of
the problem is not as much the lack of funds and programmes, but rather poor
performance and expenditure management of many of these programmes.
1.2 Dissatisfied with centralized approaches to delivering local public services, India
has recently adopted the strategy of decentralization to rural governments to improve
rural service delivery. The 73rd Constitutional Amendment of 1993 and the subsequent
State legislations have created three tiers of democratically elected sub-State rural local
self governments. Elections are held regularly, with most States having completed two
election cycles. Functions, functionaries and funds are being progressively, but slowly,
devolved on these local governments.
1.3 For a country of the size of India, decentralization to the sub-State level makes
immense sense. Even though, India’s rural decentralization is to increase the voice of
neglected areas and communities and to improve the match between diverse local
preferences and public services by bringing government closer to the people, the progress
so far has not been easy. Vested interests, in particular, those of State bureaucracies and
State and Central politicians have many a times erected obstacles in the way of effective,
representative and responsive rural governments.
1.4 One of the key issues in the design and implementation of rural decentralization in
India is articulating clearly the roles of different levels of government in the provision of
key public services. According to the Constitution, districts, block and villages have
responsibilities for primary and secondary education, primary health, water and sanitation,
rural infrastructure, agriculture, watershed management, rural development, etc. within
their jurisdiction. State legislations in Kerala and Karnataka, which are among the leading
States in decentralization, have attempted with varying degrees of clarity, to evolve funds
and powers on the rural local governments for efficient service delivery. Have these
attempts been successful or does a large gap still exist between de jure promises and de
facto realities? What should the local governments be doing and which institutional
arrangement can work better for delivery of key services even in these progressive States?
In this paper we propose to examine these questions with special reference to two specific
sectors, namely Primary Heath and Drinking Water Supply.
1.5 This paper is in five sections. The next section that follows this introduction
briefly explains the evolution of Indian federalism and also gives a glimpse of the two
States covered by our study. The third section summarizes the present scenario in the
health and water supply sectors across these States, while the fourth delineates what
needs to be done in each one of these sectors. The final section summarizes the steps to
be taken for effective service delivery through local governments in India.
2. Indian Federalism:
2.1 India the seventh largest country in the world by area and the second largest by
population covers an area of 3.29 million square kilometers with about 15,200
kilometers long land frontier and a coast-line of about 6,100 kilometers. Her 28
States and 7 Union Territories have a population of about 1027 million (as per the
2001 census). India got independence from the British rule on August 15, 1947
and is now a sovereign democratic, socialist, secular republic, which has a written
Constitution that came into force on January 26, 1950.
2.2 Village communities common to most agrarian economies have been in existence
in India for over centuries. They were called “Panchayats”-council of 5 persons,
one in every village. Under the British rule in India the autonomy of the
panchayats gradually disappeared owing to the establishment of local civil and
criminal courts, revenue and police organizations, the increase in communication
etc. Though an attempt was made to revive the panchayats at the time of enacting
the Indian Constitution, it could not materialize. While the Central and State
Governments were established by the Constitution in 1950, the local governments
could get their Constitutional status only in 1993, through the Constitution 73rd
Amendment Act, which recognized the panchayats as units of local self-
2.3 The Gramsabha (i.e. the Village Council) is the basic unit of the system. It
consists of all persons registered as voters (i.e. persons above the age of 18 years)
of that village. The gramsabha exercises general supervision over the gram
panchayat (GP) which is the elected body at the lowest level. As per the
Constitution, States with a population exceeding two million will have to
constitute an elected three-tier system of panchayatiraj Institutions (PRIs) – at the
district (Zilla Panchayat), taluk (Taluk Panchayat) and village (Gram Panchayat)
2.4 A key provision of the Constitution 73rd Amendment relates to the assignment of
functions and powers to the PRIs. Since this has to be done without disturbing the
existing federal structure of the Constitution, the amendment stipulates that the
State legislatures may endow the PRIs with such powers and authorities as may
be necessary to enable them to function as institutions of self-government. The
States may also provide for devolution of powers and responsibilities for
preparation of plans and implementation of schemes for economic development
and social justice on the 29 subjects listed in the 11th schedule of the Constitution
(See Annexure I). The devolution of functions and powers to the PRIs hence
varies from State to State depending upon their commitments and ideologies. As
of now, Kerala, Karnataka, Sikkim and West Bengal are acknowledged as the
most progressive States in effective decentralization.
2.5 The decentralized system in Karnataka, a south western State in peninsular India
was conceived long before the Constitution Amendment. It was conceived by a
visionary but worldly politician Shri Abdul Nazeer Saab, who was their Rural
Development Minister in 1983. The system which was actually put in place in
1987 provided for only two levels of elected bodies – the lower covering a
population of about 10,000 and called ‘Mandal Panchayat’ and the higher at the
district level called ‘Zilla Parishad’. Wide ranging functions were entrusted to
these local Governments, with adequate powers and finances. This model ran a
full course of 5 years and was replaced, albeit after a break, by the next generation
of three tier panchayats to fall in line with the Constitution Amendment.
2.6 The panchayats in the neighbouring State of Kerala did not have any such legacy
and started on a clean slate as per the Constitution Amendment. Unlike in other
States of India, GPs in Kerala are large in terms of their geographical area and
population which has made them economically viable. In fact 2/3rd of the GPs
have a population exceeding 20,000 and an area well over 10 square kilometers.
Compared to the other Indian States, decentralization in Kerala has gone far ahead.
From 1996-97 onwards the local governments in Kerala have been given
mandatory functions in local level planning and development. Also, 30 – 40 % of
the State plan funds had been transferred to them for formulation and
implementation of development plans at the local level, with people’s
participation, in the areas assigned to them.
3. Current Scenario
3.1.1 Provision of health care facilities through Primary Health Centres/Community
Health Centres (PHC/CHC) and hospitals and disease control through health
education are the two major components in the delivery of primary health.
Though primary health is a subject that could be entrusted to the local
governments under the 11th schedule of the Constitution, (See Annexure 1), the
Central Government has been implementing a number of externally funded
programmes for health and family welfare as well as for disease control. These
programmes are invariably carried out through vertical formations without the
involvement of the PRIs, even in Kerala and Karnataka, where the subjects they
cover squarely fall within the domain of the functions transferred to the PRIs.
3.1.2 The GPs in Karnataka virtually play no role in the primary health sector except
for participating, along with the health departments officials, in campaigns like
Pulse Polio immunization. Some GPs have contributed to the infrastructure and
amenities in the sub-centres/PHCs like provision of water, electricity and toilets
besides carrying out minor repairs. They also draw the attention of the health
department bureaucracy in times of epidemics and have participated in the
treatment of water sources when requested by the departments. The GPs do not
have any power to set right anomalies, discrepancies, irregularities or non-
availability of services either at the sub-centre level or at the PHC level. Their
knowledge is quite minimal on general health and health promotion.
3.1.3 The role of the Taluk Panchayat (TP) has also been restricted to infrastructure and
procurement. Even here, the officials of the health department play a leading role
and make use of the TP only when required. The discussions in the TP sub-
committee rarely cover important health issues or the management of resources
and personnel. The situation is similar at the Zilla Panchayat (ZP) level also
where the discussions are usually about provision of infrastructure and
procurement. All the key activities in the delivery of primary health lie with the
State department and the ZPs are involved at best in the construction of buildings
through the ZP Engineering Division. The purchase of medicines has also been
centralized through the Karnataka State Drug Logistics Society set up at the State
level. However, in times of dire necessity the ZP does chip in with left over funds
to meet emergency medical requirements.
3.1.4 When compared to the rest of India, urban-rural difference in the health status is
much less in Kearala because of the wide spread availability of health facilities
through public and private institutions in rural Kerala. With a good network of
PHCs and sub-centres, the rural parts of Kerala have been provided with a high
degree of health care. The Kerala Panchayat Act (KPA) has assigned the
management of PHCs and their sub-centres, the dispensaries and the child welfare
centers and maternity homes to the GPs. Vector control, immunization,
implementation of family welfare activities, executing strategies and programmes
for disease prevention and control as well as management of environmental
hygiene are other functions that have been entrusted to the GPs under KPA.
Doctors and health workers in these institutions are expected to work under the
supervision of the GPs, even though they belong to the State Health Department
from whom they draw their salaries. The GPs sometimes employ staff on
temporary basis against vacancies if the Public Service Commission or the local
employment exchange could not offer them any candidates. They also make
purchase of medical equipments, furniture, etc. subject to State Stores Purchase
Rules. Medicines and medical supplies are usually provided by the State
department except for the purchase and supply of ayurvedic and homeopathic
medicines which can be done by the GPs. The panchayats are also empowered to
undertake construction works, repair and maintenance of buildings of the
institutions assigned to them and purchase of medicines if urgently required,
subject to availability of funds.
3.1.5 Spraying for mosquitoes is done in the villages, sometimes at the initiative of the
GPs and sometimes at the direction of the State department. The cost of spraying
is usually borne by the GPs. Other disease control activities are generally taken up
by the PRIs, at the instance of the State department. All the personnel in the
hospital/PHCs are State Government employees and their technical control rests
with the department. Postings and transfers of health staff are made by the
department. Very often lapses and delays by the department result in the non-
availability of necessary staff in the institutions supervised by the panchayats.
The training for the doctors and health staff is conducted by the department which
is also responsible for monitoring and performance review of the medical
3.2 Drinking Water Supply:
3.2.1 Like primary health, drinking water is also a subject that can be entrusted to the
local governments under the 11th Schedule of the Constitution. Here again, the
Government of India has been funding substantially for execution of programmes.
However, the guidelines for the implementation of rural water supply
programmes under the national drinking water mission leave the selection of
implementing agency to the State Governments. While in some States, the rural
development and/or the Panchayatiraj Departments implement these programmes
through the PRIs, in some other States, the implementation is directly undertaken
through parastatals or by public health engineering departments. In some of these
programmes, operation and maintenance (O&M) and management of the scheme
are with the concerned community/user group/village water and sanitation
3.2.2 The normal sources of drinking water in Karnataka villages are open wells, Mini
Water Supply Schemes (MWS), Piped Water Supply Schemes (PWS) and Bore
Wells with Hand Pumps (BWH). In most villages, drinking water is available
within a reasonable distance and people belonging to all categories have equal
access to drinking water. Availability of drinking water is usually affected by
improper quality of power supply, which causes serious problems of maintenance
and costs. The maintenance of MWS and PWS are with the GPs and that of the
BWH with the TPs. Even though the responsibility for maintenance of BWH has
also been transferred to GPs just about a year ago, the engineering support for
repairs of BWH still comes from the TPs. The user charges for water are to be
levied and collected by the GPs. However, in most GPs the water tariff is
extremely low and the recovery is also not satisfactory. The water supply
schemes are maintained by the GPs through the watermen appointed for the
3.2.3 The responsibility for planning and implementation of all drinking water schemes
in rural areas is with the ZP. The GPs are usually not consulted by the ZPs while
finalizing water supply schemes. The beneficiary groups set up in several villages
to implement centrally sponsored schemes through community participation
sometimes act as parallel bodies, independent of the GPs concerned. The GPs
also face shortage of materials for proper maintenance, as the procurement of
these materials is the responsibility of the ZPs. The public opinion in the villages
is that the GPs through their watermen are capable of maintaining the schemes,
provided sufficient funds are available for maintenance.
3.2.4 The thrust and priority in rural water supply in Kerala has been the protection of
traditional drinking water sources like private wells, ponds and other water
streams. The scattered houses and dispersed population settlements have
historically encouraged the people of Kerala to own individual wells in their
backyard. However, a State owned parastatal namely the Kerala Water Authority
(KWA) is designated as the sole agency in the State for executing all water supply
schemes as well as distribution and maintenance of these schemes. Even though a
decision was taken to transfer about one thousand rural water supply schemes,
which cover a single GP to the respective GPs, there has been some reluctance on
the part of the GPs to take over these schemes from the KWA, in view of the
refusal of the KWA to transfer the concerned staff and also the funds to the GPs.
3.2.5 Under the KPA, setting up and running of water supply schemes for the village is
a mandatory function assigned to the GP. Planning and implementation of major
schemes covering more than one GP in the district is the responsibility of the ZP.
In practice, a few water supply schemes covering more than one GP within the
block have been taken up by the TP also. There is thus some overlapping in the
functions at different levels of PRIs in the matter of drinking water supply. In
addition, beneficiary groups have been formed in some GPs and execution of
works has been undertaken by these groups also. However the beneficiary
groups wherever they exist or the GPs maintain the assets and also levy and
collect water charges.
3.2.6 Chlorination of water is done by the beneficiary groups or the GP with the
assistance of the health personnel. Water samples are collected by the GP or the
beneficiary groups and tested in the laboratories managed by the KWA or other
State approved institutions. GP also gives subsidies to families below poverty
line for digging open wells for drinking water. The beneficiaries for this are
identified by the GP from the list of poor families, approved by the gramsabha.
Since the technical personnel engaged in drinking water supply schemes in the
village, block and district panchayats are from the KWA and their posting and
transfer is seldom done in time, there is always a dearth of adequate number of
suitable staff at the disposal of the PRIs for this work. This often stands in the
way of timely implementation of water supply schemes.
3.2.7 To sum up PRIs in both these States do play a significant role in the delivery of
drinking water. While in Karnataka, the water supply schemes are taken up by the
technical officers assigned to the panchayats and then handed over to the
community/GP for O&M, in Kerala, the beneficiary groups and the GP play a key
role not only in O&M, but also in the execution of schemes. The situation in the
health sector is, however, dismal in both the States, as both the State Governments
and the elected representatives appear to believe that the PRIs have no role in
primary health delivery except perhaps in occasional campaigns for disease
4 What needs to be done?
4.1 Existence of positive correlation between community participation and delivery of
services is well recognized. Decentralization gives space for wider and deeper
participation of citizens at the local levels. PRIs can promote inclusive
democratic processes, as they have a strong influence over the community. Public
health is very much dependent on community belief and practices that have
become a custom over time. As behavioural changes cannot take place without
the support of the community, using PRIs can be very fruitful in ensuring positive
health behaviour in the society.
4.2 As is well known, primary health is influenced more by good public health than
by good medical or clinical care. Water, sanitation, nutrition and health education
are central to the maintenance of good health and should therefore take
precedence over clinical care. Heavy capital investments are made in hospital bed
and equipment, but with high levels of absenteeism of staff, patient occupancy is
low. If some of the government staff do provide good service, it is more through
a sense of professional responsibility and personal integrity rather than through
any incentive structure implicit in institutional arrangements. In such a scenario,
State should concentrate more on public health than in providing health care. A
natural corollary to this proposition is to provide public health through public
funding which should be legitimately devolved on the panchayats so that they can
carry out their mandate in that sector. The panchayats must be given adequate
capacity to handle public health, in terms of training, options of accessing
capacity and relaxation of rules so that local capacities can grow.
4.3 On the medical and clinical care, a system of allowing patients to choose their
health provider should be put in place. The panchayats may even be given funds
to access private doctor services if need be. For instance, a private doctor can be
engaged on contract by a group of panchayats, the doctor can have an
arrangement to visit each panchayat on an appointed day and collect a small
additional fee from each patient depending upon the ailment. (In fact, a similar
system is available for cows and buffaloes under the operation flood programme
4.4 Launching of the Rural Health Mission by the Government of India recently is an
excellent opportunity to empower the local governments to manage, control and
be accountable for public health services at various levels. The village health and
sanitation committee, which can be made a standing committee of the GP, can
guide all health activities at the village level and be responsible for developing a
village health plan in consultation with the GramSabha. The GramSabha can
monitor functioning of the health centre; availability of health workers; medicines
and equipments; coverage of immunization; disease prevention and cure;
identification of beneficiary for schemes; as well as people’s contribution and
participation. It can provide an enabling environment by extending support to the
health worker in terms of providing residence, ensuring safety and taking up
relevant issues with the higher tiers in the health hierarchy.
4.5 Responsibility of implementing health programme should be shared by the State
with the PRIs, with a mandate for increasing the share of PRIs as their capacities
grow. In the multilevel federalism in India, it is imperative to clearly define the
role of the panchayats at the village, block and district levels. Overlapping of
functions among the three tiers, which may be inevitable to some extent, can
cause difficulties because of poor mutual consultations and weak coordination of
their activities in the same subject. Funds and functionaries need to be devolved
upon each tier with clear responsibility and accountability. Activity mapping
could be a good way of apportioning responsibilities. For instance, in the
Reproductive Child and Maternal Health (RC&MH) programme, the GramSabha
should identify pregnant women and infants in the age group of 0 to 12 months.
The GP should ensure the visit of auxiliary nurse-cum-midwife (ANM) and
facilitate her visit by arranging mobility and stay in the villages where required.
ANMs would identify pregnant women and infants for antenatal care and
postnatal care and immunization respectively and would deliver these services on
specified dates announced prior to the visit. GPs would make necessary
arrangement for delivery of these services in the village in the presence of the
other members of the community. It shall be the duty of the TP to ensure that the
services provided are available in the PHC/CHC on specific dates and required
material input are available for delivery of services. The ZP will ensure that the
technical staff as well as equipments and medicines are in position and necessary
budget provision is made available to the TPs/GPs to carry out their respective
4.6 In the water supply sector, the State Government should sanction and release the
funds to the ZP, who in turn should identify whether the water supply scheme can
be got implemented by the TP or the GP. The TP/GP will take the lead to
constitute beneficiary groups or the village water and sanitation committees to
formulate and implement the programme. These groups will be responsible for
the execution of schemes through community participation, by arranging
community contribution towards capital costs, procuring construction material
and goods, selecting contractors for construction activities, supervising
construction activities, commissioning and taking over completed water supply
work, collecting levies and managing O & M of the water supply works. The role
of the TP/GP should be to supervise the entire process and ensure that the
beneficiary groups implement the programme in the best interests of the
communities and remain accountable to the Gramsabhas.
4.7 Capacity building of panchayat functionaries to discharge their roles effectively is
equally important. Not only members of the panchayat but also the officials
should be covered for capacity building through designated institutions. Effective
training modules providing information on public health services at every level,
knowledge of health issues and gender sensitivity can be centrally prepared and
locally disseminated through a sustained and intensive training schedule for
capacity building. The panchayats can also arrange interaction of the service
providers with the beneficiaries to create an enabling atmosphere for better
4.8 To ensure effective implementation of health care programmes, they need to be
monitored closely for performance. The Central and State Governments could get
the PRIs involved in the monitoring process by developing suitable indicators to
monitor the availability of health staff, availability and usage of resources and
skills, structure and processes of implementation in addition to outputs/outcomes.
Competent NGOs can also be involved in monitoring and evaluation of health
care facilities, through rigorous report card systems.
4.9 A disturbing feature noticed in both the States is the fact that the service providers
responsible for physical delivery of benefits are not fully accountable to the PRIs.
While in Karnataka the officers working in these sectors at the district and sub-
district levels administratively work under the respective panchayats, in Kerala
these officers remain technically and administratively within the State
Government hierarchy. The only relationship between these officers and the
panchayats is that they are ex-officio members of the concerned sub-committees
of the panchayats and are therefore obliged to attend the meetings of the sub-
committees. Usually bureaucracy is reluctant to work under elected panchayats.
A bureaucrat, as a rule, would prefer to work under his own departmental
superiors located far away and controlling him remotely as against a political boss
who would also be functioning very much from the same place, if not from the
4.10 The present day coalition governments as well as strong labour unions also
contribute to the poor accountability of the bureaucrats to the panchayats. In a
coalition government, portfolios are allocated among the political parties
constituting the coalition. If the Minister for Health does not share the political
ideology of the Minister in charge of Panchayati Raj, he would very much like to
have his officers totally answerable to him rather than to the panchayats. The
labour unions believe that their bargaining powers would be substantially eroded,
if decentralization in cadres sets in. The senior officers of the line departments
also do not wish to work under the panchayats for fear of their own future. Most
of them generally feel that if the delivery of services in their sector is entirely
handed over to the PRIs, either they would become redundant or their future
prospects in service world be jeopardized. The interse seniority between the
Chief Executive Officer of the ZP/TP and the district/block heads of the key
service departments like health, or public health engineering is another factor
which is responsible for the sectoral heads preferring to remain with the State
Government rather than working under the panchayats.
4.11 It is, therefore, desirable for the PRIs to establish their own cadres in the long run
through direct recruitment by a Local Service Commission. Till then the
politicians and the bureaucracy at the State level should have to be continuously
educated to exhibit necessary political will and administrative acumen to let the
local governments exercise full control over their employees, even if they belong
to the State cadres.
4.12 As noted earlier, several structures and bodies have been in existence for
delivering sectoral benefits in rural areas prior to the Constitution 73rd amendment.
In the presumed interest of unity of command, professional integrity, operational
efficiency and achievement of sectoral targets, departments, boards, authorities
and corporations in each sector grew into large numbers creating their own
vertical hierarchy down to the local level. These parastatals continue to exist even
after the Constitution amendment, without being integrated into the new system.
(For example, water supply in Kerala is the function assigned to the PRIs whereas
the Kerala Act on Water Authority does not assign any role to any panchayat in
that sector.) A conscious decision has to be taken to annul these parallel
structures or to bring them under the respective tier of PRIs, by amending the
relevant sectoral legislations.
5.1 Two of the significant shifts in India, during the 21st century, have been the
increased attention to the delivery of public services on the one hand and greater
decentralization of responsibilities for these services on the other. The
decentralized local government institutions are eminently suited for service
delivery as they can ensure equity and / or equitability in the provision of services
(in view of their nearness to the people), inclusiveness (in view of the assured
representation available to all sections of the society in the PRIs), accessibility,
transparency, local participation, accountability and sustainability of services.
However, several initiatives are required to be taken to make the local
governments really effective in service delivery. These include:
ensuring participatory local level planning by the PRIs to identify needs,
levels of delivery and the enhancements desired by the people in each sector;
assigning clearly demarcated roles to the PRIs through activity mapping;
confining centrally sponsored and State schemes to a small number of
important programmes to achieve declared national and State goals and also
providing adequate space for the PRIs to participate in these schemes;
undertaking a well structured process of administrative and fiscal devolution
that matches the resource availability at each level of the panchayats with
functions assigned to it;
providing capacity to the PRIs in the widest sense of the term to perform their
responsibilities efficiently; and
putting in place systems of accountability by duly empowering the Gramsabha,
so that citizens, the ultimate recipients of services, are enabled to hold the
PRIs accountable for any inadequacies in service delivery.
5.2 Moving from a model of central provision to that of decentralization to local
governments introduces a new relationship between national and local policy
makers, while altering several existing relationships such as that between the
citizens, elected politicians and the local bureaucracy. While the decentralized
local institutions should be encouraged to take upon themselves the delivery of
basic services, they need to be empowered suitably for the purpose. As a World
Bank study rightly concludes the problem of implementing decentralization is as
important as the design of the system in influencing service delivery outcomes.
1. Government of India, 2006. Report of the Expert Group on planning at the
Grassroots level, Ministry of Panchayatiraj, Government of India, March,
2. Government of Karnataka, 2006. Annual Report of the Rural Development &
Panchayati Raj Departments, 2004-05.
3. Government of Kerala, 2006. Service Delivery Project - Document paper and
status paper on Local Self Governments.
4. Institute of Social Sciences, 2001. Consultation paper on “The Working of
the Constitutional Provisions for Decentralisation – Panchayats”.
5. Public Affairs Centre, Bangalore, 2005. Benchmarking India’s public
services – A comparision across the States.
6. Meenakshisundaram, S.S., 2004. Decentralization in Developing Countries,
Concept Publishing Company, New Delhi.
7. World Bank, 2005. “Decentralisation and Service Delivery”, World Bank
Policy Research Working Paper 3603.
1. Agriculture, including agricultural extension.
2. Land improvement, implementation of land reforms, land consolidation and soil
3. Major irrigation, water management and watershed development
4. Animal husbandry, dairying and poultry.
6. Social forestry and farm forestry
7. Minor forest produce.
8. Small scale industries, including food processing industries.
9. Khadi village and cottage industries.
10. Rural housing.
11. Drinking water.
12. Fuel and fodder. .
13. Roads, culverts, bridges, ferries, waterways and other means of communication.
14. Rural electrification, including distribution of electricity.
15. Non-conventional energy sources.
16. Poverty alleviation programme.
17. Education, including primary and secondary schools.
18. Technical training and vocational education.
19. Adult and non-formal education.
21. Cultural activities.
22. Markets and fairs.
23. Health and sanitation, including hospitals, primary health centres and dispensaries.
24. Family welfare.
25. Women and child development.
26. Social welfare, .including welfare of the handicapped and mentally retarded.
27. Welfare of the weaker sections, and in particular, of the Scheduled Castes and
the Scheduled Tribes.
28. Public distribution system.
29. Maintenance of community assets.