A study by IIM Lucknow finds that affirmative action in local government leadership can substantially enhance health outcomes in India, especially improving infant survival and maternal prenatal care.
A study led by researchers at the Indian Institute of Management (IIM) Lucknow has found that affirmative action in local government leadership can significantly improve health outcomes in India, particularly infant survival and maternal prenatal care. The study was published on Tuesday in the Proceedings of the National Academy of Sciences (PNAS) journal and highlights how structural interventions can help tackle long-standing social and health inequities.
The research showed that village clusters with leaders from historically disadvantaged groups, selected through leadership reservations for Scheduled Castes (SC), recorded notably better health outcomes. Infant mortality rates were lower, and maternal health indicators improved, including higher chances of receiving at least two prenatal visits, tetanus vaccinations, and prenatal supplements by the second trimester.
“Our study found that local leaders from historically disadvantaged groups made health and education spending decisions that appear to address structural inequalities in their communities,” said Prof. K. G. Sahadevan from IIM Lucknow.
Using a quasi-experimental design, the team compared 60 village clusters with SC-reserved leadership to 60 clusters without such reservations in 2021. They relied on administrative health records, primary school data, and in-depth interviews with local leaders.
While affirmative action improved health outcomes, the study found no significant gains in education. Test scores did not differ meaningfully between villages, and SC leaders faced challenges collaborating with teachers, suggesting that entrenched social inequalities may limit improvements in education and discourage potential SC leaders from seeking office.
The findings offer important insights for policymakers in low- and middle-income countries aiming to improve human development outcomes through structural reforms.
