Do institutions matter? The political economy of public health provision in the British Raj (1869 - 1904)

Abstract

British India was characterized by wide regional disparities in the provision of health-related services. This late-19th century regional inequality has been under-researched, despite health being a fundamental dimension of human and economic development. This paper relies on qualitative and quantitative research to show that land-related institutions, such as the land revenue system or the type of settlement, influenced health expenditure at the local level. The importance of geographical factors such as the rainfall should be considered, and relevant provincial differences in hospital and dispensaries expenditure have been found. Finally, the origins of each institution, as well as the mechanisms through which they influenced the supply of health services, are considered.