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In 1992 the 73rd amendment to the Indian constitution called on states to create and empower rural local governments. Despite the amendment, however, there is variation in the extent of decentralization of power from states to rural local governments in the country. How has this process of decentralization influenced health outcomes in India? The research note addresses this question by collecting preliminary data on political, administrative and fiscal decentralization and examining trends in different dimensions of decentralization and infant mortality rates among select states (Assam, Rajasthan, Kerala and Tamil Nadu) from 1994 to 2017. These states display disparities in the outcome of interest and infant mortality, and have income levels that do not explain all the variation in infant mortality trends. Preliminary results demonstrate the need to adopt a multidimensional approach toward studying the consequences of decentralization.

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This is an Accepted Manuscript of an article published by Taylor & Francis in Contemporary South Asia on June 2022, available online: