Publication year: 2011
Source: Social Science & Medicine, In Press, Accepted Manuscript, Available online 12 July 2011
Evan S., Lieberman
In much of the developing world, a model of polycentric governance has become increasingly prevalent for the control of health and infectious disease – one in which a panoply of governance actors work concurrently on the same development projects, within the same localities. And yet, the question of whether polycentrism helps or hinders disease control/mitigation, or service provision more generally, has not been sufficiently studied. This article details findings from an exploratory case study of the polycentric governance of infectious disease in the Eastern Cape Province, South Africa. Combining analyses of an original survey of local councilors, structured interviews with…
Highlights: ► Identifies key challenges associated with polycentric or multi-actor governance of infectious disease. ► In the Eastern Cape, South Africa, polycentrism has led to substantial bottlenecks in the implementation of key AIDS policies. ► Polycentric governance poses multiple principal-agent problems, creating incentives for “free riding”. ► The misalignment of citizen preferences and the actual configuration of governance actors impedes democratic accountability