Transformation of Health Systems and Governance: Case of Surat City, Gujarat
Surat is one of the fastest growing cities in India with a total population of 48, 49,213, of which, the migrant population constitutes 58 per cent. Disaster-prone Surat witnessed a remarkable change in its governance by Surat Municipal Corporation (SMC) after the floods in 1994 and the subsequent plague outbreak. This study assessed how urban governance by the SMC evolved in the aftermath of the plague outbreak. The assessment was conducted through the thematic analysis of semi-structured interviews with key informants who included officials of SMC, members of the Surat Climate Change Trust, academics and citizens. The study traced various factors that led to the institutional transformation in public health management by the SMC after 1994. These include the revamping of SMC structure to instate a decentralised approach to governance, the commitment of SMC towards the welfare of citizens, strengthening of disease surveillance systems, involvement of academic institutions in research projects, working with international agencies on health and climate issues, e-governance initiatives, setting up an early warning system, trust of community members in the city’s leadership and the “Surati” attitude of cooperation.