Infrastructure in India

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Introduction to Infrastructure Definition: Infrastructure provides supporting services for industrial and agricultural production, domestic and foreign trade, and commerce. Components: Roads, railways, ports, airports, dams, power stations, oil/gas pipelines, telecommunication, educational system, health system (hospitals), sanitary system (clean drinking water), and monetary system (banks, insurance). Impact: Direct impact on production of goods and services. Indirect support by building the social sector of the economy. Categories: Economic Infrastructure: Energy, transportation, communication. Social Infrastructure: Education, health, housing. Relevance: Essential support system for efficient working of modern industrial economy and agriculture. Contributes to economic development by increasing productivity and improving quality of life. Inadequate Infrastructure: Can lead to multiple adverse effects, e.g., on health (morbidity from waterborne diseases, limited access to healthcare due to poor transport). State of Infrastructure in India Traditionally, the government was solely responsible for infrastructure development. Current trend: Private sector and public-private partnerships (PPP) play a significant role due to inadequate government investment. Rural Infrastructure Challenges: Majority of rural population (over 60%) still uses biofuels (crop residues, dung, fuel wood) for energy. Low electricity connection (56% households in 2001 census). High kerosene usage (43% households in 2001 census). Limited tap water availability (24% rural households). Reliance on open sources for drinking water (76% population). Poor access to improved sanitation (20% rural areas). Investment: India invests about 34% of its GDP on infrastructure, which is lower than China and Indonesia. Future Projection: To become the third biggest economy, India needs to boost infrastructure investment significantly. Shifting Needs: Low-income countries: Basic infrastructure (irrigation, transport, power) is crucial. Mature economies: More service-related infrastructure (power, telecommunication) becomes important as basic consumption demands are met. Energy Sector in India Importance: Critical for national development, essential for industries, agriculture (production and transportation of inputs), and households (cooking, lighting, heating). Sources of Energy: Commercial Sources: Coal, petroleum, electricity (bought and sold). Generally exhaustible (except hydropower). Non-Commercial Sources: Firewood, agricultural waste, dried dung (found in nature/forests). Generally renewable. Non-Conventional Sources: Solar energy, wind energy, tidal power. India has high potential for these, requiring cost-effective technologies. Consumption Pattern of Commercial Energy (India): Commercial energy consumption: ~74% of total. Largest share: Coal (54%), followed by oil (32%), natural gas (10%), and hydro energy (2%). Non-commercial energy sources: ~26% of total (firewood, cow dung, agricultural wastes). Import dependence on crude and petroleum products is a critical feature. Sectoral consumption changes: Transport sector's share has fallen, while household, agriculture, and industrial sectors' shares have increased. Power/Electricity Significance: Most visible form of energy, identified with modern civilization's progress, critical for economic development. Demand Growth: Generally higher than GDP growth rate; needs to grow ~12% annually for 8% GDP growth. Power Generation Mix (2016): Thermal: 67% Hydro: 14% Nuclear: 2% New and Renewable Energy: 17% Challenges in the Power Sector: Insufficient installed capacity to meet 7-8% annual economic growth (only adds 20,000 MW/year). Under-utilised installed capacity due to improper plant operation. State Electricity Boards (SEBs) incur huge losses (over Rs 500 billion) due to transmission/distribution losses, wrong pricing, and inefficiencies. Private sector and foreign investors not playing full role. Public unrest due to high tariffs and prolonged power cuts. Thermal power plants face raw material (coal) shortages. Policy Shift: Government has pursued privatisation, especially in distribution, and allowed higher electricity prices. Energy Conservation: Promoting CFLs and LED bulbs for energy saving. LED bulbs use significantly less energy than incandescent bulbs and CFLs. Health Infrastructure in India Definition of Health: Not just absence of disease but ability to realise one's potential; holistic process related to national growth and development. Health Indicators: Infant mortality rate, maternal mortality rates, life expectancy, nutrition levels, incidence of communicable/non-communicable diseases. Government Role: Constitutional obligation to guide and regulate health, evolve policies, render financial/technical assistance. Three-Tier Health System: Primary Healthcare: Includes education on health problems, promotion of food supply/nutrition, water/sanitation, maternal/child care, immunisation, mental health, essential drugs. Provided by Auxiliary Nursing Midwives (ANMs), Primary Health Centres (PHCs), Community Health Centres (CHCs), and sub-centres in villages/small towns. Often manned by a single doctor, nurse, and limited medicines. Secondary Healthcare: Hospitals with better facilities (surgery, X-ray, ECG), located in district headquarters and big towns. Provide both primary and better healthcare. Tertiary Healthcare: Hospitals with advanced equipment and medicines for complicated health problems. Includes premier institutes for medical education, research, and specialised care (e.g., AIIMS, PGI Chandigarh). Expansion of Health Services (1951-2017): Government hospitals and dispensaries: Increased from 9,300 to 51,300. Hospital beds: Increased from 1.2 lakh to 7.1 lakh. Nursing personnel: Increased from 0.18 lakh to 28.8 lakh. Allopathic doctors: Increased from 0.62 lakh to 10.4 lakh. Resulted in eradication of smallpox, guinea worms, and near eradication of polio/leprosy. Private Sector in Healthcare Grown significantly due to public sector shortcomings. Runs >70% of hospitals, controls ~2/5ths of hospital beds. Runs ~60% of dispensaries. Provides healthcare for 80% of out-patients and 46% of in-patients. Dominant role in medical education, training, technology, diagnostics, pharmaceuticals, and hospital construction. Lack of regulation: Many private practitioners are not registered doctors. Health Indicators & Critical Appraisal (India vs. Other Countries, 2015-2017) Indicator India China USA Sri Lanka Infant Mortality Rate / 1000 live births 34 8 5.7 7.5 Under-5 mortality / 1000 live-births 39.4 9.3 6.6 8.8 Birth by skilled attendants (% of total) 85.7 100 99 99 Infants immunised (DTP) (%) 88 99 95 99 Government health spending as a % of GDP (%) 3.9 5.7 16.8 3.0 Out of pocket expenditure as a % of current health expenditure 65 32.4 11.1 38.4 Government expenditure on health (3.9% of GDP) is very low compared to other countries. India bears 20% of the Global Burden of Disease (GBD) with 17% of world population. Over half of GBD in India is due to communicable diseases (diarrhoea, malaria, TB). High infant mortality from water-borne diseases (5 lakh children die annually). Indian Systems of Medicine (ISM) Includes: Ayurveda, Yoga, Unani, Siddha, Naturopathy, Homeopathy (AYUSH). Current status: 3,943 AYUSH hospitals, 27,700 dispensaries, 7.4 lakh registered practitioners. Potential: Effective, safe, inexpensive; can solve a large part of healthcare problems. Challenge: Lack of standardisation in education and research. Urban-Rural and Poor-Rich Divide in Healthcare Rural Disparity: 70% of population in rural areas, but only 1/5th of hospitals are located there. Rural areas have only ~half the number of dispensaries and ~30% of government hospital beds. Many PHCs in rural areas lack basic facilities like X-ray or blood testing. States like Bihar, MP, Rajasthan, UP lag in rural healthcare. Shortage of doctors in rural areas persists despite many graduates (many leave for better prospects or opt for urban private hospitals). Economic Disparity: Poorest 20% spend 12% of income on healthcare, while rich spend 2%. Medical costs push 2.2% of population below poverty line annually. Poor are forced to sell assets or incur debt for treatment, often leading to death if unable to pay. Women's Health Women face disadvantages in education, economic activities, and healthcare. Deteriorating child sex ratio (927 in 2001 to 914 in 2011) indicates growing female foeticide. High rates of child marriage and early motherhood. Over 50% of married women (15-49 years) suffer from anaemia and nutritional anaemia (contributes to 19% of maternal deaths). Abortions are a major cause of maternal morbidity and mortality. Conclusion Infrastructure is crucial for economic and social development. India has made progress since Independence, but distribution remains uneven, especially in rural areas. Modernisation increases demand for quality infrastructure with environmental considerations. Reform policies (concessions, incentives) aim to attract private and foreign investment. Equal access to energy and health infrastructure is a significant goal.