What is Infrastructure?
Infrastructure provides supporting services in the main areas of industrial and agricultural production, domestic and foreign trade and commerce.
These services include roads, railways, ports, airports, dams, power stations, oil and gas pipelines, telecommunication facilities, the countrys educational system including schools and colleges, health system including hospitals, sanitary system including clean drinking water facilities and the monetary system including banks, insurance and other financial institutions.
Some of these facilities have a direct impact on production of goods and services while others give indirect support by building the social sector of the economy.
Some divide infrastructure into two categories economic and social. Infrastructure associated with energy, transportation and communication are included in the former category whereas those related to education, and health and housing are included in the latter.
Relevance of Infrastructure
Infrastructure is the support system on which depends the efficient working of a modern industrial economy.
Modern agriculture also largely depends on it for speedy and large scale transport of seeds, pesticides, fertilizers and the produce using modern roadways, railways and shipping facilities.
In recent times, agriculture also depends on insurance and banking facilities because of its need to operate on a very large scale.
Infrastructure contributes to economic development of a country both by increasing the productivity of the factors of production and improving the quality of life of its people.
Inadequate infrastructure can have multiple adverse effects on health.
Improvements in water supply and sanitation have a large impact by reducing morbidity from major waterborne diseases and reducing the severity of disease when it occurs.
In addition to the obvious linkage between water and sanitation and health, the quality of transport and communication infrastructure can affect access to health care.
Air pollution and safety hazards connected to transportation also affect morbidity, particularly in densely populated areas.
The State of Infrastructure in India
Traditionally, the government has been solely responsible for developing the countrys infrastructure.
But it was found that the governments investment in infrastructure was inadequate. Today, the private sector by itself and also in joint partnership with the public sector has started playing a very important role in infrastructure development.
A majority of our people live in rural areas. Despite so much technical progress in the world, rural women are still using bio-fuels such as crop residues, dung and fuel wood to meet their energy requirement. They walk long distances to fetch fuel, water and other basic needs.
The census 2001 shows that in rural India only 56 per cent households have an electricity connection and 43 per cent still use kerosene. About 90 per cent of the rural households use bio-fuels for cooking.
Tap water availability is limited to only 24 per cent rural households.
About 76 per cent of the population drinks water from open sources such as wells, tanks, ponds, lakes, rivers, canals, etc.
Access to improved sanitation in rural areas was only 20 per cent.
Energy is a critical aspect of the development process of a nation. It is, of course, essential for industries.
Now it is used on a large scale in agriculture and related areas like production and transportation of fertilizers, pesticides and farm equipment. It is required in houses for cooking, household lighting and heating
Sources of Energy:
There are commercial and non-commercial sources of energy.
Commercial sources are coal, petroleum and electricity as they are bought and sold.
Non-commercial sources of energy are firewood, agricultural waste and dried dung. These are non-commercial as they are found in nature/forests.
While commercial sources of energy are generally exhaustible, non-commercial sources are generally renewable. More than 60 per cent of Indian households depend on traditional sources of energy for meeting their regular cooking and heating needs.
Non-conventional Sources of Energy: Both commercial and non-commercial sources of energy are known as conventional sources of energy.
There are three other sources of energy which are commonly termed as nonconventional sources solar energy, wind energy and tidal power.
Being a tropical country, India has almost unlimited potential for producing all three types of energy if some appropriate cost effective technologies that are already available are used. Even cheaper technologies can be developed.
Consumption Pattern of Commercial Energy:
At present, commercial energy consumption makes up about 65 per cent of the total energy consumed in India.
This includes coal with the largest share of 55 per cent, followed by oil at 31 per cent, natural gas at 11 per cent and hydro energy at 3 per cent.
Non-commercial energy sources consisting of firewood, cow dung and agricultural wastes account for over 30 per cent of the total energy consumption.
The critical feature of Indias energy sector, and its linkages to the economy, is the import dependence on crude and petroleum products, which is likely to grow rapidly in the near future.
Health is not only absence of disease but also the ability to realize ones potential. It is a yardstick of ones well being.
Health is the holistic process related to the overall growth and development of the nation. Though the twentieth century has seen a global transformation in human health unmatched in history, it may be difficult to define the health status of a nation in terms of a single set of measures.
Generally scholars assess peoples health by taking into account indicators like infant mortality and maternal mortality rates, life expectancy and nutrition levels, along with the incidence of communicable and non- communicable diseases.
Development of health infrastructure ensures a country of healthy manpower for production of goods and services.
In recent times, scholars argue that people are entitled to health care facilities. It is the responsibility of the government to ensure the right to healthy living. Health infrastructure includes hospitals, doctors, nurses and other paramedical professionals, beds, equipment required in hospitals and a well-developed pharmaceutical industry.
It is also true that mere presence of health infrastructure is not sufficient to have healthy people: the same should be accessible to all the people.
Since, the initial stages of planned development, policy-makers envisaged that no individual should fail to secure medical care, curative and preventive, because of the inability to pay for it.
State of Health Infrastructure:
The government has the constitutional obligation to guide and regulate all health related issues such as medical education, adulteration of food, drugs and poisons, medical profession, vital statistics, mental deficiency and lunacy.
The Union Government evolves broad policies and plans through the Central Council of Health and Family Welfare. It collects information and renders financial and technical assistance to state governments, union territories and other bodies for implementation of important health programmes in the country.
Over the years, India has built up a vast health infrastructure and manpower at different levels.
At the village level, a variety of hospitals technically known as Primary Health Centers (PHCs) has been set up by the government.
Indias health infrastructure and health care is made up of a three-tier system primary, secondary and tertiary.
Primary health care includes education concerning prevailing health problems and methods of identifying, preventing and controlling them; promotion of food supply and proper nutrition and adequate supply of water and basic sanitation; maternal and child health care; immunization against major infectious diseases and injuries; promotion of mental health and provision of essential drugs.
Since independence, there has been a significant expansion in the physical provision of health services.
During 1951-2000, the number of hospitals and dispensaries increased from 9,300 to 43,300 and hospital beds from 1.2 to 7.2 million, during 1951-99, nursing personnel increased from 0.18 to 8.7 lakhs and allopathic doctors from 0.62 to 5.0 lakhs.
Expansion of health infrastructure has resulted in the eradication of smallpox, guinea worms and the near eradication of polio and leprosy.
Private Sector Health Infrastructure:
More than 70 per cent of the hospitals in India are run by the private sector. They control nearly two-fifth of beds available in the hospitals.
Nearly 60 per cent of dispensaries are run by the same private sector. They provide healthcare for 80 per cent of out-patients and 46 per cent of in-patients.
In recent times, private sector has been playing a dominant role in medical education and training, medical technology and diagnostics, manufacture and sale of pharmaceuticals, hospital construction and the provision of medical services.
In 2001-02, there were more than 13 lakhs medical enterprises employing 22 lakhs people; more than 80 per cent of them are single person owned, and operated by one person occasionally employing a hired worker.
Scholars point out that the private sector in India has grown independently without any major regulation; some private practitioners are not even registered doctors and are known as
Indian Systems of Medicine (ISM):
It includes six systemsAyurveda, Yoga, Unani, Siddha, Naturopathy and Homeopathy (AYUSH).
At present there are 3,004 ISM hospitals, 23,028 dispensaries and as many as 6, 11, 431 registered practitioners in India.
But little has been done to set up a framework to standardize education or to promote research.
ISM has huge potential and can solve a large part of our health care problems because they are effective, safe and inexpensive.
Indicators of Health and Health Infrastructure
A Critical Appraisal: As pointed out earlier, the health status of a country can be accessed through indicators such as infant mortality and maternal mortality rates, life expectancy and nutrition levels, along with the incidence of communicable and noncommunicable diseases.
Womens Health: Women constitute about half the total population in India.
They suffer many disadvantages as compared to men in the areas of education, participation in economic activities and health care.
The deterioration in the child sex ratio in the country from 945 in 1991 to 927, as revealed by the census of 2001, points to the growing incidence of female feticide in the country.
Close to 3, 00,000 girls under the age of 15 are not only married but have already borne children at least once.
More than 50 per cent of married women between the age group of 15 and 49 have anemia and nutritional anemia caused by iron deficiency, which has contributed to 19 per cent of maternal deaths.
Abortions are also a major cause of maternal morbidity and mortality in India.
Infrastructure, both economic and social, is essential for the development of a country. As a support system, it directly influences all economic activities by increasing the productivity of the factors of production and improving the quality of life.
In the last six decades of independence, India has made considerable progress in building infrastructure; nevertheless, its distribution is uneven.
Many parts of rural India are yet to get good roads, telecommunication facilities, electricity, schools and hospitals.
As India moves towards modernization, the increase in demand for quality infrastructure, keeping in view their environmental impact, will have to be addressed.
The reform policies by providing various concessions and incentives, aim at attracting the private sector in general and foreign investors in particular.
While assessing the two infrastructures energy and health it is clear that there is scope for equal access to infrastructure for all.
Health is a vital public good and a basic human right. All citizens can get better health facilities if public health services are decentralized.
Success in the long-term battle against diseases depends on education and efficient health infrastructure.
It is, therefore, critical to create awareness on health and hygiene and provide efficient systems. The role of telecom and IT sectors cannot be neglected in this process.
The effectiveness of healthcare programmes also rests on primary healthcare. The ultimate goal should be to help people move towards a better quality of life.
There is a sharp divide between the urban and rural healthcare in India. If we continue to ignore this deepening divide, we run the risk of destabilizing the socio- economic fabric of our country.
In order to provide basic healthcare to all, accessibility and affordability need to be integrated in our basic health infrastructure.