Infrastructure: Energy & Health

Part A: Energy

Types of Energy

• Commercial energy: Coal, petroleum, natural gas, electricity. Bought and sold in the market.
• Non-commercial energy: Firewood, cow dung cakes, agricultural waste. Used mainly in rural households; not traded commercially.
• Renewable energy: Solar, wind, hydro, geothermal. Inexhaustible sources; environmentally cleaner.

India's Energy Challenges

Despite being the world's 4th largest holder of coal reserves, India faces a persistent energy crisis:

• Power deficit of approximately 10% — supply regularly falls short of demand
• Transmission and Distribution (T&D) losses of ~27%, compared to the global average of ~8%. Huge wastage in the grid.
• India imports approximately 75% of its crude oil needs — a major energy security and balance-of-payments concern
• Per capita electricity consumption ~900 kWh/year vs ~13,000 kWh in the USA — enormous gap

Policy Responses

• Electricity Act 2003: Restructured the power sector. Allowed open access, private participation, and delicensing of generation.
• Jawaharlal Nehru National Solar Mission (JNNSM): Ambitious target for solar energy capacity. Part of India's renewable energy push.
• RGGVY (Rajiv Gandhi Grameen Vidyutikaran Yojana): Rural electrification scheme — aimed to provide electricity to all villages and below-poverty-line households.

Part B: Health

Health Infrastructure — Four Tiers

India's public health system is structured in four tiers, each serving a larger population catchment:

• Sub-Centre: Serves ~5,000 population. First point of contact in rural areas. Run by ANM (Auxiliary Nurse Midwife). Handles basic preventive care, immunisation, and maternal care.
• Primary Health Centre (PHC): Serves ~30,000 population. Has a doctor. Handles outpatient care, deliveries, and disease surveillance.
• Community Health Centre (CHC): Serves ~1.2 lakh population. Has specialists. Provides referral services, surgery, and in-patient care.
• District Hospital: Serves the entire district. Full specialist services, emergency care, blood bank.

Public Health Spending and Issues

• India's public health expenditure is approximately 1% of GDP — far below the WHO recommended 5%
• Severe shortage of rural doctors — doctor-patient ratio ~0.7 per 1,000 (WHO norm: 1 per 1,000)
• High out-of-pocket expenditure pushes millions below the poverty line each year
• India has emerged as a major health tourism destination — affordable private hospitals attract international patients

NRHM and Key Schemes

• NRHM (National Rural Health Mission, 2005): Strengthened rural health delivery. Introduced ASHA workers (Accredited Social Health Activists) — community health volunteers who act as a link between the community and the public health system. Now called NHM (National Health Mission).
• Janani Suraksha Yojana: Cash incentive for institutional deliveries to reduce maternal and infant mortality.

Key Health Indicators (2011–12)

• Infant Mortality Rate (IMR): 44 per 1,000 live births (2011)
• Maternal Mortality Rate (MMR): 178 per lakh live births
• Life Expectancy at Birth: 66.1 years (2011)
• Public health spending: ~1% of GDP
• Doctors per 1,000 people: ~0.7 (WHO norm: 1)

Key Concepts at a Glance

Sample MCQs