insufficient government healthcare services and expensive treatment costs, India's public infrastructure is becoming increasingly inaccessible to the general populace. "Institutions of private medicine The central government should make healthcare a bigger part of its budget. State governments must be the healthcare services and to continuously raise the standards of healthcare services from one percent of GDP to about three percent of GDP; state governments must be the healthcare services and to continuously raise the standards of healthcare services The government has two objectives. They should also get a bigger piece of the healthcare pie. To ensure that everyone has equal access to It must be noted that, because of our reliance on the service industry, education and healthcare are two sectors to which the government must devote increasing attention. The future of the service sector will be determined by human capital (professionals) and a better working environment. The general public's health would undoubtedly have a positive impact on the service sector. There are no ready-made solutions or step-by-step instructions that can help us improve healthcare. "Many times, there have been outbreaks of various diseases in one country that were not reported to the world community. However, in today's globalised world, there is a risk of disease spreading to other countries, thus WHO must ensure that states are required to share information regarding disease outbreaks. Furthermore, an international surveillance network must be established in order to take necessary preventative measures to avoid disease transmission53. Although the process may require international cooperation, the Indian government must take the lead and offer a strategy to the world community.

1. TOPIC
Health infrastructure in India and need for its Development
Name - Harsh Pratap Yadav
Sap Id – 500071402
Roll – 71
Course- BBA LLB ( BFIT)

2. Acknowledgement
• I've put in a lot of time and work into this project. However, it would
not have been possible without the generous support and assistance of
many people. I'd want to express my heartfelt gratitude to each one of
them. I owe a great debt of gratitude to Bhagya Laxmi Mam for her
persistent guidance and supervision.as well as for supplying the
project with crucial information.
• I'd want to offer our heartfelt gratitude and appreciation to one of our
staff members for their efforts, patience, time, and assistance in the
development of the project, as well as people who have willingly
contributed With their abilities, they assisted us.

3. Introduction
“Life isn't just about being alive; it's also about being well.” “An key measure for
understanding health-care policy is health infrastructure.” and a country's welfare system It
denotes the importance of the investment in terms of the Health-care facilities are being
built. India has one of the world's largest populations.in addition to the widespread
poverty1In India, it has become a severe issue. The country is in a good place. Due to its
tropical climate, which is both a blessing and a curse, it is geographically challenged. A
Subtropical Climate is beneficial to agriculture, but it also provides a breeding environment
for pests a disease's germination.
As a result of the combined effects of poverty, population density, and climate conditions,
Because of these circumstances, India's people is extremely vulnerable to disease.
“Infrastructure has been described as the foundation for delivering public health services.”
“One of the reasons for India's poor health state, according to the Government of India's
1946 Report on the Health Survey and Development Committee (commonly known as the
Bhore Committee), is the inadequacy of existing medical and preventive health
organizations.” Furthermore, the recommendations included a three-tier health-care
infrastructure plan.system4Residents in both districts will receive preventive and curative
health care at the district level.

4. • The Bhore committee report emphasized primary health care as a fundamental
right, which later became the foundation of the national health-care system. Since
the Bhore Committee, nine other committees have been constituted to look into
the healthcare concerns. The National Commission on Women was the most recent
post-independence body in the sector.2005, Macroeconomics and Health. The
report brought up the issue of a shortage of resources . This has rendered the
health-care system unaccountable and detached from public-health objectives, and
not qualified to meet people's rising expectations The entire estimated investment
Rs 74,000 crore is made up of a huge anticipated Rs 33,500 crore. The entire
estimated investment . A huge anticipated Rs 33,000 crore for capital investment is
included in the Rs 74,000 crore total .alone would be necessary to repair the
shattered health-care infrastructure. The commission made a recommendation.
As of the year 2010, more than 37% of India’s population lives below the poverty line.
The research conducted by various institutions and individuals over the past decades has exposed the vulnerability of Tropical Countries to spread of infectious diseases. See: Science Daily (20th February, 2008).
“Emerging Infectious Diseases on the Rise: Tropical Countries Predicted as Next Hot Spot”, available at <http://www.sciencedaily.com/releases/2008/02/080220132611.htm>, site accessed on 31th November, 2011.
Lloyd F. Novick, Cynthia B. Morrow, Glen P. Mays (2008). Public Health Administration (Principles for Population-based Management), 2nd edition, Jones and Bartlett Publications, Massachusetts, p.56.
At the lowest level, primary health centers (PHCs) were designed to provide basic medical care, disease prevention, and health education. The next tier, sub centers (SCs), were intended to provide public health
services. A top tier of community centers and district hospitals offers specialist services.

5. Background
• "India has the world's second-largest population. The Indian economy has been characterised by
strong growth and consistent fiscal consolidation in recent years. The rate of growth has been
8.6%.In 2010-11, it was around 9%, and in the next fiscal year, it is predicted to be around
9%.5However, in the The country lags behind in terms of health infrastructure. Economic
development is not a one-size-fits-all solution. In this perspective, Human Development is a
necessary indicator of public health in a country. Years used to calculate the index. The following
data is taken from the National Health Profile 2010 and depicts the current state of health.India's
infrastructure, on the other hand, paints a quite different picture, with the country ranking 119th in
the world.
• A). Hospital Bed Shortage: "There are 12,760 hospitals in the country, with 576,793 beds." 6795
hospitals with 149,690 beds are located in rural areas, whereas 3,748 hospitals with 399,195 beds
are located in metropolitan areas. Average number of people served each hourThe average
population served per government hospital is 90,972 people.The bed size is 2,012.8.In places like
Assam, Bihar, and Jharkhand, the situation is even worse.where only one bed is available for every
39,114,163 and 5,494 people, respectively.

6. • B). Low Number of Healthcare Centers: "As of March 2009, India has 1,45,894 S
ub Centers, 23,391 Primary Health Centers, and 4,510 Community Health Centers
" (Latest).
• Considering the 2005 National Model, these figures are insufficient.
• A SubCenter for Macroeconomics and Health was recommended by the Commissi
on on Macroeconomics and Health.
• A Primary Health Centre for every 5,000 people, a Primary Health Centre for ever
y 30,000 people, and for every 100,000 people, there is a community health centre
.
• C). Inadequate Blood Banks: "As of January 2011, the total number of licenced
Blood Banks in the country was 2,445. Except for Assam, states in North East
India have a serious shortage of blood banks; the remaining six states have only
43.Blood Banks that are licenced.”

7. • D). Urgent Need for More Medical Colleges: "The country has 314 medical institutions, 289
colleges that offer BDS (Bachelor of Dental Surgery) programmes, and 140 colleges that offer
MDS (Master of Dental Surgery) courses. "There were 29,263 total admissions (in 256 medical
colleges), 21,547 and 2,783 respectively. during the academic year 2010-11 "Assuming that all of
these new admissions would serve the increased population for the period 2010-11, each medical
professional (from medical college) would be serving a population of more than 500 people,"
each medical professional (from medical college) would be serving a population of more than
500 people. 10 Nurses and midwives are not qualified to deliver babies.
• 10 Nurses and midwives are undertrained due to a lack of infrastructure, and nursing schools in s
ome areas are more like adjuncts to district hospitals.
• In 2004, 61.2 percent of nurses worked in hospitals.
• Schools and colleges have been determined to be unfit for teaching.
• There are 11 public hospitals and clinics.
• This problem is more prevalent in areas that have been shown to be understaffed by 15-
20% on average.
• areas in the countryside

8. • E). Healthcare Concentration in Megacities: "The Central Government Health Scheme (CGHS) provides
health facilities in 24 cities, with 246 allopath dispensaries and a total of 438 dispensaries across the
country, serving 8, 47,081 registered cards/families." This diagram demonstrates. Wide disparities exist
because the majority (almost two-thirds) of these facilities are concentrated in one area. There are four
major cities.
• F). Non-availability of Critically Needed Vaccines: "The availability of life-saving vaccines is also not up
to par; for example, in 2009-10, the gap between demand and supply of DPT was over 26%; for the same
year, the gap for TT was over 16%; and for ASVS, the difference was about 12%."The difference was 54
percent (Scorpion). Poor quality pharmaceuticals are also a worry in India. Because India imports around
65 percent of its medical equipment, the lack of implementation of laws is attributable to a poor and
inadequate drug control infrastructure at equipment. Only 17 of the 31 states and union territories have
drug-testing facilities at the state and federal levels, which is compounded by a shortage of people to
implement the law regulations.
Rediff Business (25th February, 2011). “Indian Economy: A tale of robust growth” available at <http://www.rediff.com/business/slide-show/slide-show-1-budget-2011-economic-survey-indian-
economy-a-tale-ofrobust-growth/20110225.htm>, site accessed on 2nd December, 2011.
“The first Human Development Report introduced a new way of measuring development by combining indicators of life expectancy, educational attainment and income into a composite human
development index, the HDI. The breakthrough for the HDI was the creation of a single statistic which was to serve as a frame of reference for both social and economic development. The HDI
sets a minimum and a maximum for each dimension, called goalposts, and then shows where each country stands in relation to these goalposts, expressed as a value between 0 and 1.”<UNDP
(2011). For more info see: “Human Development Index” available at <http://hdr.undp.org/en/statistics/hdi/>, site accessed on 2nd December, 2011.
As per HDI index 2010 (available at http://hdr.undp.org/en/media/Lets-Talk-HD-HDI_2010.pdf).

9. Role of Government and need of an Integrated
Approach
• The Government's Role and the Need for an Integrated Approach
• According to the Indian Constitution, health care delivery is in the hands of the states.
• 17 States have struggled to maintain and govern health-care institutions in reality; they have
• "Becoming financially and programmatically reliant on the Central Government to implement health programmes."
• Although states now responsible for 75 to 90 percent of public health spending, the majority of these monies go toward salaries and
wages for healthcare workers, leaving states reliant on the federal government's fund for non-
wage items like pharmaceuticals and equipment.
• 18 Central's control has been consolidated by the method of following five-year plans.
• The system of five-year plans has solidified the central government's influence over states, and they now have complete decision-
making authority.
• The fact that many departments and agencies duplicate work or function at cross-
purposes at the federal and state levels creates a structural mismatch in governance.
• Health ineffective, such as the Indian Nursing Council's de-recognition of certain nurse training institutes.
• The Independent National Council (INC) had no effect because they continue to operate with the State's approval.
• The Nursing Council is a non-profit organisation that promotes
• As a result, one body's correction is rendered ineffective due to the intervention of another.
• The center's proposed health programmes do not always address the issue.

10. • The health programmes proposed by the centre do not always meet the people's local and neighbourhood
issues. These initiatives are focused on accomplishing policy objectives while ignoring difficulties at the
micro level, which vary by location and other demographic factors. As a result, they become unproductive
and unsustainable. An integrated and comprehensive approach20 can alleviate this problem by determining
infrastructure requirements district-by-district on the basis of population, allowing for effective infrastructure
to be constructed by the people on the ground. Better management and surveillance would be possible with
such a decentralised system. Such a decentralised system would allow for better administration and
surveillance of local health issues, as well as a shift in emphasis toward long-term strengthening and enhanced
sustainability. Finally, it would save taxpayer money because infrastructure solutions could be determined
more cost-effectively at the micro-level.”
Ma, Sai & Sood, Neeraj (2008). A Comparison of Health Systems in India and China, Occasional Paper 212, Center For Asia Pacific Policy (RAND) at pg. 19, 20.
Ibid. p. 32; A laissez- faire approach has resulted in concerns with regard to the quality of care, the absence of public regulation, mandatory registration; regular service evaluations are root cause of the problem. Due
to insufficient or non- implementation of existing laws such private entities cannot be effectively checked and made to comply with minimal requirements.
The State List (List- II) in the Seventh Schedule provides for the following entries relating to health care: Entry 6- Public health and sanitation; hospitals and dispensaries. Also article 47 of Constitution (relating to
Directive Principles of State Policy) provides for duty of the state to raise the standard of living and improve public health in the following wording: “The State shall regard the raising of the level of nutrition and the
standard of living of its people and the improvement of public health as among its primary duties and, in particular, the State shall endeavour to bring about prohibition of the consumption except for medicinal
purposes of intoxicating drinks and of drugs which are injurious to health.”
A.K. Jain (2004). “Planning Norms for Health Infrastructure” available at <http://www.helpageindia.org/helpageprd/download.php?fp=aW1hZ2VzL3B1Ymxpc2hpbmc=&f=MTMwNzA4NT I0Ny5wZGY=>, site
accessed on 6th December, 2011. The article lays emphasis on the significance of local knowledge in the fields of urban and regional planning; adoption of comprehensive approaches for water supply, sanitation,
operation and maintenance; role of town planners and architects in the creation of a healthy environment and medical infrastructure.
According to the authors such an approach would imply, a separation of programme policy, design issues, budget requirements and overall actual field implementation. Devolution of authority needs to be at central,
state, district and local levels. Involvement and empowerment of local bodies like the Panchayats (created by the 73rd and 74th Constitutional amendments) will provide for a more democratic and autonomous
system, and will ensure that no mismatch results between requirement and supply. Such delegation will not merely encompass right of such local bodies to use the government finance but would create a system of
decision-making, responsibility and accountability to the immediate higher authority.

11. • "The rapid rise of the private health sector has resulted in a situation where private actors control a major portion of
the health infrastructure; as a result, these institutions have become commercial units, and the social-welfare goal
has been lost."It's been pushed to the side. In a recent ruling21, the Supreme Court authorised government hospitals
inPoor patients would be referred to private hospitals in Delhi. This decision has been characterised as pro-poor,
with the goal of bringing poor rural patients on level with wealthy metropolitan patients who had hitherto been the
sole benefactors of such private institutions. The judge ordered that the In the meanwhile, private institutions would
give free medical care to the needy, awaiting the formulation of a plan. Private players will be involved in the
treatment of the impoverished under this arrangement. The appeal was brought in response to a previous order by
the Delhi High Court, which directed some private hospitals to provide free care to 10% of in-patients and 25% of
out-patients. The premise for the necessary finding was that the land for construction was granted on a "as is" basis
a contract requiring private players to provide free health treatment to persons who are members of certain groups
Sections of society that are economically disadvantaged. The Delhi government must comply with the apex court's
order. This decision would go a long way toward strengthening the public health system by acting as a link between
the country's economic disparities. Access to quality health care is a key issue in India, among other health-related
issues. This is something that could be addressed. This would be achieved through collaboration between state
governments and business players, ensuring that the needy receive assistance. When government facilities are
insufficient or the government is unable to meet their needs, they are entitled to compensation from private
institutions. The government is unable to offer the required access to high-quality health-care services.
"The Supreme Court's concern for child health care was evident in a case22 regarding the universalisation of the Int
egrated Child Development Scheme (ICDS), in which the court ordered massive infrastructure building in order to
adequately serve the enormous population.

12. The following were some of the instructions:
• The Government of India shall authorise and operationalize at least 14 lakh AWCs in a fiscal year."
• Starting immediately and concluding in December 2008, in a progressive and even manner.
• As a result, the Central The government would prioritise identifying SC and ST hamlets/habitations for AWCs.
"Under no circumstances shall the Government of India allow population norms for the opening of AWCs to be altered
upward." While keeping the top limit of one AWC per 1000 people, the minimum population requirement for a new AWC
is 300 people.kept in sight Furthermore, slum dwellers and rural communities should be entitled to an Anganwadi.In
circumstances when a settlement is reached, on demand (not later than three months) from the date of demandThere are at
least 40 children under the age of six who do not have access to an Anganwadi."
• "However, this grand idea has yet to be realised. The essential infrastructure has yet to be created, according to a status
report filed by the Director, Ministry of Women and Child Development (representing the Union of India) in response to
court orders. Nonetheless, significant progress has been done in accordance with the court's direction, according to the
affidavit (status report), the total number of The total number of sanctioned AWCs and micro AWCs was 10.90 lakhs
(2007). This was accomplished by The court has used an appropriate enforcement mechanism. A Scheme-Specific
method is one example.(hence referred to as ICDS) has yielded favourable outcomes and can be replicated for other
welfare programmes
Viswanathan, S (2006). “Getting for the Poor their Due in Private Hospitals” in The Hindu, 31st July, 2011.
People’s Union for Civil Liberties vs. Union of India, Writ Petition (Civil) No. 196 of 2001.

13. Judicial intervention
• The petitioner who had suffered brain hemorrhage in a fall from the train was denied
treatment at various government hospitals because of nonavailability of beds. The court
held that, providing adequate medical facilities is an essential part of the obligation
undertaken by the State in a welfare state. The Government discharges this obligation by
running hospitals and health centers. . The State fulfils this commitment by opening
Government hospitals and health centres, but in order for them to be useful, they must be
accessible to the general public and provide all of the amenities found in other hospitals.
• "The importance of health infrastructure, particularly in emergency situations, was further
examined in the landmark decision of Paschim Banga Khet Mazdoor Samiti vs. State of
W.B.24, in which the Supreme Court considered the government's legal obligation to
provide services in an emergency."Hospitals run by the government for the treatment of
those who have suffered major injuries. Medical treatment was required immediately. The
petitioner, who had a brain haemorrhage after falling from a train, was denied treatment at
several government institutions due to a lack of beds. The court determined that providing
proper medical facilities is an important aspect of the State's role in a welfare state. The
government is responsible for this. Operating hospitals and health centres fulfils this
commitment.

14. • Article 21 makes the state responsible for ensuring that everyone's right to life is protected. As a
result, the preservation of human life is of crucial importance. Any failure on the part of
government hospitals to deliver prompt medical careTo do so would be a violation of a person's
right to life. In this case, an investigation committee was formed.The committee suggested that
proper medical aid with scope be provided to study the situation.All health centres and hospitals
should have a variety of equipment and facilities to cater to patients.It also recommended other
infrastructural improvements to emergency patients and published a press release.directives to that
effect that would apply to the entire state .
• The Supreme Court stated that while financial resources would be required to carry out the
aforementioned directives, the State's fundamental commitment to provide appropriate medical
services to the people could not be compromised.be overlooked.""According to the Supreme Court,
failure to give prompt medical care is a violation."Article 21 guarantees the right to life. The state
has a responsibility to offer medical services inFinancial inability or a lack of infrastructure are not
justifications for avoiding such situations.this responsibility
• When the state fails to fulfil its constitutional obligations, the patient or immediate family members
may file a legal complaint with the Supreme Court or the High Court under Articles 32 or 226 of
the Constitution.

15. Conclusion
• "As a result of insufficient government healthcare services and expensive treatment costs, India's public
infrastructure is becoming increasingly inaccessible to the general populace. "Institutions of private medicine
The central government should make healthcare a bigger part of its budget. State governments must be the
healthcare services and to continuously raise the standards of healthcare services from one percent of GDP to
about three percent of GDP; state governments must be the healthcare services and to continuously raise the
standards of healthcare services The government has two objectives. They should also get a bigger piece of
the healthcare pie. To ensure that everyone has equal access to It must be noted that, because of our reliance
on the service industry, education and healthcare are two sectors to which the government must devote
increasing attention. The future of the service sector will be determined by human capital (professionals) and
a better working environment. The general public's health would undoubtedly have a positive impact on the
service sector. There are no ready-made solutions or step-by-step instructions that can help us improve
healthcare. "Many times, there have been outbreaks of various diseases in one country that were not reported
to the world community. However, in today's globalised world, there is a risk of disease spreading to other
countries, thus WHO must ensure that states are required to share information regarding disease outbreaks.
Furthermore, an international surveillance network must be established in order to take necessary
preventative measures to avoid disease transmission53. Although the process may require international
cooperation, the Indian government must take the lead and offer a strategy to the world community.

16. • "Many times, there have been outbreaks of various diseases in one country that were not reported to the world community.
However, in today's globalised world, there is a risk of disease spreading to other countries, thus WHO must ensure that
states are required to share information regarding disease outbreaks. Furthermore, an international surveillance network
must be established in order to take necessary preventative measures to avoid disease transmission53. Although the
process may require international cooperation, the Indian government must take the lead and offer a strategy to the world
community. "The government should evaluate its health policy on a regular basis, perhaps every two years, to analyse the
impact of the many plans and programmes it runs." The government must identify the places where healthcare services are
falling behind, and a special attention must be placed on them. For such regions, provisions should be made. Particular
attention must be paid to the areas that have been impacted by the hurricane, plagues, floods, and other natural calamities,
since disease spread is a real possibility. "The National Rural Health Mission is a fantastic programme that has improved
the quality of healthcare in rural areas dramatically." However, the mission must also encompass the urban poor,
particularly those living in slums. The mission could be expanded. If there was better resource utilisation, monitoring, and
auditing, it would be more effective. The system would broaden the mission's horizons even more. There is also a
requirement for improved technology coordination among the various parties who are directly or indirectly involved in the
domains of Central government, state governments, and civil society are all involved in healthcare. A more complete,
coordinated, and integrated approach would produce better results and result in significant changes to our healthcare
system.
The government started Janani Suraksha Yojana, under which direct conditional cash transfer schemes was initiated, it has been observed that the schemes has emerged as a big success both in reducing the maternal
mortality and reducing the expenditure of healthcare during the delivery and afterwards.
Jacob, K.S. (2011). “For a New and Improved NHRM” in The Hindu, 7th August, 2011.
In India around 350 million people have no access to safe drinking water, which directly affects their healthcare. If the government would invest substantially in providing the people safe water and sanitation
facilities, it would bring down the case of malnutrition and other many disease, For more info. See: PTI (2011). India to Blame itself for Low HDI Ranking: Infosys Chairman Narayana Murthy” in The Economic
Times, 18th July, 2010. The government must expand the NRHM to provide water purifiers to the rural people on subsidized rates, and creating sufficient physical infrastructure for sanitation facilities.