3.2 BASIC MINIMUM SERVICES

3.2.1 The Minimum Needs Programme (MNP) was launched in the Fifth Five Year Plan. Its objective was to ensure a basic minimum standard of life for all sections of people living in the rural areas of the country. The strategy was to establish a network of facilities to attain an acceptable level of social consumption in respect of selected items within a stipulated time-frame. The rationale was twofold. First, it was felt that the competing demands for greater investment in other development sectors left relatively small allocations for social services. In the face of resource constraint, the tendency was to impose economy measures or cuts in the allocations for social sectors. Second, there were wide inter-State differences in the provision of social services and infrastructure which called for governmental intervention.

3.2.2 Initially, there were eight components of MNP, viz., elementary education, rural health, rural water supply, rural electrification, rural roads, rural housing, environmental improvement of urban slums and nutrition. While adult education was added to the list of MNP components in the Sixth Plan, rural domestic energy, rural sanitation and public distribution system were added during the Seventh Plan.

3.2.3 While in some areas of MNP, great strides have been made since the launching of the programme, for certain other components of the programme, the extent of achievement are below acceptable levels. Further, the inter-State differences in the levels of achievement still remained very high.

3.2.4 Recognising the shortfall in the achievement of the basic minimum standard of life for all sections of the people, a bold initiative was taken by the Chief Ministers Conference held in July, 1996 to ensure access of all to certain Basic Minimum Services (BMS) in a time-bound manner.

3.2.5 The Conference endorsed the seven basic minimum services as of paramount importance in securing a better quality of life for the people, especially those residing in rural areas. Further, it observed that it would be in the best interests of the country, if time-bound action plans are formulated to secure full coverage of the country with these seven basic services by 2000 AD. This was essential for the rapid growth of the economy and for social justice and hence, these basic services were to constitute the core of the social sector development plan.

3.2.6 The seven basic services identified for priority attention are:

3.2.8 During the Ninth Plan, the ACA would be distributed amongst States on the basis of BMS infrastructural gaps. This exercise to assess the infrastructural gaps is being carried out by the Planning Commission in consultation with State governments. In respect of the North-East States, the 1996-97 allocations have so far been protected and are not based on the actual gaps in infrastructure.

3.2.9 In order to ensure that adequate investments are made for BMS sectors, the Planning Commission has used the notion of Minimum Adequate Provision (MAP) to be calculated on the following basis: MAP = Actual Expenditure for 1995-96 + ACA + 15% of ACA as States share. However, for the special category States/UTs, the 15 per cent contribution has been waived.

3.2.10 While entire MAP will be earmarked in the Plan of a State/UT, there will be no sector-wise earmarking. Funds allocated for BMS can be spent on any of the BMS components and on any permissible item under each sector in accordance with the State's own priorities. The States can allocate outlays for BMS in excess of the MAP in the initial stage. However, at the Revised Estimate stage, they could reduce their proposed outlay on BMS but under no circumstances below the MAP. Failure to allocate and utilise MAP requirements would result in a curtailment of Central Assistance in the following year.

3.2.11 A brief discussion of each of the BMS components is given in the following paragraphs:

Primary Health Facilities

3.2.12 The primary health care infrastructure provides the integrated promotive, preventive, curative and rehabilitative services to the population close to their residence. It is estimated that over 80 per cent of the health care needs of the population can be met by the primary health care infrastructure; only the rest may require referral to the secondary or tertiary health care institutions.

Rural Primary Health Care

3.2.13 During the Sixth Plan, the national norms for a three tier rural primary health care infrastructure consisting of the Sub-Centre (SC), Primary Health Centre (PHC) and the Community Health Centre (CHC) were evolved. While the Sixth and the Seventh Plan witnessed major expansion of the rural health care infrastructure, the Eighth Plan concentrated the efforts on development, consolidation and strengthening of the existing health care infrastructure to bring about improvement in quality and outreach of services. The national norm for a Sub-Centre vary between 3000-5000 population depending upon terrain and location; on similar considerations the norm for a Primary Health Centre is 20,000-30,000 population; for four PHCs there should be a Community Health Centre. In accordance with these national norms the requirement for population of 1991 are: SC 1,34,108, PHC 22349 and CHC 5587; as against this there are only 1,32,730 subcentres, 21854 PHCs and 2424 CHCs as of 30.6.96. There is a gap between the number required and the functioning centres in all the three types of primary care institutions but the gap is widest in the CHCs which provide the critical linkage and are the First Referral Units; this gap shall be bridged during the Ninth Plan rapidly so as to provide urgently needed care for patients with complications referred from SC/PHC; the states shall during Ninth Plan restructure the existing sub-district/ taluka hospital and block level PHCs into functioning CHCs to the extent possible; similarly existing rural hospital and dispensaries have to be restructured wherever possible to meet the requirements in PHC’s. Such an exercise would obviate the need for creating additional infrastructure and manpower to the extent possible. There are wide inter and intra State disparities in health care infrastructure. This will be attended to on an urgent basis so as to improve quality of service in poorly performing districts. An initiative in this respect was already taken during the Eighth Plan through the Social Safety Net Programme.

3.2.14 To fill the gap in physical infrastructure, 1378 SCs, 495 PHCs and 3163 CHCs are required to be established at a total cost of approximately Rs.7000.00 crore. The total resources required for providing essential equipment for strengthening and upgradation of rural primary health care infrastructure has been estimated to be Rs.1600.00 crore. In addition there are substantial gaps in critical manpower required (type of personnel and number indicated in the Section on Health). The estimates of the total requirement of funds to bridge the critical gap in manpower works out to Rs.1400.00 crore annually. Finally for essential drugs and supplies, mobility and other recurring expenses an amount of Rs.2000.00 crore will be required annually.

Urban Primary Health Care:

3.2.15 Nearly 30 per cent of India's population live in urban areas. Due to urban migration and massive inflow of population to the towns and cities, the health status of urban slum dwellers is at times worse than the rural population. There has not been any well planned and organised efforts to provide primary health care services to the population within 2-3 Kms. of their residence and to link primary, secondary and tertiary care institutions in geographically defined areas. As a result there is either a non-availability or at times under-utilisation of available primary health care facilities and consequent over-crowding at the secondary and tertiary care centres.

3.2.16 The NDC endorsed the Approach Paper to the Ninth Plan emphasising the need to create a well-structured organisation of urban primary health care aimed at providing basic health and family welfare services to the population within one-two kilometers of their dwellings.

3.2.17 Primary health care infrastructure in urban areas should consist of health and family welfare posts to cover 10,000 to 15,000 population manned by an ANM and one male multi-purpose worker with a helper. Urban health and family welfare centre should cater to about 1-1.5 lakh population. These centres should be provided with two Medical Officers and other required supporting staff; they will provide preventive, promotive, curative and rehabilitative services and essential maternal, child health and contraceptive care.

3.2.18 As on 30.6.1996, 871 urban health and family welfare posts and 1083 health and family welfare centres have been established. The number, type and quality of manpower in these institutions located predominantly in urban slums vary considerably. To meet the requirement for primary health care of the 1996 urban population, 19480 urban health and family welfare posts and 952 health and family welfare centres have to be established. In order to cover the urban population especially the slum dwellers effectively it may be necessary to redeploy the personnel in the existing centres, strengthen the centres with appropriate manpower besides providing essential equipment, mobility and drugs.

3.2.19 For providing essential physical infrastructure for urban primary health care a sum of Rs.900.00 crores will need to be invested. The urban posts, hospitals/dispensaries were established several years ago, thus requiring strengthening and re-equipping at the cost of Rs.100.00 crore. For recurring cost of critical manpower, essential drugs and supplies and providing mobility, Rs.400.00 crore would be annual expenditure.

3.2.20 Funds for urban and rural primary health care infrastructure are provided mainly from the earmarked funds for health under the BMS in the State Plan and funds from EAPs. The manpower costs are mainly met by the State, with some funding from Centrally Sponsored Family Welfare programme and national disease control programmes. Additional Central Assistance under BMS initiated during 1996-97, is yet another funding source which must be utilised for bridging critical gaps. However there is a large gap between the availability of total funds and the minimum stated requirements.

3.2.21 While every effort shall continue to be made to provide additional financial resources for primary health care in urban and rural areas as a part of BMS, it is imperative on the part of the States to constantly review the essential needs so as to ensure optimum functioning and utilisation of existing institutions. Some of the funding for this effort will have to be internalised within the State budget. The State will need to identify poorly performing districts and provide essential funds to meet their requirements so that existing gaps in the health and demographic indices among these districts and the rest of the country could be minimised.

Universalisation of Primary Education

3.2.22 In order to achieve universalisation of primary education (UPE), it had been estimated for the year 1993-94 that approximately 142 million children in the age-group 6-11 years would have to be provided primary schooling out of which 69 million would be girls. Therefore, UPE by the year 2000 will also have to take into account the additional children who would come into the age-group 6-11 years by that year. As against this, the total number of out of school children i.e. children who are not enrolled (44 million) and children who drop out (35 million) is estimated to be 79 million. Among these, as high as 43 million are girls.

3.2.23 The latest available data on drop-out rates in class 1-V for the year 1996-97 reveal that the drop-out rate for the country as a whole was 38.95 per cent. It was 39.37 % among boys and 38.35% among girls. Further, there were wide inter-State disparities in retention and drop-out. As against the above mentioned national average, the total drop-out rates for Bihar was as high as 61.78 per cent. For boys, it was 60.85% while for girls the figure was as high as 63.44 per cent.

3.2.24 According to the Sixth All-India Education Survey, 83.4 per cent of the habitations in the country were served by a primary school within 1 km. of walking distance. However the habitations without primary schools/ sections as per the norm of 1 km. distance is as high as 1.76 lakh habitations. While 45.25% of these habitations are having population less than 300, about 40000 habitations have population of 300 or more who have to be provided primary schools.

3.2.25 Apart from availability or access to primary school within a walking distance of habitations, there are a number of other problems which are required to be tackled on an urgent basis. Some of these are low enrolment of girls, high drop-out rates, education of disadvantaged groups, lack of physical infrastructure like school buildings, teachers, teaching learning equipments and the problem of working children, low levels of achievement and regional disparities.

3.2.26 Education being a subject in the Concurrent List, both States governments and the Centre provide funds for it. The Centrally Sponsored Schemes of Operation Blackboard, Non Formal Education, Teachers Training and the District Primary Education Project supplement, in large measure, the efforts of the State government.

3.2.27 In pursuance of the adoption of the National Policy on Education (NPE), 1986, the Scheme of Operation Blackboard (OB) was introduced as a Centrally Sponsored Scheme (CSS) to provide certain minimum facilities in the primary schools in order to increase enrolment and reduce drop out. The OB norms aimed at providing at least one additional teacher preferably a female teacher, in single teacher schools, at least two reasonably large all weather classrooms for every school and a set of teaching/learning equipment. Under OB, 1.74 lakh classrooms have been constructed, 1.47 lakh teachers have been appointed and 5.23 lakh primary schools have been provided with the teaching/learning material. According to the available statistics, teaching/learning equipment have been sanctioned to almost 100% primary schools and 96% of the targetted posts of teachers had been sanctioned for single teacher schools. Even after the implementation of the OB Scheme for full five years, a large number of schools were functioning without proper buildings.Selected statistics of the Sixth All India Education Survey with the reference date 30th September 1993 reveal that out of a total number of 5.70 lakh primary schools in the country, 38,657 schools still had no buildings in rural areas.

3.2.28 In order to address the needs of the drop-outs and the working children, the Non-Formal Education (NFE) scheme is being implemented. There are at present 2.79 lakh NFE centres in operation wherein about 70 lakh children are enrolled. However, the quality of education being imparted in the NFE centres needs to be improved as well as mechanisms to ensure greater accountability for various functionaries in the system need to be evolved.

3.2.29 There is an urgent need to impart necessary training to primary school teachers. This can reduce drop-outs and the high attrition rate of primary school teachers, besides enhancing the quality of education being imparted at the primary stage. The various Centrally Sponsored Schemes for teachers training initiated in pursuance of the NPE, 1986 need to be strengthened and implemented expeditiously.

3.2.30 The District Primary Education Programme (DPEP) aims at providing access to primary education for all children, reducing drop-out rates to less than 10 per cent, increasing the learning achievement of primary school students by at least 20 per cent and reducing the gap among gender and social groups to less than 5 per cent in the educationally backward districts with female literacy below the national average and districts where the Total Literacy Campaign (TLC) have been successful leading to enhanced demand for primary education. The DPEP needs to be implemented vigorously.

3.2.31 Conservative estimates of financial implications for achieving UEE place the requirement at over Rs.40,000 crores. Assuming that atleast two third of this amount is required for achieving UPE, about Rs.26,000 crore need to be allocated for this component of Basic Minimum Services.

Safe Drinking Water For All

3.2.32 The existing norms for rural water supply is 40 litres of drinking water per capita per day (LPCD) and a public standpost or a handpump for 250 persons. Further, the sources of water supply should be within 1.6 km.horizontal distance in plains or 100 metres elevation distance in hills. For cattle in DDP areas an additional 30 LPCD is recommended. Against this, the norm for urban water supply is 125 LPCD piped water water supply with sewerage system, 70 LPCD without sewerage system and 40 LPCD in towns with spot sources. At least one source for 20 families within a maximum distance of 100 metres has been laid down.

3.2.33 As against these norms, the studies as on 1.4.1997 reveal that there were 61724 habitations without any safe source of drinking water ( called not covered habitation), 3.78 lakh habitations which were partially covered and 1.51 lakh habitations which had quality problems like excess flouride, salinity, iron and arsenic etc. Apart from the provision in the state plans for water supply, there are major Centrally Sponsored Schemes called the Accelerated Rural Water Supply Programme and the Urban Water Supply Programme for small towns with population of less than 20,000. In order to cover this backlog in rural drinking water supply, it has been estimated that approximately Rs.40000 crore will be required including the funds required for operations and maintenance and funds to tackle quality problems. Similarly, the estimates of investment required for full coverage of urban water supply is Rs.30734 crore.

Nutrition

3.2.34 There are two major programmes which provide food supplements to the vulnerable segments of the population; these are the Special Nutrition Programme (SNP) and the Midday Meal Programme (MDM).

3.2.35 Special Nutrition Programme is one of the important component of the Integrated Child Development Services Programme. The target group receiving food supplementation are children between the age of 6 months to 6 years and pregnant and lactating mothers. Efforts are made to provide 300 calories and 10 grams of proteins per child, 500 calories and 15 to 20 grams of proteins for pregnant/nursing women and 600 calories and 20 gram of proteins to severely malnourished children as food supplements at prevailing prices. The beneficiaries receive the supplements through ICDS infrastructure which is funded by the Dept of Women and Child Development. The cost of food supplements is met by the State Governments and UTs through the State plan budget. As of 1996, there are 4,200 ICDS blocks with 5,92,571 anganwadis in the country; 426.65 lakh beneficiaries are covered. By 2002, it is planned to operationalise ICDS programme in 5614 blocks with 804671 anganwadis; 579.36 lakh beneficiaries can be covered by these. Funds required for covering all these beneficiaries under SNP in the period 1997- 2002 is Rs 6792.29 crore.

3.2.36 The Programme of Nutritional Support to Primary Education popularly known as the Mid-day Meal scheme, was launched in 1995 as a fully funded Centrally Sponsored Scheme. Under this scheme, all school children in the primary schools in government and government-aided schools are to be covered. Ideally, a hot meal is provided to the children at school but for 10 months in a year. The foodgrains are delivered directly at the district level by the Food Corporation of India under instructions from the Department of Education in the Government of India. So far, the scheme has not been universalised but once it is done the annual expenditure would be of the order of Rs.2226 crore in 1997-98 going up each year on account of the increase in cost.

3.2.37 In so far as nutrition is concerned, the funds required are in the nature of recurring costs and not for the creation of infrastructure for delivery of this service. Hence, there cannot be any time-bound plan as there will be recurring expenditure until such time as poverty has been eradicated.

Housing

3.2.38 According to 1991 census, there are 3.41 million rural households who are shelterless. Apart from this, about 10.31 million households live in unserviceable katcha houses. Therefore, the total housing shortage is about 13.72 million. It should be pointed out that this shortage covers both the poor and the non-poor households. In addition it has been estimated that another 10.75 million houses would be required between 1991-2002 AD on account of an average annual growth of 0.89 million people without shelter. Thus around 24.5 million houses would have to be constructed by 2002 AD. However, it is estimated that 6.8 million houses would have already been constructed under various housing schemes of both the Centre and the States. Therefore, the total housing shortage would be approximately 17.67 million. Of this, 10.3 million would require upgradation and 7.36 million units would have to be newly constructed. The Centrally Sponsored Scheme for providing shelter to the shelterless poor is called the Indira Awaas Yojana, wherein free houses are distributed to targetted beneficiaries belonging to the poor segments, specially those who belong to SCs/ STs or freed bonded labour. Under this programme the Centre provides 80 per cent of the funds and the States the remaining 20 per cent . This is a major initiative taken by the Central government.

3.2.39 The financial implications of this are as under: The average unit cost of a house is estimated at Rs.20900 and therefore construction of 7.36 million new houses would cost Rs.15382 crore. In addition, upgradation of 10.3 million houses at an average unit cost of Rs.10,000 would amount to Rs.10300 crore. Thus, the total funds required to alleviate the housing shortage would be in the region of Rs.25700 crore. Of the total shortage, some would be financed by beneficiaries themselves particularly among those belonging to the non-poor families. Hence, the financial implications for the Government would be less than the estimated sum of Rs.25700 crores. There would also be some credit-linked housing schemes with part subsidy which would also reduce the financial burden of the Government. However, it is difficult to make a proper assessment of the funding required to meet the housing demand of the shelterless poor more precisely.

Rural Connectivity

3.2.40 Under the Minimum Needs Programme, connectivity of all villages was the long-term objective. However, it was envisaged that villages with population of 1500 and above and villages with population of 1000 to 1500 would be connected by all weather roads' by the end of the Eighth Plan. It is estimated that about 85 per cent of such villages would have been connected by all weather roads by the end of the Eighth Plan.

3.2.41 In the Ninth Plan, the target is to ensure that 85 per cent of the village population (not 85 percent of the villages) are connected by all weather roads. It is estimated that this would cost around Rs.13000 crore (excluding black topping) over a period of 5 years. However, if there has to be 100 per cent connectivity it would involve an expenditure of about Rs.65000 crore. This difference is on account of the fact that the cost of connecting a large number of small villages is very high particularly in the hilly and remote areas of the country with small population. Hence, it is suggested that 85 per cent of the population be covered first at an estimated cost of Rs.13000 crore; and that villages with population of 1000 and above be completely covered. As much as 75 per cent of villages with population of 500 to 1000 should also be covered on priority. However, in the hill areas and also in tribal, coastal, riverine and desert areas 100 per cent of the villages with population 500 should be covered.

3.2.42 While there is no CSS for rural roads, approximately 20-25% of the outlay on JRY and EAS is estimated to be spent on rural roads, amounting to approximately Rs.1000 crore.

Public Distribution System

3.2.43 The Public Distribution System has been an important part of the Government's strategy for ensuring food security. Foodgrains, mainly rice and wheat, are distributed through the network of Fair Price Shops. The Government procures and stocks the foodgrains which are then released for distribution through the PDS network. However, until recently it provided entitlement to all consumers without special focus on the poor. A fall-out of this has been that States like Orissa, Bihar, Madhya Pradesh, and Uttar Pradesh which have the highest incidence of poverty have the lowest per capita off-take from PDS. Consequently, a recent initiative, the targetted PDS (TPDS), was introduced w.e.f. 1st June, 1997. Under this, a quantity of 10 kilograms of foodgrains are to be issued per month to every Below-Poverty-Line (BPL) family at highly subsidised rates. The non-BPL families would also be entitled to foodgrains but on the same pattern as the existing PDS. In fact, while the issue prices would be about 40 per cent of the economic cost for the BPL families it would be 80 per cent for the above-poverty-line families. The subsidy implications of the TPDS at 1997-98 prices works out to about Rs.6000 crore and the carrying cost to an additional cost of Rs.1500 crore. This would be the recurring cost which would increase each year as the procurement price goes up.

3.2.44 The provision for the food subsidy accrues to the non-Plan budget of the Central Government. However, for strengthening the delivery system, schemes for construction of godowns, purchase of mobile vans/trucks and manpower training are funded from the Plan. The first two schemes are largely confined to remote, inaccessible and hilly areas to augment shortage in storage capacity through construction of small godowns and also to distribute foodgrains in these areas via mobile vans where Fair Price Shops are not found feasible. The financial implications of these schemes are small, assessed at Rs.115 crore for the Ninth Plan period.