In this paper, we seek to investigate the extent of financial inclusion achieved in India based on the latest available data. We analyse latest empirical trends across all states (rural and urban) for various financial instruments, outreach of financial institutions and the changes in the enabling institutions which actively promote financial deepening in India. The financial instruments that we study include bank accounts, credit outreach, insurance products, pension and payments. The financial institutions that we study include banks (ATMs, branches), the postal system, microfinance institutions and Self Help Groups as well as new institutions such as small banks and payment banks. We also analyse the role of expanding enabling institutions, specifically Aadhaar and the telecommunication network across India, which has helped facilitate the growth of financial inclusion across the country.
The Indian government's JAM trinity comprises three components: Jan Dhan bank account, Aadhaar unique identity number and mobile phone. A combination of these three elements is seen as the pathway to implementing large-scale direct benefit transfers in India. The Jan Dhan Ayojana (Peoples' Wealth Scheme) is a government scheme that aims to expand and make affordable access to financial services such as bank accounts, remittances, credit, insurance and pensions to the poor in India. This has seen a phenomenal uptake within the first few years, with an average of 2 million accounts per week. The Jan Dhan scheme was awarded a Guinness World Record for opening the most bank accounts in a single week (18 million during August 23-29, 2014). The second component is the unique identity number, Aadhaar, which is nearly universal today within the country. In early 2017, the Government of India declared that more than 1.1 billion people have an Aadhaar number, covering more than 99 percent of the Indian adult population. The third component is access to mobile phones, and this has spread across the country, mostly through private licensed operators. In India, it is not unusual for the rich to receive more welfare money than the poor. As India's Finance Ministry noted in its annual Economic Survey released in January 2017, the problem is "almost intrinsic" to the country's anti-poverty and social programmes. Much of the money is funnelled through India's convoluted bureaucracy and ends up "leaking to non-poor and…corrupt local actors." But a new promising idea is catching hold: real time, technology-enabled Direct Benefit Transfers (DBTs). The Economic Survey 2016 reported that introduction of DBT of LPG subsidies in the PAHAL scheme reduced leakages by 24 percent. Increasingly, more subsidy schemes are considering this route. It is therefore, important to take stock of the preparedness for this transition across the country. To assess the state's capability to implement DBTs, we calculate JAM preparedness indexes using household-level data. We prepare these indexes combining data on whether households have at least one bank account, whether at least one member of the household possesses an Aadhaar identification number, and whether the household owns a mobile phone.
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In this report, we focus on three important aspects of medicines in India – accessibility, quality, and affordability of drugs. The first part analyses access to drugs from two main perspectives – the accessibility of medicines via Jan Aushadhi (JA) stores and e-pharmacies. With branded generic drugs priced far higher than their unbranded generic counterparts, access to reasonably-priced drugs is limited in India. To address this, the Jan Aushadhi scheme was launched in 2008 to increase access to affordable and quality medicines. The key features of this scheme included setting up pharmaceutical stores with government support and making cheaper drugs available to consumers. Using district-level demographic and economic characteristics, we find that more JA stores are found in districts with larger proportions of urban population, higher literacy rates and a greater level of development. Despite the incentive-based nature of the scheme, which rewards store owners for the volume of business, some districts in the Northeast and Central India failed to attract any JA entrepreneurs. Lastly, with the proliferation of the internet in urban cities, we have witnessed the growth of e-pharmacies. The market share of this segment is currently small but the convenience and price discounts offered by startups in this domain are set to propel the e-pharmacy sector in the coming years. In this relatively new, innovative space, business growth has to be balanced against important regulatory needs. Without an accurate prescription validation mechanism, we could witness a rise in antibiotic resistance over time or overuse and habit formation for opioids.
In this study, we use National Sample Survey (NSS) data from surveys conducted by the Government of India. These are recall-based household surveys on multiple topics, including healthcare and consumer expenditure. More specifically, we use the 60th and 71st rounds of the NSS which included a questionnaire focused on healthcare, with questions on morbidity and the consumption of healthcare for all individuals within the surveyed households. Over the 10 years, the similarity of information collected in the two rounds of the surveys, gives us an opportunity to make scientific comparisons to understand the big changes in health and morbidity outcomes for Indian households. Our main results for health-seeking behaviour show that households still overwhelmingly depend on private providers for healthcare services. While as much as 75 per cent of out-patient care is exclusively private, 55 per cent of in-patient care is from private hospitals in India. This dependence, however, is declining and more significantly so for in-patient care. Indian households' dependence on public care has risen by 6 per cent for out-patient care and by 7 per cent for in-patient care. Most of these increases are driven by rural women seeking more public healthcare, over last 10 years. More precisely, our analysis of the data shows that the Janani Suraksha Yojana incentives led to a significant increase of 15 per cent in institutional childbirth in India with a commensurate decline in deliveries at home. The disaggregated data also shows that there was a large increase of 22 per cent in deliveries in government hospitals, which was mirrored by an 8 per cent decline in childbirth at private hospitals and a 16 per cent decline in childbirth at home. Given that the fundamental objective of the JSY was to raise institutional deliveries, the NSSO data shows that the scheme performed well over the 10 years. At the same time, it is important to note that our analysis points to the increase in public hospitalisation being incentive driven, which does not allow us to draw an inference about either the quality of services provided or the sustainability of the increase.
In this study, we describe several of the fundamental pillars that define smart cities in India, using Ajmer, Allahabad, and Visakhapatnam (Vizag) as examples. First, we establish additional context behind these efforts and provide a critical appraisal of previous government programs centered on urbanization, including the Jawaharlal Nehru National Urban Renewal Mission (JnNURM). We describe the central role of local governments in spearheading future changes across India, including the continued devolution of fiscal responsibility and authority. In particular, states and municipalities throughout India have varied widely in their implementation of the 74th Constitutional Amendment Act, which was designed to improve local governance. Across the public and private sectors, in turn, a wide range of institutional and financial factors must be weighed carefully when accelerating Smart City improvements in years to come.
