Democracy, Civil Society and Health in India

A long period of democratic rule is associated with steady improvements in a nation's health. India, however, appears to be an exception in this regard. Its health failures remain visible and pronounced despite high rates of economic growth since the 1980s and more than six decades of democratic rule. While some Indian states such as Kerala and Tamil Nadu have done well to improve population health, populous states in north India have lagged behind. One of the main reasons for India's disappointing health performance is the poor provision of public services, including water supply, education, health services, garbage removal and others, whose deficits have adverse consequences on health. Based on field research in two low-income communities in New Delhi, the authors inquire why low-income groups do not use their political freedom to mobilize and make sustained claims on the state for improving those social services which affect their health and/or are a drain on their incomes.