Introduction: India’s Health Puzzle

Abstract

A large number of studies show that an extended period of democratic rule benefits population health. Among other things, democracy brings about improvements in the provision of social services, which, in turn, lead to broad health gains in a country. The expansion of and improvements in social services typically come about through some combination of top-down interventions and bottom-up pressures. Looking at the health performance of India, which lags behind many developing countries despite 65 years of democratic rule, this book examines the role of bottom-up pressures in improving social services. Specifically, the book addresses the following question: Why don’t subordinate social groups utilize their political freedoms to make concerted demands for improvements in health services even though they suffer deeply from health deficits?