The last 15 years have been a period of unprecedented economic growth. However, the health status of the poor and especially that of women continues to be a matter of serious concern. We live in paradoxical times, where economic growth is coupled with hunger deaths and increasing malnutrition among women and children. In the domain of reproductive health India continues to contribute the largest proportion to the global burden of maternal mortality. Access to safe abortion services, an area in which India has been a pioneer in the past, has been compromised. Issues of access (and supplies), quality and informed choice continue to dog the family planning programme. There is continued discomfort in addressing sexual rights and sexual health, with lack of clarity over the need and form of adolescent sexuality education. This has potentially disastrous health consequences for large sections of the population. While HIV and AIDS have right-fully been accepted as areas of concern, the programme is vertically driven with little integration with other communicable diseases or reproductive health programmes. There is little acknowledgement of violence against women, severely impacting their health status. Same sex relations continue to be criminalized.

 This period has also seen the emergence of new concerns e.g. artificial reproductive technologies, growing needs of adolescent population and needs of the elderly.  While there has been some mention of women’s vulnerability in policy making, many other socially vulnerable groups like dalits, adivasis, religious minorities, transgender and sexual minorities, remain invisible in the policy domain. Policy-making continues to be influenced by international concerns and agencies and also by corporate sector and commercial interests. The ‘for-profit’ private sector continues to grow without any regulation and health costs remain an important reason for impoverishment of people. While new schemes to bring women within the ambit of health systems have been floated there are hardly any measures to make the system accountable to the citizens of the country, which is an essential component of a rights based approach.