Centre for Global Health Policy

Realising global rights to health

Realising Global Rights to Health: An ethnographic analysis of rights-based organisations in promoting reproductive health in India is an ESRC funded project led by Dr Maya Unnithan.

India, unlike most other countries in the global South, has experienced a rapid shift over the past two decades from coercive, population-based health programmes, to rights-based ones. State and non-state organisations have been at the forefront of this change. Civil society organisations (CSOs) were a primary focus of the project because they have in particular been able to respond quickly to global discourses on rights and yet little is understood about what they understand by rights or how they use rights-based approaches in their work on reproductive and sexual health ‘on the ground’ and in their work with other institutions such as the state.

The research is an empirical and theoretical study tracking the transmission of rights ideas and practices transnationally and through to local recipients, producing an analysis of how rights operate within different discursive spaces. The empirical study is based in Rajasthan, which has amongst the worst reproductive and child health indicators in the country. The fieldwork focus is on rights discourse and practice at three sites: 34 civil society organisations (health related and legal), the private health sector and the state.

Key findings of the research include: 

  • Rights-based development programmes such as the National Rural Health Mission demonstrate a shift in civil society-state partnerships in India whereby CSOs are constrained from effecting change independently of the state.
  • Human rights concepts and language, however, also function as effective instruments for CSOs to maintain their critical position vis-à-vis the state, demanding accountability and transparency in the functioning of health budgets and in demanding access to universal health care and generic medicines.
  • The role and character of CSOs is shifting with an increasing contribution to legislation and policy but less on-the-ground involvement with the delivery of health services. Their work continues to be significant in mobilising communities around health issues through promoting democratic processes such as public hearings or jun sunwai.
  • Legal activists working in the field of reproductive rights in India are creatively drawing upon and strengthening legal processes such as in public interest litigation (PIL) and integrating the rights framework into their work.

Forthcoming articles:

  1. ‘Do Global Human Rights Change Development Practice?: NGO Cultures, the State and Rights-based Approaches to Health in NW India.’
  2. ‘Globalisation and the meaning of southern NGO-state partnerships: Learning from the experience of health NGOs in NW India’.
  3. ‘Realising reproductive rights in Indian law: The work of legal NGOs in promoting maternal health’.


  1. A copy of the report on this project is available:

    Thinking through Rights-based Development in Health: Institutional approaches to social inequality and gender violence in reproductive, maternal and sexual health (All India consultation and dissemination workshop report, Institute of Development Studies, Jaipur, April 9th-10th 2010).
    [PDF 2,461 KB]

  2. An overview of the final conference report is available:

    Global Flows, Human Rights, Sexual and Reproductive Health: Ethnographies of Institutional Change in the Global South (International conference, University of Sussex, July 4-5, 2011)
    [Word 33 KB]

Research team: Pradeep Kacchawa, Manju Sharma (Research assistance in India); Carolyn Heitmeyer (Post-doctoral fellow); Sumi Madhok, LSE (p/t writing input); Maya Unnithan (Principal Investigator).

For more information, please contact Dr Maya Unnithan.