Introduction

India is one of the fastest growing economies in the world (Gupta et al., 2014). Although growth in gross domestic product (GDP) has been quite volatile at times, India has still maintained an average annual growth rate of more than 7% since 2000, even reaching double-digit growth in 2010. This compares with just over 2% in the UK over the same period (World Bank, 2016a). The growth of the Indian economy has been matched by the steady increase in its labour force, which has risen from 330 million in 1990 to nearly half a billion people in 2014. This is roughly double the size of the labour force of the entire European Union. Not only has the workforce grown but it has also changed from one dominated by agriculture to one with vibrant and growing service and manufacturing sectors (World Bank, 2016b). Yet, despite drawing hundreds of millions of people into work and reducing levels of absolute poverty it is estimated that there are still 600 million Indians who lack access to necessities such as clean drinking water (Gupta et al., 2014). These privations are most keenly felt by those who are already in the most disadvantaged positions in society, such as poor people, wage labourers, agricultural labourers in rural areas, Scheduled Tribes and Scheduled Castes (Kumar, 2015). As Dreze and Sen (2014) critically note the benefits of India's tremendous economic growth have been unevenly distributed across society.

The same is true of developments in the health of the Indian population. On the one hand, there have been great improvements across a wide range of health indicators. Life expectancy has risen steadily for both sexes, largely owing to falling infant and maternal mortality rates. Life expectancy in India today (about 66 years) is more than twice what it was in 1951 (32 years) and infant mortality is about a quarter of what it used to be – 44 per thousand live births today as opposed to 180 or so in 1951 (Dreze and Sen, 2014). Infectious diseases have declined over the past few decades with some key diseases, such as maternal and neonatal tetanus and polio, being eliminated or even eradicated (Centers for Disease Control and Prevention, 2015; Narain et al., 2015; WHO, 2015).