Abstract: Human development and health improvements in a nation—whether democratic or authoritarian—commonly come about through top-down interventions, bottom-up pressures or some combination of both. In India, bottom-up pressures for public services such as health, clean water and other health-related services are nearly absent. The seminar will explain: 1) why and how democracy provides 'enabling conditions' for claims for public services by civil society actors (i.e. bottom-up pressures) but 2) political freedoms are insufficient for such claims-making.