ACCESS TO FEMALE SURGICAL STERILIZATION IN BRAZIL AND INDIA: POVERTY, POLICIES AND POLITICS

India and Brazil face the same nature of challenges regarding the supply of family planning services and, more specifically, of tubal ligation. The size and complexity of decentralized political and administrative organizations in both countries imprint a high degree of difficulty in health provision that central governments and state-level authorities are not able to control and enforce. In this sense, local-level heterogeneity as for economic, political, social, and demographic differences reigns. The aim of this article is to analyze the factors associated with the differentials in the access of tubal ligation and clinical reversible methods in the public health sector in Brazil and India as well as to establish and discuss common treads stemming from public policies and politics that influence family planning. The focus is on poor women parity two or higher. We use the 2006 Demographic and Health Survey for Brazil and the National Family Health Survey 2005-06 for India. Although access has improved over time our findings point that contemporary obstacles to public family planning services can be traced in the early initiatives and are related to the political economy of family planning organization in the three spheres of political power – central, state-, and local-level.