That women often receive inadequate health care is increasingly being recognized. On the whole women in developing countries are exposed to the same illnesses as men, although they also have special health needs: they are likely to carry a heavier workload than men, and to spend many years in pregnancy and lactation. Despite these difficulties, the low status of women in many societies often results in their receiving an inadequate diet-putting further strain on their health-and having less access to health care. In response to the inequality and discrimination faced by women, the United Nations proclaimed 1975–85 to be the Decade for Women. This created a new awareness of the problems, but the effects have yet to be felt in the lives of most women. This paper uses the example of Indian women to highlight some of the problems addressed during the Decade for Women, and to chart some recent developments. Women in India have a particularly low status and tend to have many pregnancies, often too closely spaced. Despite high levels of malnutrition, diarrhoea and infection among women, they use health services less than men, even when they are available. This is not because women's need is less, but because they do not recognize their need or cannot overcome social and cultural barriers. The paper draws on experience gained in a programme to extend and develop health care delivery in the Indian State of Orissa to suggest policies which need particular attention if the health of women is to improve.