Early in her career, Poonam Muttreja chose an unconventional path- one that would later underpin her significant contributions to India’s public health landscape. Inspired by Gandhiji, she left the office behind and travelled across India, living with communities, watching how people actually lived, what they struggled with, and what their lives looked like from the inside.
She did not just observe. She paid close attention to how NGOs operated, how they related to government programmes, and what their role looked like within local governance structures.
That experience never left her. It became the foundation of everything she would go on to do.
Today, as Executive Director of the Population Foundation of India (PFI), Muttreja works at the intersection of population, public health, and gender. Her work spans policy engagement, community-level programmes, and mass media campaigns. But at the heart of it all is a simple conviction: policies fail when they are designed without the people they are meant to serve.
From Control to Choice
When Muttreja started working in this space more than three decades ago, population was seen largely through the lens of numbers and targets. The dominant concern was control. Over time, especially after the International Conference on Population and Development in 1994, the framing began to shift toward a rights-based approach, one that placed women’s health, agency, and choice at the centre.
Speaking to The Logical Indian, Muttreja pointed out that despite significant progress, the tension has not gone away entirely.
“Even today, we see cycles of panic around population explosion and population collapse,” she said. “The real evolution we need is to move away from numbers altogether and focus on people, on whether individuals, especially women, are able to make informed choices about their lives.”
The persistence of alarmist narratives, she argues, is not accidental. “Population narratives are often driven more by perception, anxiety, and misconception than by evidence. It is easier to talk about ‘too many’ or ‘too few’ people than to address deeper issues like inequality, gender norms, poor governance, or lack of investment in health and education.”
What Policy Misses
One of the recurring themes in Muttreja’s work is the gap between what policies assume and what life on the ground actually looks like. Programmes are often built on the assumption that individuals, especially women, have the autonomy to make decisions.
“A programme may assume that a woman can decide when to seek care or use contraception,” she explains, “but in reality, those decisions are shaped by family dynamics, social norms, and economic dependence.”
This is why PFI has long argued for engaging with what is known as the “social determinants of health.” Coverage on paper does not automatically translate into outcomes in practice. As Muttreja puts it, PFI’s goal has been to “bring public into public health,” meaning communities must not just receive services, but shape them. Policies, she notes, are often translated into programmes not at the district or block level but by experts who have little contact with the public.
Between 2005 and 2023, PFI, by a government order, hosted the Secretariat of the Advisory Group on Community Action constituted by the Ministry of Health and Family Welfare (MoHFW) under the National Health Mission, helping scale community accountability mechanisms from 9 to 25 states. Over that period, PFI supported community action processes in more than 230,000 villages.
What Government Cannot Do Alone
Muttreja is careful not to pit civil society against the government. She sees them as essential to each other, but with genuinely different strengths.
Civil society brings innovation and community trust. The government brings scale. But there is something more specific at play too. Adaptive challenges, the kind that require flexibility, responsiveness, and mission-driven commitment, are not naturally in the government’s DNA. That is where NGOs step in, driven by their mandate and motivation in ways that institutional systems are not built for.
“When communities, frontline workers, and policymakers are in the same room,” she says, “accountability becomes real.”
A Three-Level Approach
At PFI, the work is structured across three distinct but closely linked levels. At the policy level, the focus is on engaging decision-makers to translate evidence into effective policies and stronger systems. At the societal level, PFI uses social and behaviour change communication to shift norms, attitudes, and public discourse. At the individual level, the goal is to support informed choice by ensuring people have access to the right information and services.
Across all three levels, rigorous research serves as the anchor. It informs both programmes and policy engagement. And alongside research, media plays a critical role, shaping narratives, amplifying evidence, and creating an enabling environment for sustained change.
But Muttreja is candid about a practical challenge: “Policies are not always driven by evidence or data,” she says. This is why PFI has a dedicated Knowledge Management team, whose role is to translate complex evidence into compelling, accessible narratives, grounding statistics in lived realities and connecting them to policy implications. It is an iterative process where insights shape storytelling, and storytelling in turn sharpens how evidence is communicated.
The Difference Between Agency and Empowerment
Perhaps the most important distinction Muttreja draws in her work is between agency and empowerment.
“Agency is the ability to make choices. Empowerment is the ability to act on them,” she says. “And that shift, from intention to action, is shaped as much by social norms as by access to resources.”
A woman may have access to a service. She may even know about it. But if the norms within her household or community restrict her from using it, access means little.
Crucially, Muttreja also insists that this is not just a conversation about women. “Patriarchy is not sustained by men alone; norms are internalised and reproduced across society, including among women.” Any effort to advance gender equality must therefore engage men and boys as well, challenging what it means to hold power and what masculinity is allowed to look like. At As PFI, our motto is: “Desh badlega jab mard badlega.”
When Stories Do What Policies Cannot
One of PFI’s most well-known contributions is the transmedia initiative Main Kuch Bhi Kar Sakti Hoon, a show that used entertainment edutainment to create awareness on gender norms, family planning, and gender-based violence.
The choice of medium was deliberatte. “Policies can set direction, but stories make change feel personal, possible, and immediate,” Muttreja says. Through characters and narratives, the show could raise sensitive issues without triggering resistance, and it could tap into something that data alone cannot access: people’s aspirations.
The programme reached millions of viewers and demonstrated that when people see change modelled through storytelling, they begin to imagine it for themselves.
Navigating Resistance
Pushing for gender-sensitive reform means encountering resistance, whether cultural, political, or institutional. Muttreja does not shy away from that reality, but her approach to it is careful and deliberate.
“The key is to stay grounded in evidence, build alliances, and engage rather than confront where possible,” she told The Logical Indian. “At the same time, one has to be willing to speak truth to power.”
In practice, this means sharing data-based briefs not just with allies but with those who hold opposing views, and being equally attentive to the arguments coming from the other side. PFI makes it a priority to engage with its critics rather than talk past them.
On politically charged topics, such as the communally inflected narratives around Muslim population growth rates, PFI has responded consistently with credible government data. They have challenged distortions across print, digital, and electronic media, often prioritising the very outlets most responsible for spreading misinformation. “We are concise, non-confrontational, and share the mirror where facts are distorted,” she says.
Measuring What Numbers Cannot Capture
Development work often measures success in numbers. But much of what Muttreja’s work aims to shift, such as dignity, choice, and autonomy, does not fit neatly into a spreadsheet.
PFI tracks proxy indicators of agency, including decision-making, mobility, and access to resources. But Muttreja is clear that these tell only part of the story. To fill the gaps, PFI uses qualitative methods alongside quantitative ones: longitudinal interviews, narrative documentation, and community insights that reveal how people actually perceive their own choices and constraints over time.
She also looks at the enabling environment, asking whether shifts in social norms are happening, whether services are becoming more responsive, and whether policies are translating into practice on the ground. “Ultimately, success is not just about service delivery,” she says. “It is about whether people feel they have control over their lives.”
The Work That Remains
After decades in this space, Muttreja is clear-eyed about what still needs to change. Media narratives around population and reproductive health continue to swing between extremes, and the taboo around public discussion of reproductive health remains one of the biggest roadblocks to building awareness. Funding for health and development is shrinking. The pressures of ageing populations, climate change and its impact on livelihoods and migration, and rapid technological disruption are reshaping how population issues are experienced, yet these forces remain underexamined in mainstream conversations.
And gender inequality, the thread running through all of Muttreja’s work, persists.
But she does not speak without hope. “We have seen shifts in norms, improvements in health, and growing awareness among young people,” she says. “Even in difficult environments, the fact that we can continue to speak, challenge, and engage gives me hope.”
For those entering the development sector today, she has a clear message: do not assume that technical solutions alone can fix social problems. Development is about people, power, and context. Programmes conceived without people’s input are designed for less impact. Spend time with communities, question your assumptions, and be open to learning from the ground up. And understand that leadership is not a position; it is something you do.
“People do not have to be in powerful positions to exercise leadership,” she says. “The exercise of leadership is a verb, while a position of authority is not necessarily an exercise in leadership.”
It is a line that could easily describe her own career.
The Logical Indian’s Perspective
India’s public health and population debates are too often driven by headlines and politics rather than evidence and empathy. Poonam Muttreja’s decades of work remind us that the hardest problems are rarely solved by more data or better policy alone.
They are solved when people are genuinely placed at the centre, not as subjects of change, but as its authors.
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