The notion of quality in the public health system is becoming increasingly an issue for policymakers and planners in India. The Eighth Five-Year Plan identified the poor quality of family welfare services as one of the factors

Demographic literature is replete with observations of an inverse relation between certain attributes of modernity and family size (Thompson 1929; Notestein 1945; Coale and Hoover 1958; Leiberman 1980, Srinivasan 1986).