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

In recent years there has been a growing concern in many countries, including India, that public health and family planning programs have placed insufficient emphasis on the quality of their services (Ickis 1992; Khan et al. 1994; Mensch 1993; Miller et al. 1991).

Every year, as millions of women marry, they dream of starting a family, of having their homes filled with tiny cries and the happy laughter of gurgling babies. In India however, pregnancy is too often followed by the question of
whether the unborn child is a girl or a boy.

Sterilization for men and women is the most commonly used contraceptive method both in India at large and in Uttar Pradesh.

A preference for sons or for more sons than daughters has been documented in several countries in the world.

Sterilization is the most popular method of contraception in India. The 1992-93 National Family Health Survey found that of the 36.2 percent of eligible couples using any modern method, most (30.7 percent) had been sterilized and only 5.5 percent were using temporary methods (IIPS 1995).

Highlighted by sensational titles such as "The endangered sex" (Miller, 1981) or "More than 100 million women are missing" (Sen, 1992), studies have long drawn attention to the unfavourable life chances of females versus males in various parts of East and South Asia.