India is a signatory to the Alma Ata declaration and has committed herself to achieving "Health for All by the Year 2000". Since then, a lot of planning, effort and public expenditure has been devoted to improving the health of the people both in rural and urban areas of the country.

With the increase in the urbanization and industrialization, the concept of family in India, which once was to create and maintain a common culture among the members of the family, is undergoing changes.

Acceptance and sustained use of family planning especially of modern spacing methods have generally been low in developing countries particularly in India. The use rate for modern spacing methods was only 6 per cent among the eligible couples in India in 1992 (IIPS, 1995).

In recent years, there has been increased recognition of the scope and significance of gynaecological problems experienced by poor women in developing countries.

Inter-spouse communication, though not a new dimension of fertility and family planning research, has remained much less explored in the Indian context than any other correlate of contraceptive use and current fertility.

In 1978, the Bangladesh family planning program launched a national program of outreach services that continues to the present. Young married women were hired and trained to visit women in their homes, offer contraceptive services, provide information, and support sustained use over time.

High family size desire and low acceptance of family planning constitute, the two main factors underlying the high fertility of the Indian population. Excessive loss of children in early childhood in rural areas is considered to be contributory to both of the above factors.

The search for explanations for the high rate of fertility in India has led many to theorize the link between poverty and fertility. Several micro-studies have affirmed the hypothesis of positive association between poverty and fertility.