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).

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).