Our healthcare and family welfare programmes are supposed to be demand driven under the new paradigm given in the post ICPD (International Conference on Population and Development, held in Cairo, 1994) era (United Nations Population Fund, 2004). But supply side issues are also considered equally important in terms of availability and quality of services. The network of Primary Health Centres (PHCs) and Sub-Centres (SCs) is the mode for providing healthcare services to the rural masses. The emphasis on family planning and immunization is obvious in view of the enormity of the population problem affecting the economic development and conditions of the poor in the country. The PHCs and SCs are also responsible for the prevention and eradication of major communicable and deficiency diseases such as malaria, filaria, tuberculosis, leprosy, blindness, and diarrhoea.

In rural areas, government health centres and government programmes play a key role in the provision of prenatal, natal, and postnatal services, including family planning services, immunization and treatment of common diseases. The implementation of the programme depends to a large extent on the availability and performance of doctors and Auxiliary Nurse Midwives (ANMs), Multi-Purpose Health Workers (MPHWs), trained birth attendants and village health guides. These grassroot level functionaries are the backbone of the health and family welfare programmes in the rural areas.

In the family welfare programmes, the Maternal and Child Health (MCH) care provisions are unbalanced, focussing on immunization and the provision of iron and folic acid rather than on sustained care of women and children, or on the detection and referral of high-risk cases.