Introduction

In our country, Primary health care is at the center stage of health care systems. The approach has been to coordinate the preventive, promotive and curative aspects of health care, so as, to promote public health as a whole. Over the years, a fairly extensive rural health infrastructure has been built up in the country based on the model of Primary Health care. It is a three – tier structure comprising a sub center for every 5000 population (3000 population in hilly, tribal and backward areas), primary health centers for every 30,000 population (20,000 population in the hilly, tribal and backward areas) and community health centers for a population of 80,000-1,20,000. India has nearly 74% of its population living in the rural areas. By 1996, there were 1,37,027 sub centers, 23,266 Primary Health Centers and 2,962 Community Health Centers in the country, to cater to the health needs of the people. Not only is the doctor population ratio low at 48/100,000, many studies reflect that there is a concentration of doctors (73.6%) in urban areas where only 26.4% of the people live.