Focused on NFHS-1 results from India's four large northern states Uttar Pradesh, Madhya Pradesh, Bihar, and Rajasthan this analysis shows that variations in utilization of family planning and maternal and child health services are explained mainly by variations in household- and individual-level socioeconomic and demographic factors, not by variation in community access to services. Apparently family planning and maternal and child health services are available at a sufficient level in rural India so that further improvements in physical accessibility alone will not make a substantial difference in the propensity to use these services. Quality of services is likely also to be important, but NFHS-1 did not assess service quality.

The NFHS Subject Reports is a series summarizing secondary analysis of data from the 1992-93 National Family Health Survey (NFHS) in India. The NFHS collected information from nearly 90,000 Indian women on a range of demographic and health topics. Conducted under the auspices of the Indian Ministry of Health and Family Welfare, the survey provides national and state-level estimates of fertility, infant and child mortality, family planning practice, maternal and child health, and the utilization of services available to mothers and children. IIPS conducted the survey in cooperation with consulting organizations and 18 population research centers throughout India. The East-West Center and a U.S.-based consulting firm, Macro International, provided technical assistance, and the United States Agency for International Development (USAID) provided financial support.