This paper presents case study data from family planning clinics in Tanzania which suggest that obstacles in three realms -- supply, interpersonal relations, and policy/program -- may interfere with the provision of good quality of care for clients. By examining these obstacles carefully, this paper builds on our current understanding of quality of care, suggesting that the way quality of care studies are operationalized and interpreted may be improved. In addition, this study identifies areas needing improvement in a given family planning program.