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Abstract
Developing nations have been focusing on relevant infrastructure, technology, disease control, and health outcomes in terms of deaths and disability-adjusted life years, largely ignoring the service quality aspect from the patient’s viewpoint (J K Sharma and RituNarang 2011). Health is an important commodity not only at the individual level but also in terms of the micro- and macro-economic scale of a country. Improvement of health status is therefore on the political agenda of every government. In India health has been a major policy issue since independence. The development of rural health infrastructure, immunization programmes and the extension of water supply and sanitation led to health gains. Major achievements include the rise of life expectancy, decline of infant mortality and crude birth rate as well as eradication of smallpox. Nevertheless, the health situation in the country is not satisfying for several reasons. First up all targets set in the five-year plans and in the National Health Policy 1983 have not been met.