In spite of good infrastructure developed during the previous plan periods especially under rural health in terms of sub centres, primary health centres, it has not been possible to demonstrate an improvement in mother and child health status. The problem is compounded by poor accessibility of facilities, large number of vacancies in health care institutions and socio-cultural factors. During the last 5-6 years not much emphasis has been given to TBA training. This has resulted in wide gap between the supply and demand of basic and preventive MCH services in the rural areas. Inspite of implementation of CSSM and RCH-1 program, the skills and performance of TBAs has not improved. The Institute of Health Management Research, Banglore has developed a well structured, short duration, hands-on, skill based training program in the hospital settings for traditional birth attendants, which enable them to cater to the maternity services in the rural areas. This may contribute to the decline in infant and maternal mortality rates.