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Studies from Asia and Africa have established the positive effect of family planning on economic and per capita income growth and reduction in poverty. Although large scale public investment has made female sterilization a free service in public health centers in India, the quality of care (QoC) still depends heavily on the ability to make Out of Pocket (OoP) expenditure. The financial compensation provided to acceptors also varies between states. This paper proves the need for large scale public sector funding and allocation to maintain quality of care during sterilization, and the need to rationalize the compensation as attempts to extend reach and adoption of this method of family planning.