The majority of previous studies in this area have employed structural quality measures to evaluate health interventions, such as the presence of medical doctors (Thomas et al 1996), nurses (Thomas et al 1996; Thomas and Strauss, 1992), hospital beds (Thomas et al 1996), drug supply (Strauss 1990), and village midwives (Frankenberg and Thomas, 2001) 1 . The underlying assumption in employing structural measures is that the availability of such tangible assets leads to high technical quality with no variation in provider practice. Yet the existence of a facility or clinician is not synonomous with high quality care. Research conducted.
