Background: “Health for all” through primary health care was initiated in 1978. Productivity, efficiency and quality of care of public rural health service sector has always been questioned. Information about community perception with a thorough understanding of the needs and expectations of the community about the primary health care services can help in better delivery and higher utilization of health services. Scarcity of information on this aspect of health care inspired to carry out the present study to reveal the true condition of the system by examining the relationship between efforts and accomplishments. Material and methods: A Qualitative study was undertaken through focus group discussions and exit interviews of women in reproductive age group in 24 villages of Himachal Pradesh selected through multistage stratified random sampling to assess the perceptions of rural population regarding the available primary health care services. Data was analyzed using thematic analysis approach. Results: Qualitative exploration suggests that physical accessibility, availability & social acceptability in community emerge as critical avenue for the utilization of primary health care services. For health related issues community members first discuss with family members and then decide pragmatically. Majority of people opt for approaching health institution in their vicinity. Literacy status, socioeconomic status, perceived quality of health care services and community dynamics also have great impact on its utilization. AWWs & TBAs plays a pivotal role in delivery of services. Geriatric component still need voice. Un-Sustained socio-political commitment and insufficient supervision were found to be the major bottlenecks in this study. Conclusion: Sub-centers are crucial for the delivery of Primary health care services in Himachal Pradesh. Sustained socio-political commitment, inter-sectoral co-ordination and constant supervision need to be strengthened.
