This chapter discusses the history of India's family planning programme since inception up to now. It reviews the organizations and institutional structures created to administer the family planning programme at the national and state levels to manage service delivery. The chapter assesses the adequacy and efficacy of human resources. It explores the interplay between health sector reform and health systems strengthening, both of which began to dominate the global and national scenes post 2000. The chapter discusses the extent to which existing strategies are likely to have an influence on meeting demographic and family planning goals and the key structural changes required to meet these goals. In 1977 both the National Institute of Health Education and Administration and the Central Family Planning Institute organizations were merged to create the National Institute of Health and Family Welfare (NIHFW) whose mandate is to provide training support to states through State Institutes of Health and Family Welfare (SIHFW).