In an attempt to bridge the gap between the goals set by the Chinese government in 1997 for development of the community health system and ongoing deficiencies in the Northwestern region after ten years of effort, this five-year project proposes to study existing policy, analyze the problems, and explore a suitable community health service model for economically underdeveloped areas of Northwest China. In consultation with the University of Nebraska Medical Center and Zhongshan Medical University of Taiwan, a successful model of community health care will be identified for testing in ten model communities in China.  In each location, 50-60 general practitioners and 50-60 nurses will be given standardized training in community medicine. Additionally, medical education and community health service managers in these model communities will be given training appropriate to their responsibilities.