This article reports the findings of a questionnaire survey of 43 health workers and a survey of health stations in 27 villages in three relatively poor counties in China. This is a small sample, but the findings provide an insight into some of the major characteristics of village health services. The survey found big differences between health services in Xunyi and in the other two counties. A higher proportion of Xunyi’s population sees a health worker when they are unwell and its preventive programmes provide much better coverage (Li et al. 1997; Shu et al. 1997). This article tries to explain these differences and concludes by discussing the issues that policy makers have to address with regard to village health services in poor rural areas.