The concept of primary health care is inherently vulnerable. It seems ironic that the very needs that necessitate the proposal of PHC solutions may also inhibit the effective implementation of those solutions. The reasons are numerous. Such villages may have poor cash economies, supervision and supply are more difficult, and workers are more difficult to find. The expectation had been that relative isolation would imply a greater need for health services, and that once offered, acceptance of village health posts would be highest in areas most dependent on them. This would not appear to be so. Community involvement is arguably the most difficult part of PHC to put into effect. Since 1974, the Lardin Gabas Rural Health Program of the Church of the Brethren Mission has been training village health workers from 119 villages in northeastern Nigeria. From 1976, the scheme was introduced, with few modifications, to the central plateau region by the Church of Christ in Nigeria Rural Health Program, in a further 33 villages. The ingenious teaching techniques--using parables and local stories, drama, songs and riddles to convey health messages--have received considerable international exposure in the literature, but little attention has been given to the pratical difficulties experienced in actually establishing and maintaining the program. The purpose of this paper is not to detract from the worth of village health schemes; the teaching methods are both sound and appropriate, the aims are worth pursuing, the need for such services great. However, it is necessary to point out that the primary health care approach, by its very nature, needs to be sensitive to the individual social and cultural situation in which it is to be implemented.