One of the most prevalent and enduring health care delivery problems in the Third World and less developed countries is the lack of skilled medical personnel. This is particularly true in Ecuador where there are serious deficiencies at the community health level. This paper describes the health problems which have resulted from this situation. A planning model is then presented which Ecuador is beginning to follow for improving its rural community health nursing capabilities. Other countries or developing regions with similar problems might consider the model and its implementation in resolving their own community health problems.