Primary health service coverage has increased in many developing countries over the last 10 years. The number of components included in the basic package has also expanded. This has led in some countries to primary health workers becoming overloaded with responsibilities. To maintain high quality care, primary health workers not only need appropriate training, but clear performance guidelines, as well as essential resources and supportive supervision. We report on the establishment of standards for primary health services by the Ministry of Health in Papua New Guinea (PNG).