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This dissertation has explored the problem of a yawning gap between policy and the implementation of lay participation in health development activities in Ghana, using data from 577 households in 22 rural communities. / A Health Systems model has been applied to data, to explain relationships and four sets of variables--household need for health services, predisposing attributes, participatory patterns, enabling factors--on household use of available health facilities and services. / Overall, results indicate a complex interdependence of factors which influence modern health services use. A multiple regression procedure identifies the presence of children under 5 years, the household's perception of its influence in the community, household participation in community health-related activities, household socio-economic and educational levels, to be significantly related to services use. Results suggest that Need for services is Not a sufficient condition for the Use of available health services.