Continuing education systems can improve the performance of health workers in countries around the world and support the functioning of district health systems. Continuing education guides health personnel toward the principles and methods of primary health care and improves their work with the community and family to attain an adequate level of health. The components of the district health system continuing education are planning and management, community involvement, financing and resource allocation, and district human resources development. Factors affecting continuing education at district level are: (1) system organization; (2) political and financial commitment; (3) health systems and personnel; (4) educational needs and levels; (5) target groups; (6) involvement; (7) problem solving; (8) resource persons; (9) evaluation; and (10) performance assessment. Both the World Health Organization and its Member States should encourage operational and action research on continuing education and health services to be used in future health planning. (16 references) (NLA)