The full contribution of hospitals, clinics, pharmacies, etc to the rural economy often goes unrecognized. Quality health services are needed to attract businesses, and required for rural populations with a high proportion of elderly. This paper will share economic tools which can be used in any country to assist rural leaders in maintaining and advancing their health services. More specifically: 1. Health impact model to measure the economic impact of the health sector on a local economy 2. Community engagement tool to evaluate local health services; and 3. Health budget tools to determine the feasibility of a specific health service.