Table 6 Using local evidence to monitor and evaluate policies

A national programme for the rollout of comprehensive HIV and AIDS care, including antiretroviral treatment (ART), has been implemented in South Africa. The Joint Civil Society Monitoring Forum - a local forum including a number of NGOs research institutes and other stakeholders - was established to assist government with the effective and efficient implementation of the programme. A briefing document outlining the lessons from this process notes that: "Democracy may be portrayed by the public's ability to contribute to and influence the state's decisions and programmes. With regard to [ART] rollout, it has been reported that access to information has been a major challenge. Reportedly not all provinces have been willing to provide information in this regard. This has made monitoring and development of appropriate resolutions difficult" ([42] p3-4). The report also highlights difficulties with obtaining disaggregated data on HIV and AIDS expenditure. It notes how these difficulties, in turn, create problems with monitoring how global HIV/AIDS budgets are being spent, particularly with regard to relative spending on treatment versus prevention, care and support [42]. This example highlights the need for local evidence to effectively monitor the implementation of a key health programme.