were sensitive to the need to listen both to stakeholders who are active participants and to those who are not before reaching conclusions about intervention strategies or performance indicators.

Concern about the potential for harmful use of data provided by performance monitoring was raised. There is a possibility that data could be misused in resource allocation if overly simplistic formulas are applied, and the committee must remain aware of these risks. Communities with multiple needs and few resources might lose funding for doing poorly, or communities that are achieving positive results might be at risk of losing funding if needs are assumed to be met. A community that is addressing a difficult problem may be doing a good job if it can maintain a given level of performance. For some health issues, prevalence of HIV/AIDS infection, for example, finding only a small increase might represent progress over higher increases in the past. It is also important to monitor ''what is going right'' rather than just looking for poor outcomes.

Final comments addressed social change issues. The models described to the committee contribute to the notion that the process of change is as important as the outcome. They also emphasize that the role of each stakeholder in the process is important for the committee to consider.



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