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General practitioners (GPs) have a role in improving population health through health promotion and disease prevention (HPDP) activities such as immunisations, screening, and lifestyle advice. However, GPs must also respond to the patient’s agenda in a consultation. With limited time in a consultation, it might be difficult for GPs to prioritise HPDP with their patients. My thesis aimed to offer insights into the behavioural determinants of GPs to deliver HPDP. I considered behaviour theories such as Ajzen’s Theory of Planned Behaviour (TPB) to help understand clinician behaviour and how they could be applied to influence their behaviour to deliver HPDP programmes. I conducted an overview of systematic reviews to examine impact of behavioural interventions, directed at GPs, to improve health of their patients. The overview suggested there is insufficient evidence for any type of intervention to be consistently effective in influencing GPs behaviour. The National Chlamydia Screening Programme aims to detect and treat chlamydia infection in young people. Primary Care Trusts used different behaviour interventions to encourage GPs to deliver screening. I interviewed GPs and practice nurses (PNs) in London about their experiences of delivering chlamydia screening and the behavioural interventions, such as those discussed in systematic reviews, to influence their behaviour to deliver other public health programmes. The interview data suggested the constructs of TPB - behavioural beliefs, normative beliefs, and control beliefs – could be used as a conceptual framework to explain why these primary care clinicians might deliver public health care. Strategies used to implement public health programmes need to consider how primary care clinicians might respond to the different constructs of TPB. In addition, organisational factors such as contracts and financial incentives, and perception of intrusion into the patient’s agenda need to be managed carefully as they could either facilitate or impede delivery of public health programmes.

Development organisations have moved from reporting on 'what they do' to addressing 'what difference they make' in an environment that forces them to compete for resources. Thus, measuring their effectiveness has evolved from accountability reporting to results enquiries and to evaluation of the impact of interventions at the end user's level. To adapt to these changes, most development organizations and donors have adhered to results based management and use logical framework approaches for their operations. These approaches and systems have recognised usefulness in project planning, although their utility in project monitoring and organizational performance assessment is more contested. The analysis of recent experiences calls for alternative approaches to assessing performance to improve the effectiveness of development and technical organisations at the country level. This research explores the use of logframes to assess the programmatic performance in a multilateral organization at country level, in the context of an increased focus on results based management. It uses a qualitative methodology to a) assess the comparative advantages and challenges of various assessment tools and systems that WHO uses to measure its performance in EPR in Myanmar and in Nepal; b) address the WHO contribution in terms of results and impact in the area studied; and c) propose options for addressing WHO accountability performance and cooperation effectiveness in EPR at country level. The two case studies uncover the importance of contextual factors, and stakeholders' perceptions and intemctions. They further highlight the role that organisational setting and team profile play in using systems and tools to measure progmmmatic performance. Logframes proved useful for planning and financial accountability, although they confronted major difficulties when assessing the core contribution of the teams to the programme achievements and stakeholders' expectations. The research contributes to the understanding of how routine performance assessment systems work in practice. The comparison of the findings in the two countries raises institutional issues and offers the possibility for organizational learning. Finally, the research proposes alternative options that WHO may adopt to measure its programmatic performance in countries.