The French Alzheimer Plan 2008-2012 anticipates the implementation of new Units specialized in cognitive rehabilitation and psycho-behavioral therapy of Alzheimer's disease (AD) patients. Conceived for AD and other dementia patients of all ages, their objectives are to propose a cognitive rehabilitation program, to prevent or treat psycho-behavioral crises, and to provide support and educational therapy to the family and professional caregivers, in order to ease the patient's return to his or her previous way of life. Studies on green spaces and healing gardens in health-care settings have revealed objective and measurable improvements in the patient's well-being. The Plan officially stipulates for the first time the need to make healing gardens an integral part of these Units, but it does not provide specific recommendations or criteria for implementing such gardens. Although green spaces and gardens are available in many French Care Units, they are rarely specifically adapted to the needs of AD patients. In Nancy, the Art, Memory and Life garden, a specific concept guided by a neuropsychological approach, was developed and complemented by an artistic vision based on cultural invariants. The main objective of this article is to describe the various steps of the process that led to the creation of this garden: the collection of experiences and information by a pilot group, surveys of patients, visitors, and caregivers before and after establishment of the garden, and implementation of a multi-professional group project. The specifications, the organizational criteria, the therapeutic project, and the criteria for the conception of such a garden stemming from our clinical experience with the Art, Memory and Life garden in Nancy, are described herein. We also present the first assessment following the implementation of the project.

This article describes the development of the national evaluation system in South Africa, which has been implemented since 2012, led by the Department of Planning, Monitoring and Evaluation (DPME, previously the Department of Performance Monitoring and Evaluation) in the Presidency. It suggests emerging results but an evaluation of the evaluation being carried out in 2015 will address this formally. Responding to dissatisfaction with government services, in 2009 the government placed a major emphasis on monitoring and evaluation (M&E). A ministry and department were created, initially focusing on monitoring but in 2011 developing a national evaluation policy framework, which has been rolled out from 2012. The system has focused on improving performance, as well as improved accountability. Evaluations are proposed by national government departments and selected for a national evaluation plan. The relevant department implements the evaluations with the DPME and findings go to Cabinet and are made public. So far 39 evaluations have been completed or are underway, covering around R50 billion (approximately $5 billion) of government expenditure over a three-year expenditure framework. There is evidence that the first evaluations to be completed are having significant influence on the programmes concerned. The big challenge facing South Africa is to increase capacity of service providers and government staff so as to be able to have more and better quality evaluations taking place outside of as well as through the DPME.

The Home Support Exercise Program (HSEP) was developed to reach frail community seniors through home support workers (HSWs) rather than more costly health care professionals such as visiting nurses or physical therapists. This article describes the development and formative evaluation of the HSEP prototype, including the training of case managers and HSWs. In the HSEP’s final form, each client is instructed on 10 simple, functional, and progressive exercises and given an illustrated booklet and a short video. Ongoing encouragement is provided by specifically trained HSWs during regular visits (at least once a week). Formative evaluation of the HSEP model was used to examine and resolve implementation and delivery issues. Qualitative data were collected through focus groups or interviews with each stakeholder group—administrators/coordinators, case managers, HSWs, agency supervisors, and clients themselves. Evaluation findings were used to modify training, instructional, and support materials and the exercises.

This paper describes the expansion since 2001 of a public pre-school programme in South Africa known as ‘Grade R’, summarises the findings from an impact evaluation of the introduction of Grade R, discusses the policy recommendations flowing from the evaluation and reflects on the process of implementing the recommendations. The Grade R programme has expanded dramatically, to the point where participation is nearly universal. Although a substantial literature points to large potential benefits from pre-school educational opportunities, the impact evaluation reported on in this article demonstrated that the Grade R programme, as implemented until 2011, had a limited impact on later educational outcomes. Improving the quality of Grade R, especially in schools serving low socio-economic status communities, thus emerges as a key policy imperative. Recommended responses include professionalising Grade R teachers, providing practical in-service support, increasing access to appropriate storybooks, empowering teachers to assess the development of their learners, and improving financial record-keeping of Grade R expenditure by provincial education departments. The impact evaluation was initiated by the Department of Planning, Monitoring and Evaluation (DPME) and the Department of Basic Education (DBE), and was conducted by independent researchers. The move towards increased evaluation of key government programmes is important for shifting the focus of programme managers and policymakers towards programme outcomes rather than only programme inputs. Yet the process is not without its challenges: following a clear process to ensure the implementation of the lessons learned from such an evaluation is not necessarily straightforward.