Abstract
To limit the notion of evaluation to that of a search for causes entails corresponding conceptual limitations upon the practices under scrutiny, which have far-reaching social, political and professional implications. Rather, the paper argues, evaluation is concerned with the construction of defensible narratives. The concepts of care, the methods of evaluation and the language employed should be appropriate to the purposes and interests of the relevant community. The interests of beneficiaries and their community are not necessarily those of the technical and political elites which control the provision of health care.
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