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The study is still in progress, but this paper describing &quot;mid-project observations&quot; illustrates the need for monitoring, describes some research and ideas contributing towards more effective monitoring, and suggests some of the difficulties facing its further development. The work is set in the specific terms of a particular service in one country; but the issues involved are of universal significance, for the development of systems by which large-scale public programs can &quot;learn&quot;, gradually but systematically, in a long cyclic progress.</abstract>
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