Developing Indicators to Measure the Implementation of the Western Cape Alcohol Harms Reduction Strategy in South Africa

This manuscript describes a process to develop a set of indicators to monitor and evaluate the implementation of the Western Cape Alcohol-Related Harms Reduction (AHR) White Paper in South Africa and provide a final set of indicators. Drawing on the framework in Andréasson et al. (2009), a logic model with categories and types of indicators (i.e. prevention, determinants, consumption, and alcohol-related harms) was used to develop an initial set of 255 indicators. The methodological process followed involved a) scoping of a large electronic database maintained by the South African Medical Research Council, b) a comprehensive literature review and, c) reaching out to18 international key informants. Iterative communications with stakeholders from diverse government entities via email, telephone calls and individual and multi-person face-to-face meetings, together with a consensus process involving the study team was used to refine the indicators. The final set included 176 indicators; 108, (61.4%) of these were “core” indicators, and 68 (38.6%) were “expanded” indicators, meaning they added to the core indicators in given areas which would be useful to have but are of a lower priority or are likely to be less easy to obtain. Of the core indicators, 45 (42.4%) were deemed by policy makers/researchers in the Premier’s office as “high-level indicators,” denoting that they were the most essential. This manuscript demonstrates that it is possible to develop evidence-based, location-specific indicators to evaluate policy implementation.