Despite recent growth of NGOs in the developing world, especially in the field of PHC, many questions are raised on their impact, effectiveness, efficiency, sustainability, accountability, and synergistic roles in national development. The capacity and systems for performance evaluation is a constant challenge facing most NGOs at various levels. To help an NGO self-analyse its performance, this book provides a performance analysis framework (PAF), structured to analyse the performance of a service provider NGO at three main levels: organisational, project, and service delivery, with PHC as a focus of enquiry. The underlying concept is that the performance of an NGO in health and social development is the outcome of an interaction of many factors within both its external and internal environments. The book documents the process of PAF development, field testing and validation for wider use, and concludes with an outline performance improvement strategy. The book should be useful reference for professionals and researchers in the health and development arenas working in the NGO sector.