Abstract
This paper describes and reflects on an initiative to develop environmental health indicators in Cape Town, South Africa. The project aimed to provide decision makers, environmental health professionals and the community with better information on the health impacts of environmental hazards. The paper summarizes the social, environmental and health conditions in the city and the organization of local government services, and then describes the participatory process used by the initiative including the qualitative approaches used to develop a situation analysis of environmental health information systems. Despite the use of participatory methods to involve planners and field staff from different municipal agencies, the initiative failed to develop the hoped for set of indicators. The primary reasons for this were difficulties in creating an “institutional space” for the project; on-going local government restructuring; and poor linkages to other initiatives. The paper concludes that there is a need for planners, managers and academics to begin using a more structured approach to implementing policies and managing uncertainty in order to facilitate change in areas such as environmental health information systems. Policy instruments which can be used for planning and managing change are discussed.