Home-made indicators have also provided surprise evidence of massive increases in childhood asthma, and unearthed other problems. Nevertheless, problems have been encountered. Opening up the assessment process to a wider range of stakeholders may also expose conflicts over what is most important, how it should be tracked, and whether goals are being met. Failure to predict and deal with conflict can lead to frustration. To be sustainable it requires openness, a willingness to listen to different points of view, a recognition of the knowledge and role of different participants, and an ability to give credit where credit is due.
Indicators are central to most monitoring and evaluation processes.
They can be qualitative or quantitative, and provide a way of spotting and measuring underlying trends. In Uganda, for example, the number of households eating 'beer bananas' is an indicator of hunger, since this type of bananas is only eaten during times of food shortage. For example, the InterAmerican Foundation uses an approach that encourages the inclusion of indicators such as 'cultural identity', 'self-esteem', and 'degree of civil responsibility'. But it is no easy option. It can also provoke more far-reaching changes than realised.