Development organisations have moved from reporting on 'what they do' to addressing 'what difference they make' in an environment that forces them to compete for resources. Thus, measuring their effectiveness has evolved from accountability reporting to results enquiries and to evaluation of the impact of interventions at the end user's level. To adapt to these changes, most development organizations and donors have adhered to results based management and use logical framework approaches for their operations. These approaches and systems have recognised usefulness in project planning, although their utility in project monitoring and organizational performance assessment is more contested. The analysis of recent experiences calls for alternative approaches to assessing performance to improve the effectiveness of development and technical organisations at the country level. This research explores the use of logframes to assess the programmatic performance in a multilateral organization at country level, in the context of an increased focus on results based management. It uses a qualitative methodology to a) assess the comparative advantages and challenges of various assessment tools and systems that WHO uses to measure its performance in EPR in Myanmar and in Nepal; b) address the WHO contribution in terms of results and impact in the area studied; and c) propose options for addressing WHO accountability performance and cooperation effectiveness in EPR at country level. The two case studies uncover the importance of contextual factors, and stakeholders' perceptions and intemctions. They further highlight the role that organisational setting and team profile play in using systems and tools to measure progmmmatic performance. Logframes proved useful for planning and financial accountability, although they confronted major difficulties when assessing the core contribution of the teams to the programme achievements and stakeholders' expectations. The research contributes to the understanding of how routine performance assessment systems work in practice. The comparison of the findings in the two countries raises institutional issues and offers the possibility for organizational learning. Finally, the research proposes alternative options that WHO may adopt to measure its programmatic performance in countries.