Short Summary: What are the issues that must be addressed in the analysis of a sectoral budget from a gender perspective? How can national, provincial and local budgets be linked to achieve better policy-making and implementation? This paper from the South African Women’s Budget Initiative shows how gendered budget research can throw up important information on policy-making and implementation in the health sector. The research was conducted through workshops and interviews with government officials, government and health researchers, and representatives of the South African Local Government Association. The different perspectives of the various interviewees provided important contrasts and insights on how the relationships between people at different levels affects health service delivery. The establishment of how national, provincial and local policy-making could be linked was a key factor, as was whether all people’s knowledge and experiences were being taken into account in decision- making or whether it was primarily a “top down” approach. The paper therefore identifies the importance of greater empowerment at the local level and better communication between levels. It also points to the need for policy-makers to be more aware of resource implications, and for health managers to know more about the budget process. For a copy of this publication, contact the Health Systems Trust: hst@hst.org.za