Globally, there is growing recognition of participatory public expenditure management (PPEM). PPEM is seen as the process whereby citizens and civil society organisations participate in the management of public expenditures. The adoption of PPEM is aimed at ensuring greater transparency, better targeting and tracking of resources, and increased overall responsiveness. The Gauteng Department of Health and Social Development (GDHSD) is committed to co-operative governance; this includes working with different spheres of government and civil society or non-profit organisations (NPOs). NPOs are required to have a governing committee to manage funds allocated by GDHSD. The committee has the capacity to hold the NPO management accountable for the resources (financial and material) entrusted to it by the GDHSD. The effectiveness of NPOs is challenged by poor attendance of board members at meetings, poor understanding of the board's mandate and responsibilities and lack of experience amongst members. The paradigm of PPEM is still faced with challenges to ensure that significant flows of revenue are accounted for and used effectively for growth and poverty reduction. This study is divided into three components. The first section focuses on the background, the introduction and the conceptual framework. The second part focuses on the empirical study for deriving a benchmark for the South African NPO sector. The third section highlights good practices as well as governance-related challenges. Finally, for further consideration by the GDHSD, a series of recommendations is provided, focusing on how key domestic stakeholders can better contribute to successful participatory budgeting programmes.