Decentralization reforms, in which central government agencies transfer rights and responsibilities to local institutions, are high on the agenda in many countries in the Europe and CIS region. Decentralized, streamlined and empowered local governments are better equipped to meet citizen’s expectations for public services and better livelihoods, and to ensure transparent, effective and accountable government actions.To exchange experiences, review lessons learned and discuss challenges faced while effecting governance reforms at the subnational and local levels, the International Conference “Making Decentralization Reform Work: Opportunities and Innovations for Local Governance and Service Delivery” took place on 2-3 December 2015 in Kyiv, Ukraine. 

The City of Brampton, located in the Ontario province of Canada, has a highly mobile workforce that needs data at a moment’s notice to do their jobs. The city is using Microsoft cloud solutions to deliver highly secure IT services to its workforce when and where they’re needed. The city has created a collaborative culture where employees come together to address citizen needs, work more efficiently, and ultimately save taxpayers money.

Auckland, New Zealand, has big plans for our city’s transportation infrastructure. We can’t afford to think in half-measures, because Auckland continues to grow at a dramatic pace. By 2020, our city of 1.4 million is expected to expand to 2.2 million, and a lot of those people are going to need ways to get around. We adopted a custom digital solution called Fulcrum that could manage the 200-plus construction projects on our plate from end-to-end. Developed by LeapThought, the 2015 Microsoft CityNext Partner of the Year, Fulcrum uses the capabilities of SharePoint Server to provide cross-departmental tools that help manage properties impacted by projects such as City Rail Link. Although Fulcrum was implemented initially for City Rail Link, the solution can grow and evolve with our agency’s needs. The cost savings and operational efficiencies gained by using Fulcrum on big projects can also extend to smaller capital projects as well. We estimate a savings of $3 million in the first 10 years alone, and the more projects we put into the system, the more savings we’ll realize.

A number of approaches have been adopted in medical education geared towards training health professionals that can improve access to health care by communities most vulnerable to inequalities and injustices in health systems. Relevant health professions education is vital for improvements in health and health care access. A symbiotic medical education can improve the quality of health care and impact on career choice, yet the challenge to sustain equitable access to improved health and healthcare particularly for those most in need remains a major global challenge ( Ssewankambo, 2012). Within a decentralized system, such as in Uganda, Local Governments are mandated to ensure health promotion and equitable healthcare for the population under their jurisdiction. Whereas public service reforms have mainly focused on decentralization and good governance (Mamdani, 2012, Stiglitz, 2012), the role of curriculum reforms in addressing health and health care challenges through needs-based education of health professionals has been largely ignored. Through an analysis of the challenges of health care within a decentralized Local Government setting, this paper, by presenting experiences from one public university in Uganda, reveals how a partnership between Universities and Local Government can go a long way in addressing health disparities and reduction of morbidity and mortality.

This paper provides an overview of key trends and developments impacting on local democracy and is intended to be a broad-ranging background paper to assist in discussions at a workshop organised by the International Institute for Democracy and Electoral Assistance (International IDEA), in partnership with the Commonwealth Local Government Forum (CLGF), to be held in Stockholm in early November 2014, which will bring together academics and practitioners to explore current trends and developments in local democracy.