Programs that induce citizen participation to improve the quality of government at the local level are the subjects of large amounts of funding and intense debate. This paper combines a randomized control trial of a citizenship training and facilitation program in rural India, with an in-depth, four-year ethnography of the intervention to understand the underlying mechanisms of change. The quantitative data show no impact from the intervention. Household and village survey data from 100 treatment and 100 control villages show considerable improvement across a wide variety of governance and participation indicators over time, but the differences in the changes between treatment and control villages are not statistically significant. The detailed qualitative data from a 10 percent subsample allow us to unpack the reasons why the intervention "failed," highlighting the role of variations in the quality of facilitation, lack of top-down support, and difficulties with confronting the stubborn challenge of persistent inequality. However, the qualitative investigation also uncovered subtle treatment effects that are difficult to observe in structured surveys. The paper thus demonstrates that a concerted effort to use "thick description" to uncover the process of change using careful and detailed qualitative work can add value to standard impact evaluations.

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. 

Too often, government leaders fail to adopt and implement policies that they know are necessary for sustained economic development. Political constraints can prevent leaders from following sound technical advice, even when leaders have the best of intentions. Making Politics Work for Development: Harnessing Transparency and Citizen Engagement focuses on two forces—citizen engagement and transparency—that hold the key to solving government failures by shaping how political markets function.

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 report was prepared by the International Labour Office as the basis for discussions at the Joint Meeting on the Impact of Decentralization and Privatization on Municipal Services to be held from 15 to 19 October 2001 in Geneva.