The relations between central and local governments as well as with their partners in the delivery of services is the subject of this study. This subject is important in understanding the way institutions contribute to development, particularly given the argument that decentralisation accelerates poverty reduction through the delivery of basic services.

For many developing countries, the challenge faced in decentralisation is how to balance central-local relations in a way that improves the provision of basic services. A second challenge is how to strengthen partnerships with non state actors to expedite the delivery of services.

Decentralisation can sometimes lead to pluralism or to distributed institutional monopoly. Pluralism refers to a situation where decentralisation ensures that roles are shared by two or more organisations or institutions. Distributed monopoly refers to a situation where roles are distributed spatially (from the centre to the local government level), but concentrated in one organisation or institution.

In this study we explore the reality of balancing central-local relations in the provision of basic services in Ghana; the type of decentralisation that has emerged since the introduction of economic and institutional reforms in the late 1980s; and, whether it is characterised by distributed monopoly or pluralism. We further examine whether plural central-local relations, where they exist, perform better than monopoly arrangements in the delivery of basic services, with and emphasis on water and sanitation