Enhanced Health care services address not only one of the key Sustainable Development Goals (SDG) which is goal No 3, but also the development strategies for most developing countries. Good governance is critical to improving health care systems. Many developing countries therefore have decentralized health care systems as a way of improving good governance and as a means of attaining improved access to and delivering quality health care services to both urban and rural population. Decentralization involves the extent of planning, management and decision making from national to lower levels of government. From the 1990s the capacity of governments in developing countries to deliver public goods and services was stretched to the extent there was dire for partnerships. The Public Private Partnerships (PPP) therefore became fundamental in the provision of health services under decentralization. The nature of PPP differed from country to country and the level of decision making within each level of government. The paper has discussed the extent to which decentralized governance has facilitated the management of health care systems in the urban centres through Public Private Partnership initiatives, by conducting a comparative case study analysis of existing literature on urban health care systems under different forms of decentralized governance in Kenya, Uganda, Ghana and India, respectively. The study established that access to health care services differed with forms of decentralization. Secondly, there were more public private partnerships in devolved governments which also registered higher improvement in access to health care services in urban centres. The paper concluded that the more the involvement of public private partnership, the better health care services in terms of access was noted.

Public-private partnership has increasingly become a preferred public service delivery approach in the provision of water services in Kenya. As a strategy, PPP in water service provision was started in Kenya following water sector reforms as contained in the Water Act 2002. In order to establish the impact of PPP on water service delivery in Kenya, a household survey of 288 respondents from seven (7) Water Service Providers (WSPs) comprising four Water Utility companies and three Community Water projects, under the Lake Victoria South Water Services Board (LVSWSB) umbrella was conducted. Using quantitative techniques to analyze the data under governance theory, the study established that compared to the period up to 2004, the households experienced better services in the year 2012 in terms of water quality, affordability, access and customer service levels as currently observed compared to the period up to 2004 to the extent that public institutions that had adopted more private sector participation performed better than those that have not. On average, there was reduction in: distance to water point reduced by 78.3 m; frequency of coloured water by 0.2 days, time taken to restore water 3 days within the ten years period.

Public-Private Partnership refers to an approach which combines positive aspects of Public and private sectors to come up with better public service delivery model. The PPP arrangements neither appear uniformly nor apply in all circumstances. The study investigated whether or not, through water sector reforms PPP has been realized in the provision of water services in Kenya. Using Public choice theory the study used secondary data and primary data from seven (7) Focus Group Discussions, and 33 Key informant interviews. From seven (7) WSPs, the study found out that PPPs exist in regulation, provision and financing of water services and that in Kenya, PPPs have been incorporated more by the community water projects than the Public water companies.

The state of citizens' political knowledge in shaping local governance interest formulation patterns has been identified as a vital mechanism in democratic systems for centuries. Nevertheless, political knowledge proficiencies remain remarkably scanty among ordinary citizens in the developing world, with significantly few studies directly engaging this local governance reality. The paper discusses how political knowledge influences the changing local interest determination dynamics to reinforce local governance functionality in Uganda. From a sample size of 99 respondents, the study used descriptive qualitative methods and techniques to collect data and analyze the responses. The study found out that notwithstanding institutional inconsistencies, local farmers were considerably more influential in local interest determination compared to politically erudite citizen groups. There were limited structures for citizen participation in decision-making processes, yet likewise found nascent progressive virtual platforms for local interests' deliberations mostly based on digital and traditional media platforms. The nature of drivers which framed political knowledge were typically influenced by structural, political, economic and international dynamics. The study recommended that in order to address the local citizen participation constraints, profound local governance policy transformation interventions should be embarked on to reinforce local infrastructure, the local economy and expansion of education and the democratic space for civil society agencies' operations.

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