An epidemiological survey of proximal femoral fracture (PFF) was carried out in Gran Canaria (Canary Islands) in 1990. We identified 211 cases of PFF affecting residents, which gave an incidence of 161 per 100,000 per year (92 per 100,000 per year for men and 176 for women). Three quarters of all fractures occurred to residents of urban areas and nearly all fractures were caused by falls indoors. There was a higher incidence in winter than in summer months.

Since the early 1990s, World Bank officials in many countries have pressed their government borrowers to include nongovernmental organizations as development partners. What impact has this new partnership norm had in the bank's borrower countries, and why? This article investigates these questions through longitudinal analysis of three cases: Guatemala, Ecuador, and the Gambia. In their first iteration in the 1990s, these bank‐sponsored efforts generally failed to take root; yet by the 2000s, NGOs and state actors were engaged in multiple partnerships. This article suggests that over time, bank officials' repeated efforts to embed these new ideas fostered a social learning process that led NGOs to adopt more strategic partnership practices and government officials to see NGO partners as useful. Several factors may affect this learning process: levels of professionalism and the growth of professional networks, the presence of effective “bridge builders,” and the level of historical conflicts.

Almost all agree that political systems in Latin America underwent a transformation in the 1980s. The usual quick description of this change was ‘democratization’. But whether one takes an optimistic or a pessimistic view of the level of democracy that was achieved, one thing was sure—the traditional forms of participation by, and representation of, the poor, the working population, and others structurally disadvantaged had changed. The chapters examine the labour organizations, political parties, indigenous and environmental groups that have emerged, sometimes amidst new forms of violence. Others recount efforts to rebuild social–democratic projects and to create new models of participatory politics in municipalities and around social programmes. There is no consensus on whether these new forms will produce more democracy. Rather, the chapters present a variety of conceptual tools to identify trends and assess their impact.

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Over the past decade, the World Bank has pressed its borrowers to include NGOs in ‘partnerships’ that range from shared design and implementation of projects, to substantive negotiation over development policy. What explains the domestic political outcome of these transnational partnership efforts? This chapter examines the case of the negotiation over Ecuador's Social Investment Fund to include substantial NGO participation and finds that these new ‘partnerships’ between NGOs and the state failed in their first iteration. Presidential concerns over patronage blocked the construction of new working relations between NGOs and the state. Yet, the initial failure was followed by reflection and renewed collaboration. Political change resulted from a process of socialization around new sets of norms regarding civil society's participation in social policy as they became embedded in new, often informal, institutions. The impact of this socialization on democracy in Ecuador is still an open question.