Research topic: My research seeks to understand the conditions under which decentralization leads to improved service delivery by examining the relative performance of health services in five municipal areas in Ghana. The question is ‘under what conditions can some Municipal Health Directorates perform better than others?' To answer the main research question, I set out to find answers to two sets of inter-related sub-questions around informal relationships at the local level. These are (1) to what extent can the nature of embeddedness and complementarity based on informal relationships between health department and local elected institutions (Municipal Assemblies) affect health care delivery at the municipal level? (2) to what extent can the nature of embeddedness and complementarity based on informal relationships between health department and civil society affect the delivery of health care?

I suggest conditions around informal relationships to explain the variations in the performance of health care delivery. I argue that in addition to the other conditions, the kinds of embeddedness and complementarity based on informal relationships in the municipalities might matter for decentralization to work and possibly lead to health care improvement.