The development of reproductive health service delivery is continually confronted by challenges from a changing environment. An important element of this is health sector reform, particularly decentralisation, being undertaken by most governments in Africa. The general objective of this applied, multidisciplinary research is to make health sector decentralisation more effective in the development of appropriate reproductive health services. The general research question is: How does decentralisation affect reproductive health services? The project will compare different forms of decentralisation in Anglopohone and Francophone African countries to assess their impact on, and importance for, the development of reproductive health services. The research will result in lessons learned and guidelines for policy makers.