This book examines the issues of accountability in the delivery of public services. Each chapter of the book incorporates, in addition to technical, economic, and statistical analysis, an analysis of the institutional context for service delivery. A common theme that cuts across this book is the issue of accountability as developed by the World Bank in its 'World Development Report: Making Services Work for Poor People' (2004). The main conclusion of the book is that, while Peru has made significant progress in both education and health care, there remain significant challenges to achieving greater equity and better quality of services, particularly for the poor. The book finds that Peru has achieved high levels of coverage in all levels of education and in some programs of basic health care and of social assistance. Still, the average quality of most of these programs is low, and health and education outcomes are extremely inequitable. The book recommends three types of interventions: a. quality standards and quantitative goals need to be set, b. accountability chains need to be established so that providers take responsibility for their services; and c. investments are needed to create and sustain the capacity to reach these goals.