The article demonstrates that decentralisation has been eulogised as a participatorymeans to development, which enhances good governance and democracy.Developing countries have embarked on various public sector managementreforms in an effort to improve public service delivery. These reforms entailamong other things redefining the role of the state, hence a shift from a focuson government to governance as nations strive towards lean, decentralisedand democratic states. Governments have been urged to decentralise in orderto improve service delivery and efficiency. Decentralisation has been eulogisedas a participatory means to development, enhancing good governance anddemocracy. Botswana has been exemplary in public service management; thecountry has continuously embarked on and successfully implemented variouspublic sector reforms in an effort to improve its public administration. Amid theimplementation of decentralisation [as espoused by developing countries] thegovernment of Botswana in 2009 made a decision to transfer the managementof clinics and primary hospitals together with the related personnel from localgovernment to central government. Drawing from content-based examination ofgovernment’s decisions on centralisation of primary health services and rural watersupplies, using theories and concepts of decentralisation, the article shows thatthe discourse of centralisation vis-à-vis decentralisation enhancing participatorydemocratic governance and service delivery efficacy, or lack thereof, remains anunresolved story for developing countries

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