The issue of public toilet provision in Ghana, as is being championed under the Ministry for Special Development Initiatives (SDI), remains a concern for democratic governance and its imperatives for development. Much as such a policy addresses a major environmental challenge of open defecation and its attendant health effects, in terms of governance and democratic development it creates a debate on whether centralisation or decentralisation serves as a better medium for enhancing democratic governance and development, especially in the developing and emerging democracies.

The key issue to be addressed in this study is how democratic governance and development can be improved. The theoretical foundations in this study relate to the subsidiarity principle, which is employed here to explain the deployment of functions and responsibilities for effective democratic governance at the local level. The study utilised programme documents and reports, key informant interviews and focus group discussions with citizens and governance practitioners to determine the appropriate levels for optimal service provision in democratic governance and its implications for decentralised development administration.