This article attempts to examine the relationship between decentralization and service delivery through an analysis of the performance of local governments established under the "Khyber Pakhtunkhwa Local Government Act 2013" with respect to the delivery of basic social services. While exponents of decentralization often argue that the devolution of powers to the lower levels of government improves public service delivery through equity, productive efficiency, and cost recovery, the findings of this study evince that the effects of decentralization on service delivery are often contingent on the social and political dynamics prevalent within a given context.

This paper critically examines the 18th constitutional amendment of Pakistan, which is a revolutionary legal change and helped to see a huge adjustment of a federal form of government to provincial autonomy. The 18th Amendment provided for the abolition of the Concurrent Legislative List, the devolution of significant ministries, and reinforcement of intergovernmental institutions like the Council of Common Interests and the National Finance Commission. Although the amendment revitalized the federal spirit of the 1973 Constitution and gave the provinces the strength in legislative and fiscal areas, its early practice revealed the shortcomings in institutions and capacities. The paper concludes that sustainable federalism in Pakistan entails an enhanced level of intergovernmental coordination, institutional changes, and political commitment to handle the asymmetries between provinces.