This report examines the quality of public policies in Latin America and the Caribbean after more than a decade of political and economic reform. A wide variety of examples and case studies are presented in an analytical framework to help explain why policies that work in certain institutional environments may not work in others. The focus of this report is not the content of policies, or their effects on major economic and social variables, but rather the process by which these policies are discussed, approved, and implemented. In presidential democracies like those in the majority of the Latin American countries, the process of adopting and implementing public policy occurs in political systems in which a variety of actors participate, ranging from the president to voters in small rural communities and including congressmen, judges, public opinion leaders and businessmen.