In Chapter six Tendler reviews different aspects of the cases discussed in this book that led to their success.  She argues that much of the advice offered to developing countries has not taken into account the the evidence of good government in the countries being advised( 135).  Tendler states that all programs discussed in the book presented signs of high performance and impact.

The cases described in the book reveal that government can be a remarkably strong moral presence (141).  Tendler argues that the experiences described in the book do not confirm theories that local government and non-government agents are better suited to provide good services at the local level.  First, she suggests that improvement local governments government performance was less a result of decentralization, but more a result of an active central government promoting good governance standards to citizens and pressuring local government through publicity to be a part of these programs. Second, she points to a two-way dynamic between civil society and government, government was causing civil society to form, then, at the same time civil society was acting  independently from the outside to challenge its wisdoms and its actions, or to demand better services.(146).  Third, the cases discussed do not support the assumption that non-governmental organizations are inherently more flexible and client friendly than government.  Tendler gives the example of the preventive health program and suggests that the state department of health delivered in a more decentralized, flexible and client friendly fashion than the existing NGOs.

Tendler also argues that to the extent that the cases in Ceara reflected the assumed benefits of decentralization, these cases revealed a different dynamic.  In fact central government took power away from the local government, even though its actions ultimately contributed to strengthening the capacity of local government (147). Furthermore, contrary to the theoretical assumptions about decentralization, the state (Central) government was more active, doing things that it had never done before. The local government and civil society were also more active with these new programs than they were prior to it.

According to Tendler proponents of the decentralization and privatization would argue that the case of Ceara is not a case of genuine decentralization, given that the state government is playing a central role in these programs.  But in this chapter, Tendler challenges these proponents to recognize the limitations of their theory and advises them to develop premises that can explain the good government practices in Ceara. She suggests that even though this might not be a case of genuine decentralization, the results achieved through these programs were in accordance with the results supposed to be achieved through decentralization: stronger local institutions in the form of more capable government, and a more developed and demanding civil society (148).