Implementing public policies in federations involves clashes of concept and practice. In its design, federalism is not particularly conducive to the formulation and implementation of public policy because the acclaimed strengths of a federal form of government, including diversity, fragmentation of power and sovereignty, and responsiveness to regional and cultural interests, all serve to make the introduction of national policies complex and challenging. This is especially the case regarding the implementation phase of policies which tends to be a most difficult task given the layers and negotiating steps through which policies must pass before being delivered to clients. Success in implementing public policies in federations requires a mixture of strategies that can range from coercion to collaboration and cooperation. Achieving performance with accountability throughout this process has proven difficult in most federations. Moreover most of the literature has avoided the client perspective, in particular whether citizens really care about the vagaries of federal arrangements as they simply want to see the programs that affect their daily lives delivered efficiently, effectively, and accountably.