The importance of involving the poor recipients in planning and implementing development policies has long been recognized, and has been the official aim of large donors, including the World Bank and major donor agencies. This text assesses their success and the results of the primary stakeholder participation achieved. It analyzes the institutional changes necessary for stakeholders to participate in decision-making, and the strategies and behaviour of other parties involved, including NGOs. From this review and analysis, it draws an important range of lessons for future donor and NGO policies and organizational reform.