European Journal of Political Research  :  –  , 2018 1 doi: 10.1111/1475-6765.12313 Designing institutions to improve well-being: Participation, deliberation and institutionalisation BRIAN WAMPLER 1 & MICHAEL TOUCHTON 2 1 Department of Political Science, Boise State University, USA; 2 Department of Political Science, University of Miami, USA Abstract. Social accountability institutions are at the forefront of democratic reformers’ efforts to improve well-being by harnessing the power of citizen participation. This article builds on recent research identifying a positive relationship between participatory budgeting (PB) and well-being. The article is the frst large-N study to identify relationships between specifc rules of PB programme design and well-being. A unique dataset of 114 Brazilian municipalities with PB programmes from 2009 to 2016 is constructed to evaluate whether internal mechanisms within PB explain variation in local infant mortality rates – an outcome associated with wellbeing. Hypotheses are tested that correspond to citizen participation, the scope of deliberation and embeddedness within local institutions. It is found that PB programmes are associated with lower infant mortality rates when they broaden participation, expand deliberation and embed the new institutions in ongoing policy-making venues. The results offer a framework for designing PB programmes and other social accountability institutions to maximise impact. Keywords: democracy; institutions; participation; governance; human development; Brazil Introduction Democracy increases accountability, protects rights, promotes economic growth, increases spending on public goods and improves standards of living (Sen 1999; Acemoglu et al. 2000; Brown & Hunter 2004; Gerring et al. 2015). Of course, there are extensive differences within democracies regarding the extent to which individual citizens have opportunities to exercise political rights, elect leaders or select policies, and hold leaders accountable. Poor and politically marginalised citizens are frequently unable to participate in democratic processes and thus miss out on democracy’s benefts, especially in the developing world (Schattschneider 1960; O’Donnell 1998; Ross 2006; Cleary 2010). Many democratic governments recognise this problem and now use a wide variety of sub-national political institutions and policy programmes to directly engage poor citizens, improve their well-being and gain their votes (Grindle 2004; Snyder 2001; Fox 2015). Social accountability institutions (SAIs) represent the vanguard of efforts to redesign democratic institutions to harness the potential power of citizen participation to improve social well-being; citizen-participants engage in different types of political activities including deliberation, decision making and oversight (Smulovitz & Perruzzoti 2000; Smith 2009; Fox 2015). SAIs are proliferating around the world as governments and their civil society allies seek to adopt democratic policy-making processes to include both citizens and government offcials (Mansuri & Rao 2012; Smith 2009). Well-known examples of SAIs include participatory budgeting, citizen audit institutions, citizen juries, deliberative councils C  2018 European Consortium for Political Research