Internationally, many public sector reform initiatives have been undertaken over the last three decades under the label New Public Management (NPM), with improvements in accountability and management among their main objectives. This thesis draws on social capital theory to examine the potential of a Ugandan community-led HIV/AIDS programme to supplement NPM approaches to public service delivery and accountability. Hermeneutics methodology is used to guide the research design and the interpretation of evidence.The findings of this study suggest that Uganda's community-led HIV/AIDS initiatives operate within a "bottom-up" accountability framework, characterized by the community taking a role in budgeting, program implementation, reporting, project-oversight, and audit activities. In regard to accounting practices, this study reveals that Ugandan community projects use basic and simple accounting procedures. The findings suggest that simple communal accountability mechanisms can compensate for the types of formal control mechanisms typically promoted within NPM-style reforms. The findings also suggest that multiple accountability relationships can operate in the form of both hierarchical and lateral accountability practices and that these multiple accountability relationships lead to tighter control and accurate accountability, even though formal accountability mechanisms may be weak.This study identified some challenges for community-led service delivery initiatives, including the potential for corrupt practices in some community groups and variations in the level of participation of group members in the execution of various tasks. Further, several areas for further research have been identified. These include the measurement of social capital within community groups and the establishment of measures of group capacities.This study has revealed the latent accountability technology of a "bottom-up" communitarian accountability framework and demonstrated its potential as a complement to NPM models of service delivery and accountability. As an accountability innovation, it needs to be keenly watched as further field experiences emerge over time and reveal more of its potential in developing countries, and perhaps beyond.