Governance reforms like decentralization and performance-based management aim to improve public services by increasing accountability among street-level bureaucrats: bureaucrats may be held to account by communities, supervisors, intermediary organizations, or all of these. To assess the relationship between accountability and bureaucratic effort, we utilize data from a lab-in-the-field behavioral experiment conducted with Honduran health workers across decentralized and centrally administered municipalities. We presented health workers with an incentivized effort task that included instructions that were neutral, had a bottom-up political accountability prompt, or a top-down bureaucratic accountability prompt. Our results show that administrative context moderates the accountability-to-effort relationship. With neutral instructions, civil servants in decentralized systems exert greater quality effort than their counterparts under centralized administration. Importantly, both accountability prompts increase quality effort in centrally administered settings to levels comparable with those in decentralized settings. These findings support multiple accountability as a potentially important mechanism linking decentralization reform to improved service delivery.