The rapid, global expansion of democracy has today shifted the focus of policymakers and scholars from ‘how to bring down authoritarian rule’ to ‘how to make democracy work’ (Diamond, 2008). While we know a good deal about why some democracies deliver high-quality government and others do not, we know little about a) citizens’ responsiveness to democratic quality and b) the influence of citizens’ demands on outputs. Do citizens reward their leaders for institutional outcomes such as rule of law, competent and efficient bureaucracy, independent legal systems, and low corruption? Or are public assessments of their leaders driven by more pressing concerns relating to security and material well-being, without regard to how such outcomes come about? Finally, can accountability to the citizenry bring about the institutional change required to make democracy work? In this paper we explore some of these questions with data from the Executive Approval Project combined with Quality of Government indicators. These cover 18 Latin American democracies from the 1980s to 2013.