The agreement was approved by voters across the island of Ireland in two referendums on 22 May 1998. In Northern Ireland, in the 1998 referendum on the Good Friday Agreement in Northern Ireland, voters were asked if they supported the multi-party agreement. In the Republic of Ireland, voters were asked whether they would allow the state to sign the agreement and authorize the necessary constitutional changes (nineteen constitutional amendments from Ireland) to facilitate it. The citizens of both countries had to approve the agreement to implement it. Direct domination of London ended in Northern Ireland when power was formally transferred to the new Northern Ireland Assembly, the North-South Council and the Anglo-Irish Council when the opening decisions of the Anglo-Irish Agreement came into force on 2 December 1999.    Article 4, paragraph 2 of the Anglo-Irish Agreement (the agreement between the British and Irish governments on the implementation of the Belfast Agreement) required both governments to inquire in writing about compliance with the terms of entry into force of the Anglo-Irish Agreement; The latter is expected to come into effect as soon as both notifications are received.  The British government has agreed to participate in a televised ceremony at Iveagh House in Dublin, the Irish Foreign Office. Peter Mandelson, Minister of Northern Ireland, participated in his participation in early December 2, 1999. He exchanged notifications with David Andrews, the Irish Foreign Secretary. Shortly after the ceremony, at 10:30 a.m., the Taoiseach, Bertie Ahern, signed the declaration of formal amendment of Articles 2 and 3 of the Irish Constitution. He then informed the D`il that the Anglo-Irish agreement had entered into force (including some endorsements to the Belfast Agreement).   Northern Ireland`s leaders face difficult challenges in providing basic services and managing denominational divisions. One of the most urgent tasks is to improve health services, which have become increasingly mired in crisis after the collapse of local authorities.
About three hundred thousand people – about one-sixth of the population – were on waiting lists for health care by the end of 2019, and nurses and other employees went on strike in December of that year to protest lower wages than the rest of the UK. Until February 2020, many health unions had agreed with the government on higher wages and other demands on whether the health sector was on a sustainable path but remains open. There are, of course, many others who contributed to the agreement crossing the line, including political parties such as the Northern Ireland Women`s Coalition, an outright party that participated in the peace negotiations, religious figures and, of course, the people of Northern Ireland who voted overwhelmingly in favour of it.