Publications

CSC leads to an estimated 57% increase in the use of modern contraception.

“Effects of a social accountability approach, CARE’s Community Score Card (CSC) on reproductive health-related outcomes in Malawi: A cluster-randomized controlled evaluation.”

The cluster-randomized controlled evaluation assessed the CSC’s effect on reproductive health related outcomes in Ntcheu, Malawi. Results demonstrated a large and significant effect on use of modern contraception, with an estimated 57% greater use in the intervention versus control condition at end line.  The evaluation also showed that the CSC increased community health workers’ home visits during pregnancy by 20% and after pregnancy by 6%, compared to control areas. In addition to this, women’s satisfaction with reproductive health services increased significantly, compared with control areas. Further, it was found that the CSC builds mutual accountability, and ensures that solutions to problems are locally-relevant, locally-supported and feasible to implement.

This is the first study to use a rigorous cluster-randomized controlled design to evaluate the effectiveness of CARE’s CSC on a wide range of reproductive health-related outcomes. Click on the link below to read the full article.

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ODI Research into CSC “CARE’s experience with Community Score Cards”

CARE’s experience with Community Score Cards.

What works and Why?

by Joseph Wales and Leni Wild

This policy brief explores the experience of CARE International in implementing community score card programmes in four countries – Ethiopia, Malawi, Tanzania and Rwanda – and aims to address the significant research gap around cross-country comparative analysis of social accountability programmes.

The key findings of the research are that:
•• CARE’s Community Score Card programmes have contributed to strengthening service provision and community-state relations in each of these countries
•• Often this requires high levels of engagement with, and working through, different levels of the state apparatus. For support based on the idea of civic engagement, this is a counter-intuitive finding.
•• Reinforcing this, impacts are often ‘stuck’ at the local level and have only translated into national level impacts where they have plugged into existing government reforms.

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Connecting the World’s Poorest People to the Global Economy: New Models for linking savings groups to formal financial services

Despite the many benefits that CARE’s Village Savings and Loans schemes bring to poor communities, they are not a panacea. As groups mature they seek the security of a bank account, or wish for larger loans than the group can provide. This report looks at eight different models that CARE has explored to connect savings groups with formal financial services. Including Barclays, Vision Finance, Vodacom and Mwanga Community Bank, Orange and Equity Bank and Jubilee Insurance.

High uptake of savings, credit and insurance products have allayed concerns that products might prove too expensive for very poor communities. A total of 4,200 groups, or 105,000 individuals have been linked to the new products developed. Businesses too are benefitting, with increased customer bases and strong repayment rates. The report does recognise however, that overall transaction costs of linking savings groups to formal institutions remains high, albeit mobile banking offers opportunities to reduce this cost. The report also recommends that customer protection must be maintained. It outlines a set of ‘Linkage Principles’ that CARE has designed to help guard their interests.

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The Community Score Card (CSC): A generic guide for implementing CARE’s CSC process to improve quality of services

CARE Malawi developed the Community Score Card (CSC) in 2002 as part of a project aimed at developing innovative and sustainable models to improve health services. Since then, the CSC has become an internationally recognised participatory governance approach for improving the implementation of quality services. This toolkit gives practical, step-by-step guidance on using the CSC approach. The toolkit is generic in nature and can be applied in any sector including health, education, water and sanitation, and agriculture.

The Community Score Card (CSC) approach can be used to facilitate good governance through promotion of participation, transparency, accountability and informed decision-making. The approach brings together community members, service providers, and local government to identify service utilization and provision challenges, and to mutually generate solutions, and work in partnership to implement and track the effectiveness of those solutions in an ongoing process of quality improvement.

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