1. CARE’s experience with Community Score Cards What works and why?

2. Lessons learned 1.Working with and through the state 2.Solving internal collective action problems 3.Creating a space for co-operation 4.Linking the local to the national 2

3. Working with and through the state – Increasing recognition that building coalitions across state and non- state actors is key (Fox – “sandwich strategy”) – Often a challenging process for non-state actors Research here suggests: – Where the state is strong and coherent a wider range of outcomes were achieved and programmes were more sustainable – Where state capacity is weaker, outcomes tend to come from informal processes outside state structures, but still involving state actors – Organisations with a history of working with the state and state officials at the local level have advantages in terms of links and building trust, but often a long term process needing careful leverage 3

4. Working with and through the state – Increasing recognition that building coalitions across state and non- state actors is key (Fox – “sandwich strategy”) – Often a challenging process for non-state actors Research here suggests: – Where the state is strong and coherent a wider range of outcomes were achieved and programmes were more sustainable – Where state capacity is weaker, outcomes tend to come from informal processes outside state structures, but still involving state actors – Organisations with a history of working with the state and state officials at the local level have advantages in terms of links and building trust, but often a long term process needing careful leverage 4

5. Solving internal collective action problems – Attempts to “move beyond supply and demand” tend to assume that there are cohesive interests that can be brought together – However, problems of free-riding and moral hazard exist within groups e.g. water point maintenance duties within communities, ability to admit problems and short-comings in service providers Research here suggests: – Solving collective action issues within groups is a key step – Requires careful engagement and building links with local leaders in communities, as well as within local state and service provision institutions – Particular priority where state coherence and community cohesion is weak 5

6. Creating a space for co-operation Research here suggests key elements are: – Buy-in from local officials, community leaders and service providers – A non-confrontational approach In strong cohesive states – Aligning with national targets and priorities improves engagements and outcomes (GTP and imihigo) In less cohesive states – Alliances must be built across a range of groups, often at the very local level, and programmes must be flexible enough to adapt to changing circumstances (e.g. elections and new funds) 6

7. Linking the local to the national – Using local level mechanisms to link to national level changes in policy or conditions is hard – Only a single case was documented in this study (Rwanda and health insurance fee classifications) Research here suggests: – Linking to the national will be easier in strong, coherent states – Aligning programmes to national priorities and linking to existing mechanisms for national dialogue may be key – Strategies in less coherent states are unclear 7