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Use of a Social Accountability Tool - 20% Increase in Community Health Worker Visits to Pregnant Women


Strategy researched

A social accountability tool to improve maternal and reproductive health outcomes by empowering community members, health service providers, and others to identify and overcome obstacles in resource-limited settings

Impact achieved

The Community Score Card (CSC) intervention increased community health worker (CHW) visits to women during pregnancy by 20% and during the postnatal period by 6%, compared to control. Results also showed a 16% increase on overall service satisfaction for the women who had healthcare providers who underwent CSC intervention, as well as 57% higher use of contraceptives. There was a significant 37% increase in the indicator relationship between the community and health providers in the groups who underwent the intervention, and a 22% increase in the indicator on availability and accessibility of reproductive and maternal health information in the groups who underwent the intervention.

Country of study


Research methodology

Cluster RCT


PLOS ONE; 2017

Journal paper title and link

Effects of a social accountability approach, CARE's Community Score Card, on reproductive health-related outcomes in Malawi: A cluster-randomized controlled evaluation

Excerpt from Abstract

"By facilitating the relationship between community members, health service providers, and local government officials, the CSC contributed to important improvements in reproductive health-related outcomes. Further, the CSC builds mutual accountability, and ensures that solutions to problems are locally-relevant, locally-supported and feasible to implement."

Summary at this link


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  • Published since 2010.