"Citizens’ Voice and Accountability (CV&A) work has emerged as a priority in the international development agenda from the 1990s onwards. In their CV&A work, donors recognise the importance of context: it shapes relation to that context. However, context awareness has not proven sufficient to enable donors to grapple with key challenges posed by the interaction between formal and informal institutions, the prevalence of the latter over the former in many instances, and underlying power relations and dynamics. Some examples of positive impact of CV&A interventions have emerged from the interventions analysed for this study. This is mostly at the level of positive citizen awareness, empowering certain marginalised groups, and encouraging state officials. However, within the sample analysed, such impact/effects have remained limited and isolated, and have so far proven difficult to scale up. A critical factor leading to the observed limited nature of results is related to the fact that donor expectations as to what such work can achieve are too high, and are based on misguided assumptions around the nature of voice and accountability, and the linkages between the two. There is a tension between the long-term processes of transforming state-society relations and donors’ needs/desires to produce quick results. Scaling up sustainability are also issues not currently sufficiently addressed within intervention design and implementation." (Executive summary, page v)