This document reports on the findingsfrom the first Consultative Citizens' Report Cardexercise undertaken in the City of Accra, Ghana. The workbegan in late 2009 and continues in 2010 with thedissemination of the findings to, and consultations with,City residents.The Citizens' Report Card wasundertaken by the World Bank with the full support andengagement of the Mayor's office, Accra MetropolitanAuthority, Ghana. The Citizens' Report Card involved alarge-scale household survey which was designed to bestatistically representative to the sub-metropolitan level.It incorporated Geographic Information Systems (GIS) andGoogle mapping which significantly aided fielding of thesurvey and which helps give a spatial dimension to thefindings.The survey gathered information from Cityresidents about the coverage and quality of seven core urbanservices, and also gathered perception-based information onresidents' views of the efficiency and effectiveness ofCity officials, on the accessibility and effectiveness oflocal political representatives, and on residents'views of their quality of life and standard of living. Thefindings from the Citizens' Report Card are being usedby the Mayor's office, City of Accra, to inform policyon urban service coverage and quality.