There are several actions you can take to start a population accountability process.  The order that you do them in should be the one that will work best in your community.  The start-up process involves:

• bringing together people who want to make a difference,
• forming a leadership team that is accountable to the community, and
• deciding which population group will the focus of this work.

Bring people together

The population accountability process shows how a group of programs or services together are making a difference in the lives of a population.  Because a single program or service is just one of progress toward a population goal, the population accountability process cannot be conducted by a single individual or program.  Population accountability requires a group.

If you want to start a population accountability process in your community, you might begin by taking with others, including program staff, advocates, parents, and community leaders to find out about what specific issues they care about.  You will probably find that everyone wants to make a difference.  You might be able to bring people together to consider the population accountability process by presenting it as one way to show that they are succeeding.

Form a leadership team

The people on the team should be high-level, well-respected leaders.  Examples include: public officials, private company executives, tribal or church leaders.  The leadership team has two vital roles in the population accountability process.

• It assumes responsibility to the community for the well-being of a group of people.  This means that the team states where it wants to lead and presents information to the community that includes overall progress.  The success or failure of specific efforts is only included as part of the discussion about what the next actions should be.
• The team provides oversight to be sure that the process is open and that the community has a chance to participate.

The leadership team needs to:

• Adopt some sort of framework for the work, so that the process is sensible and makes progress.
• Have at least part of someone's time is available for its support.  Members of the leadership team are unlikely to have time to take care of the detail.  The support worker(s) may make suggestions and will help compile reports.  The leadership team decides on the statement of what end-result they are responsible to the community for, how it will be measured (indicators), and what actions will be taken to move toward it.
• Provide a chance for everyone in the community to talk about the draft list of results and indicators with the leaders.  After receiving these comments, the leaders reconsider the end result and indicators and issue a final version.

You do not necessarily need to establish a leadership team.  Many communities have a health commission, coalition, or other umbrella organization that is well-suited to this role.

Choose a population

You need to decide which group will be the focus of your joint efforts.

• You could use geographic boundaries, such as a neighborhood, village, school area, city, state, nation or the world.
• You coulud include everyone who lives or works within those boundaries, or you could add specific characteristics.

You should not use criteria related to receiving a particular service.  The performance accountability process is designed for groups that are defined by the services they receive.