• From the onset, ensure health authorities are in the driver seat to provide accountability and ownership, and co-design interventions and solutions based on their priority health needs
• Beyond health authorities, create ownership among local multisector partners, patient/professional associations and community members, so all can commit to the objectives, plan and outcomes of the population health approach and ensure long-term buy-in. Ideally, this happens by forming a steering committee with representatives from all partners and chaired by city health authorities
• Openly discuss what works and what doesn’t in the steering committee, and use collected evidence to make joint strategic decisions
• Involve end users, such as health providers and patients early on to support the development of interventions that are tailored to their needs, hence also increase their future adoption
• Fund the majority of interventions locally to ensure sustainability and scale, and foster accountability
   

The indicators below can come from a variety of sources (primary and secondary data collection, national or regional surveys and databases).

Evaluation of the co-creation planning process 

• Establishment of the steering committee for the CV population health approach
• Diverse stakeholder representation (government, NGO, academic, professional associations, patient associations, private sector, civil society, etc.)
• Validated roadmap and operational plan for improving CV health
• % of funding by local stakeholders/other
• Intervention design reflects the needs of both the co-creators in the steering committee and the end users

Stakeholder-owned/funded interventions in operational plan – including but not limited to:

• Update of hypertension and CV risk reduction guidelines with latest available evidence and standardization of CV risk management
• Training and continuous medical education of health workers and supportive supervision of primary health services
• Hypertension patient registry or other form of patient data collection to monitor the cascade of care (screened, diagnosed, treated, controlled)
• Increased health literacy of patients and their families, leading to improved self-management

Progress, outcome and impact monitoring of the CARDIO interventions implemented

• % of population covered with access to improve quality of care and preventive services
• % of hypertension patients diagnosed, treated, controlled
• % of primary health budget and funding dedicated to CV care (there may be joint metrics with other CV risk factors)
• # of acute CV events avoided
• # of policies with proven health benefits that have been promoted (e.g., tobacco or sugar tax, total ban on salt and trans fat in processed food, etc.)
• Impact measurement of policies introduced