Finally, evaluation indicators need to reflect health status outcomes at both a population and a local community level. Population level indicators (e.g. epidemiological data, prevalence of risk factors across the province according to sociodemographic characteristics) can provide a profile of population or community health, against which the entire IHS system and individual IHSs can be evaluated. Population-based indicators of health are unlikely to be sensitive enough to reflect the degree to which IHSs effect the health and well-being of the most marginalized or at risk populations (e.g. the homeless, people living with AIDS, refugees, people with mental illness). Therefore, social indicators are needed to evaluate the extent to which an IHS has addressed social inequities and discrimination by narrowing the gap in health status between those most at risk and the general population. By adopting these types of indicators, the Ministry of Health would hold IHSs accountable for meeting the special needs of marginalized groups on their roster, as well as those who may be unenrollable (e.g. homeless, refugees). Local community level indicators should be developed by each IHS according to provincial guidelines, in partnership with the community served. This will enhance the ability of individual IHS to properly assess the unique health needs of their communities, and the effectiveness of their efforts in meeting those needs.