In the GTO approach, accountability is defined as the systematic inclusion of critical elements of program planning, implementation, and evaluation to achieve results. GTO weaves together several overlapping theoretical strands of evaluation and accountability that encompass traditional evaluation, empowerment evaluation, results-based accountability, and continuous quality improvement. The GTO approach is based on 10 accountability questions about needs and resources, goals, science and best practices, fit, capacity, plan, implementation, outcome evaluation, continuous quality improvement, and sustainability. The GTO approach can be useful at any stage of programming, it is not linear, and it promotes cultural competence in programming. 21 references, 1 table, and 1 figure