Promoting Evidence-Based Decision-Making in India: District Evaluation Study on Health (DESH)

The recruitment status of this study is unknown because the information has not been verified recently.

Verified October 2009 by St. Michael's Hospital, Toronto.
Recruitment status was Active, not recruiting

Sponsor:

Collaborators:

Canadian International Development Agency

Lombard Insurance Global Poverty Action Lab

St. John's Research Institute

Information provided by:

St. Michael's Hospital, Toronto

ClinicalTrials.gov Identifier:

NCT01003587

First received: October 28, 2009

Last updated: NA

Last verified: October 2009

History: No changes posted

Tracking Information

First Received Date ^ICMJE

October 28, 2009

Last Updated Date

October 28, 2009

Start Date ^ICMJE

July 2009

Estimated Primary Completion Date

July 2011 (final data collection date for primary outcome measure)

Current Primary Outcome Measures ^ICMJE

Prioritization of district health programs by District Health Officers [ Time Frame: Two years ] [ Designated as safety issue: No ]

Original Primary Outcome Measures ^ICMJE

Same as current

Change History

No Changes Posted

Current Secondary Outcome Measures ^ICMJE

Breakdown of district budgetary spending on health [ Time Frame: Two years ] [ Designated as safety issue: No ]
Implementation and utilization of district health services [ Time Frame: Two years ] [ Designated as safety issue: No ]

Original Secondary Outcome Measures ^ICMJE

Same as current

Current Other Outcome Measures ^ICMJE

Not Provided

Original Other Outcome Measures ^ICMJE

Not Provided

Descriptive Information

Brief Title ^ICMJE

Promoting Evidence-Based Decision-Making in India: District Evaluation Study on Health

Official Title ^ICMJE

Improving Use of Evidence in Policy: District Evaluation Study on Health

Brief Summary

The purpose of this study is to assess the impact of disseminating information on comparative performance, along with actionable messages on how to improve health outcomes, to district-level decision-makers in India using a randomized, controlled design. This information should improve prioritization of health services by district health officers, budget allocation for health, and implementation of priority health services at the district level.

Detailed Description

Use of evidence in policy is uneven, leading to frequent waste of resources. However, the best way to promote evidence uptake in policy formulation and implementation is unclear. Information on disease control priorities based on India's disease burden and health system capacity has been produced to help focus government efforts during a period of increased spending and decentralization.

This study tests the impact of sending information on comparative performance (using district report cards) and actionable messages (on how to reduce disease burden) to district-level decision-makers on uptake of disease control priority recommendations in India. Using a cluster-randomized design, districts will be randomized to receive either the mailed information package or no intervention. The sample includes all 594 Indian districts in existence in 2001. The intervention will target key district level decision-makers: parliamentarians (Members of Parliament, Members of Legislative Assembly), bureaucrats (District Collectors), technocrats (District Health Officers), and local government officials (Zilla Parishad CEOs).

Study outcome data will be collected using sequential surveys on prioritization and implementation of priority interventions by district health officers and review of administrative databases for budgetary and health service utilization measures. This study tests an inexpensive, pragmatic strategy on a large scale and will provide information on effective methods of knowledge translation to policy-makers.

Study Type ^ICMJE

Interventional

Study Phase

Not Provided

Study Design ^ICMJE

Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Health Services Research

Condition ^ICMJE

Infectious Disease
Cardiovascular Disease

Intervention ^ICMJE

Behavioral: District health information package

The intervention package consists of:

A report on disease burden, disease control priorities and health system performance in India
Condensed fact sheet based on the report
District health report cards (DRCs) comparing performance on key health indicators with other districts, information on causes of death in each district, and actionable messages to reduce deaths in the district
Customized speech for district level officials detailing key actions to reduce deaths
Reminder materials including poster version of the DRCs and video on key points and actionable messages

Study Arm (s)

Experimental: District health information package
Intervention: Behavioral: District health information package
No Intervention: No Intervention

Publications *

Not Provided

* Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.

Recruitment Information

Recruitment Status ^ICMJE

Active, not recruiting

Enrollment ^ICMJE

594

Estimated Completion Date

July 2011

Estimated Primary Completion Date

July 2011 (final data collection date for primary outcome measure)

Eligibility Criteria ^ICMJE

Inclusion Criteria (Districts):

All districts in India in existence in 2001

Exclusion Criteria (Districts):

All districts in India created after 2001

Inclusion Criteria (District Officials):

Members of Parliament (MPs) who sit in the Lok Sabha (Lower House of Parliament) and represent constituencies that are contained within or overlap study districts
Members of Legislative Assembly (MLAs) who represent constituencies that are contained within study districts
District Collectors (DCs) who administrate study districts
Zilla Parishad Chief Executive Officers (ZPCEOs) who administrate study districts
District Health Officers (DHOs) who work in study districts

Exclusion Criteria (District Officials):

MPs who sit in the Rajya Sabha (Upper House of Parliament), Lok Sabha MPs who represent constituencies not contained within or overlapping study districts, Lok Sabha MPs who represent constituencies that overlap both experimental and control study districts
MLAs who represent constituencies not contained within study districts
DCs who administrate non-study districts
ZPCEOs who administrate non-study districts
DHOs who work in non-study districts

Gender

Both

Ages

Not Provided

Accepts Healthy Volunteers

Not Provided

Contacts ^ICMJE

Contact information is only displayed when the study is recruiting subjects

Location Countries ^ICMJE

Canada, India

Administrative Information

NCT Number ^ICMJE

NCT01003587

Other Study ID Numbers ^ICMJE

SMH 09-049

Has Data Monitoring Committee

Not Provided

Responsible Party

Dr. Onil Bhattacharyya, St. Michael's Hospital, Toronto

Study Sponsor ^ICMJE

St. Michael's Hospital, Toronto

Collaborators ^ICMJE

Canadian International Development Agency
Lombard Insurance Global Poverty Action Lab
St. John's Research Institute

Investigators ^ICMJE

Principal Investigator:	Onil Bhattacharyya, MD, PhD	St. Michael's Hospital, Toronto
Principal Investigator:	Prabhat Jha, MD, PhD	St. Michael's Hospital, Toronto
Principal Investigator:	Prem Mony, MD, MSc	St. John's Research Institute

Information Provided By

St. Michael's Hospital, Toronto

Verification Date

October 2009

^ICMJE Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP

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