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
  Purpose

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.


Condition Intervention
Infectious Disease
Cardiovascular Disease
Behavioral: District health information package

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Health Services Research
Official Title: Improving Use of Evidence in Policy: District Evaluation Study on Health

Resource links provided by NLM:


Further study details as provided by St. Michael's Hospital, Toronto:

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

Secondary Outcome Measures:
  • 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 ]

Enrollment: 594
Study Start Date: July 2009
Estimated Study Completion Date: July 2011
Estimated Primary Completion Date: July 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: District health information package 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
No Intervention: No Intervention

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.

  Eligibility

Genders Eligible for Study:   Both
Criteria

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
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01003587

Locations
Canada, Ontario
Centre for Global Health Research, St. Michael's Hospital
Toronto, Ontario, Canada, M5C 1N8
India
St. John's Research Institute
Bangalore, Karnataka, India, 560034
Sponsors and Collaborators
St. Michael's Hospital, Toronto
Canadian International Development Agency
Lombard Insurance Global Poverty Action Lab
St. John's Research Institute
Investigators
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
  More Information

Additional Information:
No publications provided

Responsible Party: Dr. Onil Bhattacharyya, St. Michael's Hospital, Toronto
ClinicalTrials.gov Identifier: NCT01003587     History of Changes
Other Study ID Numbers: SMH 09-049
Study First Received: October 28, 2009
Last Updated: October 28, 2009
Health Authority: Canada: Ethics Review Committee
India: Institutional Review Board

Keywords provided by St. Michael's Hospital, Toronto:
India
evidence-based policy
knowledge translation
disease control priorities
decision-makers
health spending
health services delivery
maternal and child health
policy making
delivery of health care

Additional relevant MeSH terms:
Cardiovascular Diseases
Communicable Diseases
Infection

ClinicalTrials.gov processed this record on October 19, 2014