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

Not Applicable

• Conditions: Infectious Disease; Cardiovascular Disease
• Interventions: Behavioral: District health information package

• Registration Number: NCT01003587
• Lead Sponsor: Unity Health Toronto

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 national surveys of health service availability and utilization, including relevant rounds of the District Level Health and Facility Surveys and the Annual Health Surveys. 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 Timeline

• Study Start: 2009-07
• Study First Submitted: 2009-10-28
• Study First Submitted QC: 2009-10-28
• Study First Posted: 2009-10-29
• Status Verified: 2015-06
• Last Update Submitted: 2015-06-03
• Last Update Posted: 2015-06-04
• Primary Completion: 2016-03
• Study Completion: 2016-07

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 594

Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
District health information package	District health information package	-

Primary Outcome Measures

Name	Time	Method
Percentage facility-based births for the last child since 2007	Five years
Percentage children 12-23 months vaccinated against measles	Five years
Percentage children <3 yrs with diarrhea in past 2 weeks given oral rehydration solution	Five years

Secondary Outcome Measures

Name	Time	Method
Percentage women given advice on breastfeeding and newborn thermal care during antenatal care	Five years
Percentage last child >3 yrs breast fed within 1 hr of birth	Five years
Percentage community health centres with at least 1 surgeon or ob/gyn	Five years
Percentage public health centres with reagents, light microscope and lab technician for malaria blood smear	Five years
Percentage subcenters with oral rehydration solution available on day of survey and no stockouts for more than 10 days in last month	Five years

Trial Locations

Locations (2)

St. John's Research Institute; 🇮🇳 Bangalore, Karnataka, India

Centre for Global Health Research, St. Michael's Hospital; 🇨🇦 Toronto, Ontario, Canada