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| Name | Class |
|---|---|
| Canadian International Development Agency | OTHER_GOV |
| Lombard Insurance Global Poverty Action Lab | UNKNOWN |
| St. John's Research Institute | OTHER |
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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| District health information package | Experimental |
| |
| No Intervention | No Intervention |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| District health information package | Behavioral | The intervention package consists of:
|
| Measure | Description | Time Frame |
|---|---|---|
| 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 | |
| Percentage facility-based births for the last child since 2007 | Five years |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage last child >3 yrs breast fed within 1 hr of birth | Five years | |
| Percentage women given advice on breastfeeding and newborn thermal care during antenatal care | Five years | |
| Measure | Description | Time Frame |
|---|---|---|
| Differences in any of primary and secondary outcomes between Empowered Action Group and Assam (EAGA) states and non-EAGA states | Five years | |
| Differences in any of primary and secondary outcomes between measles-focus states and non-measles-focus states | Five years |
Inclusion Criteria (Districts):
Exclusion Criteria (Districts):
Inclusion Criteria (District Officials):
Exclusion Criteria (District Officials):
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| Name | Affiliation | Role |
|---|---|---|
| Onil Bhattacharyya, MD, PhD | Unity Health Toronto | Principal Investigator |
| Prabhat Jha, MD, PhD | Unity Health Toronto | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre for Global Health Research, St. Michael's Hospital | Toronto | Ontario | M5C 1N8 | Canada | ||
| St. John's Research Institute |
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| Label | URL |
|---|---|
| Centre for Global Health Research | View source |
| St. John's Research Institute | View source |
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| ID | Term |
|---|---|
| D003141 | Communicable Diseases |
| D002318 | Cardiovascular Diseases |
| ID | Term |
|---|---|
| D007239 | Infections |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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|
| Percentage subcenters with oral rehydration solution available on day of survey and no stockouts for more than 10 days in last month |
| 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 |
| Bangalore |
| Karnataka |
| 560034 |
| India |