District Evaluation Study on Health (DESH)

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The District Evaluation Study on Health (DESH) is a randomized trial targeting policymakers across India. The study will evaluate the impact of disseminating key health information (local disease burden, health system performance, and disease control priorities) on the attitudes of district policymakers and the implementation of health programs. The dissemination methods studied in DESH can easily be replicated on a large scale.

The intervention package will be delivered in three waves to key district-level policymakers, and includes the following:

  • Choosing Health: An Entitlement for All Indians (report)
  • Fact sheet for the Choosing Health report
  • District health report cards for respective districts
  • Video clip describing key points from the report cards
  • Choosing Health promotional calendar
  • Choosing Health poster

Six hundred districts in India were randomly assigned to either the “intervention” group, which would receive the intervention package, or to the “control” group, which would not receive the intervention package. The target group includes members of parliament and the legislative assembly, district collectors, chief medical officers, and civil society representatives. The effects of this initiative will be measured using mailed surveys and data from the District Level Health Survey from 2008-2009 and 2012 to assess changes in health service utilization.

More information on the DESH project can be found at www.cghrindia.org.


DESH-Bihar will establish a baseline, midline, and endpoint for the monitoring, learning, and evaluation agenda of the Bill & Melinda Gates Foundation’s Family Health Initiative Project. This Gates sponsored project aims to improve maternal and child health in Bihar, which is one of the poorest states in India.


The major causes of death and disease in India are shifting away from infectious diseases and into chronic diseases and injuries. Since these conditions may be surgically treatable, strategic health system planning at the facility, village, state, and national levels require a better understanding of common surgical conditions in the country. The primary goal of the DESH-Surgery study is to identify priorities in the management of surgical diseases in India by quantifying the country’s burden of surgical conditions. Surgeons are currently being recruited for the study.

Please see the DESH-Surgery Study site to participate in the study.


As part of the DESH initiative, CGHR is also in the process of writing a health report for the state of Karnataka. Karnataka is one of the wealthier states in India, and is poised to lead the country’s health reform. The report covers leading causes of premature death in the state, and outlines a roadmap to health through a universal health care program. The report will be published later this year.