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in-DEPtH framework: evidence- With a multitude of variables, the combinations of care, health program activities and outcomes are infinite, and this renders improvement efforts to complex health service interventions particularly intricate. Here, we describe a framework that seeks to incorporate research evidence and the multi-faceted considerations of stakeholders, context and resources to co-create sustainable health solutions that improve the health outcomes of patients and communities. This evidence-informed, co-creation framework for the Design, Evaluation and Procurement of Health services (in-DEPtH) is a systematic approach to support health agencies to commission services that are evidence-informed, contextually relevant and stakeholder engaged. The framework consists of several steps from defining the research question, health outcomes and search inclusion criteria, to the synthesis of evidence, and to co-creation and Delphi consultations with stakeholders. In this paper, we describe the various steps of the framework and explain the theoretical methods underpinning the framework. The approach of the framework is context neutral and can be applied to healthcare systems of different countries.