Commuity health insurance

'Community Based Micro Health Insurance: A recipe for replication?'.

August 18, 2010

Speaker(s): Micro Insurance Academy (MIA) team

Health risks are a serious threat to poor households as health shocks can significantly increase out- of-pocket expenditure. Community- based Health Insurance schemes in such cases are seen as a simple and affordable solution for poor communities to manage health risks. These are small scale, voluntary health insurance programs, organized and managed in a participatory manner and draw on resources of social solidarity and cohesion (Tabor, 2005).

At the Delhi seminar, researchers from The Micro Insurance Academy (MIA) shared details of an ongoing 5-year project assessing the effectiveness of Community Based Health Insurance in two districts in Uttar Pradesh and one district in Bihar. The program involves Self Help Groups in the districts and initiates a participatory and democratic process for selecting a health insurance scheme that best suits the community’s needs. The program ‘Choosing a Health Alternative Together ’ also helps the community in electing a committee of members that will eventually manage the health insurance fund. Dr. Pradeep Panda, Senior Researcher, MIA said the proposed impact evaluation was based on the hypotheses that micro-health insurance could decrease out-of pocket expenses of poor households as well as reduce borrowing or liquidation of assets to meet health needs. It could also increase utilisation of healthcare and increase the quantity of health care provided.

The impact evaluation in these districts will involve three separate Randomised Control Trials and use a ‘step-wedge’ design, where every year the project would be implemented only in 1/3rd of the villages. The research will also include qualitative aspects like the impact of the project on social capital as well as attitudes to healthcare and risk protection. 

“We are looking at impact not just in terms of quantification but in terms of factors underlying the impact,” said Conor Doyle, Researcher at MIA.

The discussion at the seminar raised questions concerning the possible negative spillover effects on the control group and whether this impact assessment could produce findings that can contribute to replication in other contexts.

Download MIA's presentation (1.7 MB)

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