By combining the rollout of three new showcase micro insurance units (MIUs) in India and an unprecedented emphasis on scientifically rigorous evaluation of their impact on the lives of the target population in terms of equitable healthcare access and financial protection over several years, this project seeks to build a solid and comprehensive knowledge base for micro health insurance initiatives.
Two generations of top-down decisions on health financing systems have produced very modest results for poor people, poor countries or indeed for the major donors/funders. In most developing countries, including India, the lion’s share of health spending is made out of pocket. Impoverishment, low access – especially for weaker segments of the population such as women and children – and thus bad health status are consequences.
Health insurance has the potential to remedy or at least reduce the severe consequences of unforeseen health care expenditures. Recently, a growing number of community based health insurance (CBHI) schemes emerge in India and other developing countries.
It is expected that CBHI can
This project will implement a new model of CBHI, characterised by:
Furthermore, a thorough analysis of the effects of introducing CBHI in 3 sites in India will be conducted using a cluster-randomised controlled trial with staged implementation.
This project will yield the first study on the impact of CBHI over a four-year period. The longitudinal monitoring and randomized roll-out will establish coherent cause-&-effect relations between insurance status and health-seeking behaviour, as well as health status & financial exposure due to catastrophic health costs.
The study will systematically scrutinize the impact of CBHI on the quantity, quality and cost of local healthcare supply due to the increase in solvent demand. This may contribute to establishing effective and efficient health services.
The study will analyze, document, and disseminate for policy purposes, the financial and social opportunities of shifting the administrative burden from agents to the ground-structure embedded within the members of CBHI, but also flag the risks and costs that this shift of responsibility entails.
The findings will hopefully enable to understand cause-effect relations between insurance status and healthcare-seeking behaviour, health status and financial exposure due to catastrophic events, the impact of micro insurance on the local healthcare supply and many other areas of crucial medical and socio-economic relevance.
Although health insurance may have limited direct potential to contribute to achieving various MDGs, it might unfold some indirect impact through provision of health related information in the training of the insurance activists and potentially increased overall health awareness after launching the insurance. We conservatively assume that at least the consequences of malaria and other diseases can be reduced through better access to care. Any relationship found in this direction in either the quantitative or the qualitative survey will be included in the project’s dissemination work.