Reconciling Research and Implementation in Micro Health Insurance Experiments in India: Study Protocol for a Randomized Controlled Trial

Trials, Vol. 12, No. 224, 2011

35 Pages Posted: 13 Oct 2011

See all articles by Conor Doyle

Conor Doyle

Micro Insurance Academy, New Delhi

Pradeep Panda

International Institute of Health Management Research

Ellen van de Poel

Erasmus University Rotterdam (EUR) - Erasmus School of Economics (ESE)

Ralf Radermacher

Micro Insurance Academy e.V.

David M. Dror

Micro Insurance Academy (MIA)

Date Written: October 11, 2011

Abstract

Background Microinsurance or Community-Based Health Insurance is a promising healthcare financing mechanism, which is increasingly applied to aid rural poor persons in low-income countries. Robust empirical evidence on the causal relations between Community-Based Health Insurance and healthcare utilization, financial protection and other areas is scarce and necessary. This paper contains a discussion of the research design of three Cluster Randomized Controlled Trials in India to measure the impact of Community-Based Health Insurance on several outcomes.

Methods / Design Each trial sets up a Community-Based Health Insurance scheme among a group of micro-finance affiliate families. Villages are grouped into clusters which are congruous with pre-existing social groupings. These clusters are randomly assigned to one of three waves of implementation, ensuring the entire population is offered Community-Based Health Insurance by the end of the experiment. Each wave of treatment is preceded by a round of mixed methods evaluation, with quantitative, qualitative and spatial evidence on impact collected. Improving upon practices in published Cluster Randomized Controlled Trial literature, we detail how research design decisions have ensured that both the households offered insurance and the implementers of the Community-Based Health Insurance scheme operate in an environment replicating a non-experimental implementation.

Discussion When a Cluster Randomized Controlled Trial involves randomizing within a community, generating adequate and valid conclusions requires that the research design must be made congruous with social structures within the target population, to ensure that such trials are conducted in an implementing environment which is a suitable analogue to that of a non-experimental implementing environment.

Keywords: micro insurance, community based, healthcare utilization, financial protection, randomised trial

Suggested Citation

Doyle, Conor and Panda, Pradeep Kumar and van de Poel, Ellen and Radermacher, Ralf and Dror, David M., Reconciling Research and Implementation in Micro Health Insurance Experiments in India: Study Protocol for a Randomized Controlled Trial (October 11, 2011). Trials, Vol. 12, No. 224, 2011. Available at SSRN: https://ssrn.com/abstract=1942192

Conor Doyle

Micro Insurance Academy, New Delhi ( email )

246 Sant Nagar
New Delhi, 110 065
India

Pradeep Kumar Panda

International Institute of Health Management Research ( email )

Plot No. 3, Sector – 18A
Dwarka, New Delhi 110075
India

Ellen Van de Poel

Erasmus University Rotterdam (EUR) - Erasmus School of Economics (ESE) ( email )

P.O. Box 1738
3000 DR Rotterdam, NL 3062 PA
Netherlands

Ralf Radermacher

Micro Insurance Academy e.V. ( email )

Colmantstr. 5
Bonn, 53115
Germany

David M. Dror (Contact Author)

Micro Insurance Academy (MIA) ( email )

New Delhi, NCR
India
+41 78 790 6789 (Phone)

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