%0 Journal Article
%T Reconciling research and implementation in micro health insurance experiments in India: study protocol for a randomized controlled trial
%A Conor Doyle
%A Pradeep Panda
%A Ellen Van de Poel
%A Ralf Radermacher
%A David M Dror
%J Trials
%D 2011
%I BioMed Central
%R 10.1186/1745-6215-12-224
%X 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 Randomised 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.When a Cluster Randomised 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.Health insurance coverage is woefully lacking in the developing world. Poor households must often resort to high-cost loans or asset sales to finance healthcare, and may be forced to forego essential treatments altogether (Binnedijk E, et al, Hardship financing of healthcare among rural poor in Orissa, India, submitted). Development organisations have increasingly recognised the role that health microinsurance (HMI) can play as a poverty reduction tool [1,2]. One form of HMI is Community-Based Health Insurance (CBHI), in which communities mutualise risks and resources into a locally-managed healthcare fund [3]. CBHI schemes have been implemented in India, Afghanistan, Nepal, Burkina Faso, Mali, Senegal, Nigeria, and extensively throughout Rwa
%K Micro insurance
%K community based
%K healthcare utilisation
%K financial protection
%K randomised trial
%U http://www.trialsjournal.com/content/12/1/224