Abstract
This paper analyzes the quantitative impact of an intervention that provides subsidized low-cost private health insurance together with health facility upgrades in Nigeria. The evaluation, which measures impact on healthcare utilization and spending, is based on a quasi-experimental design and utilizes three population-based household surveys over a 4-year period. After 4 years, the intervention increased healthcare use by 25.2 percentage points in the treatment area overall and by 17.7 percentage points among the insured. Utilization of modern healthcare facilities increased after 4 years by 20.4 percentage points in the treatment area and by 18.4 percentage points among the insured due to the intervention. After 2 years of program implementation, the intervention reduced healthcare spending by 51% compared with baseline, while after 4 years, spending resumed to pre-intervention levels.
| Original language | English |
|---|---|
| Pages (from-to) | 221-276 |
| Number of pages | 56 |
| Journal | International Journal of Health Economics and Management |
| Volume | 18 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Sept 2018 |
Funding
This research was made possible by funding from the Dutch Ministry of Foreign Affairs. This paper is also funded under the Grant “Policy Design and Evaluation Research in Developing Countries” Initial Training Network (PODER), which is funded under the Marie Curie Actions of the EU’s Seventh Framework Programme (Contract Number: 608109). The authors would like to thank the research teams in the Netherlands at AIID and AIGHD and in Nigeria at UITH for their tireless efforts and in particular Wendy Janssens, Berber Kramer and Bas van der Klaauw for their comments, Marijn van der List for her project management and Anne Duynhouwer and Marc Fabel for their research assistance. In addition, we are thankful to comments received at presentations given on previous versions of the paper at Abt Associates, Brookings Institution, DC Health Systems Board, Center for Global Development, the European Conference on Health Economics, and the University of Amsterdam. Finally, we would like to thank the anonymous reviewers for their excellent comments and suggestions to improve to this paper.
| Funders | Funder number |
|---|---|
| AIGHD | |
| AIID | |
| Policy Design and Evaluation Research in Developing Countries | |
| FP7 People: Marie-Curie Actions | 608109 |
| Universiteit van Amsterdam | |
| Ministerie van Buitenlandse Zaken |
Keywords
- Financial risk
- Health insurance
- Impact evaluation
- Nigeria
