Women's Insurance for State Health - An Impact Evaluation of Health Insurance Provided Under the Basic Health Care Provision Fund in Taraba State, Nigeria
试验速览
- 阶段
- 不适用
- 状态
- 进行中（未招募）
- 发起方
- 入组人数
- 4,000
- 试验地点
- 1
- 主要终点
- Respondent has health insurance
研究概览
简要总结
The objective of this study is to examine the impact of a free health insurance offer on healthcare use, spending, self-reported health, and economic participation of women in Taraba state of Nigeria.
详细描述
This study aims to evaluate a health-insurance intervention implemented under the World Bank-funded Nigeria for Women Project (NFWP) in Taraba State. Women in Women Affinity Groups (WAGs) received an offer for a free, 12-month policy under the Taraba State Health Insurance Agency's Basic Minimum Package of Health Services (BMPHS), which covers essential primary and secondary care, including consultations, preventive services, maternal and child health, mental health, emergency care, and laboratory services, normally priced at ₦12,000 annually. We are using a randomized controlled trial design in Bali Local Government Area (LGA). Using administrative data on WAG enrollment, we randomly assigned 1,000 WAGs (stratified by ward and mean participant age) to either treatment (n=500) or control (n=500). Within each WAG, four women were randomly selected to enroll in the study, yielding 4,000 participants (2,000 insured; 2,000 controls). The study focuses on outcomes related to healthcare utilization, health status, out-of-pocket expenditures, and women's economic participation. The findings are expected to inform policy on expanding health insurance coverage as a strategy to improve women's health and promote their economic empowerment.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- Single (Outcomes Assessor)
盲法说明
The survey enumerators will not blinded to the treatment status.
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- Female
- 接受健康志愿者
- 是
入选标准
- •Members of one of 1,000 randomly selected women's groups operating in Bali local government area in Taraba State, Nigeria.
排除标准
- •At least 18 years old.
结局指标
主要结局
Respondent has health insurance
时间窗: 6 months, 9 months, 11 months post treatment.
Zero if not no health insurance, 1 if has health insurance.
Has health insurance card
时间窗: 6 months, 9 months, 11 months post treatment
Zero if respondent has no health insurance card, 1 if they have a health insurance card.
Respondent has successfully used health insurance for consultations, diagnoses, medications, or tests.
时间窗: 6 months, 9 months, 11 months.
Zero if respondent has not successfully used health insurance for consultations, diagnoses, medications, or tests. 1 if the respondent has successfully used health insurance for consultations, diagnoses, medications, or tests.
Sought treatment for most recent illness
时间窗: 6 months, 9 months, 11 months.
Zero if respondent did not seek care for most recent illness. 1 if respondent did seek care for most recent illness
Number of health facility visits in last 3 months.
时间窗: 6 months, 9 months, 11 months.
Reported number of health facility visits outside the home in the last 3 months.
Most recent health facility visit was to a public sector facility
时间窗: 6 months, 9 months, 11 months.
Zero if last care event was in a private facility, 1 if last care seeking event was in a public facility
Money for health care is a key barrier
时间窗: 6 months, 9 months, 11 months.
Zero if "getting money needed for advice or treatment" is not listed as a barrier. 1 if "getting money needed for advice or treatment" listed as a barrier.
Most recent birth was in a health facility
时间窗: 6 months, 9 months, 11 months.
Zero if most recent birth was not in a government or private health facility. 1if most recent birth was in a government or private health facility. Limited to births in last 3 months.
Child has received any vaccinations
时间窗: 6 months, 9 months, 11 months.
Zero if children aged under 12 months has not received any vaccinations. 1 if child has received at least one vaccination.
Total cost of most recent healthcare
时间窗: 6 months, 9 months, 11 months.
Total cost of most recent healthcare visit, winsorized at the 1% and 99% levels.
Most recent care episode reflects catastrophic health expenditure
时间窗: 6 months, 9 months, 11 months.
1 if most recent healthcare visit expenditure represents represents greater than 10% of household consumption
Total indebtedness from healthcare or illness-related expenses
时间窗: 6 months, 9 months, 11 months.
Total amount of money owed for medical expenses, winsorized at the 1% and 99% levels.
Respondent is depressed
时间窗: 6 month, 9 month, 11 month.
Score equal to or greater than 10 on Center for Epidemiologic Studies Depression Scale.
Perceived health status
时间窗: 6 months, 9 months, 11 months.
Response to the following question: Think about your health over the last 3 months, including any long-term illnesses, hospital or clinic visits, or other ailments, how would you rate your health on a scale of 1-10 where 1 is very low health and 10 is very healthy with no ailments?
Number of productive days lost to severe illness in the past 3 months
时间窗: 6 months, 9 months, 11 months
Reported number of productive days lost to severe illness in the past 3 months
次要结局
- Has ever tried to use health insurance(6 months, 9 months, 11 months post treatment)
- Number of antenatal care visits(6 months, 9 months, 11 months.)
- Most recent health facility care event visit was to a secondary/tertiary care facility (hospital)(6 months, 9 months, 11 months.)
- Received lab test as part of antenatal care in most recent pregnancy(6 months, 9 months, 11 months.)
- Child has received OPV(6 months, 9 months, 11 months.)
- Child has received BCG vaccine(6 months, 9 months, 11 months.)
- Child has received measles vaccine(6 months, 9 months, 11 months.)
- Economically active in the last 7 days(6 months, 9 months, 11 months.)
- Hours engaged in economic activities in the last 30 days(6 months, 9 months, 11 months.)
- Total income over past 30 days.(6 months, 9 months, 11 months.)
- Total value of current savings(6 months, 9 months, and 11 months post treatment.)
- Total value of current borrowing(6 months, 9 months, and 11 months post treatment.)
- Household decision making(6 months, 9 months, and 11 months post treatment.)
- Respondent makes decisions about savings(6 months, 9 months, 11 months post treatment.)
- Health insurance knowledge(6 months, 9 months, 11 months.)
- Trust in state government(6 months, 9 months, 11 months post treatment)
- Trust in local government authority(6 months, 9 months, and 11 months post treatment.)