IDEAS home Printed from
   My bibliography  Save this article

Informal Groups and Health Insurance Take-up Evidence from a Field Experiment


  • Chemin, Matthieu


This paper presents the results of 20 randomized experiments aimed at understanding the low take-up of in-patient health insurance observed in developing countries. Take-up does not increase when participants receive information about the product, or an assistance to register, or small subsidies of 2, 10, or 30%. Take-up does not increase when the same information is provided by local respected community leaders, when participants are offered an in-kind gift (a chicken) if they register, when participants are offered the possibility to contribute lower and more frequent payments, or the possibility to pay by cellphone. A full subsidy generates a mere 45% take-up (with no retention after one year). In contrast to these low take-up rates, presenting the same information without any subsidies to existing informal groups raises take-up to 12% (still 7% after one year), as well as trust and knowledge of the product. Social networks play a major role in the adoption of health insurance. This paper provides a cost-effective way to increase take-up of health insurance, while subsidies are found to be largely ineffective at raising take-up in the long run.

Suggested Citation

  • Chemin, Matthieu, 2018. "Informal Groups and Health Insurance Take-up Evidence from a Field Experiment," World Development, Elsevier, vol. 101(C), pages 54-72.
  • Handle: RePEc:eee:wdevel:v:101:y:2018:i:c:p:54-72
    DOI: 10.1016/j.worlddev.2017.08.001

    Download full text from publisher

    File URL:
    Download Restriction: Full text for ScienceDirect subscribers only

    As the access to this document is restricted, you may want to search for a different version of it.


    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.

    Cited by:

    1. Aurélien Baillon & Aleli Kraft & Owen O'Donnell & Kim van Wilgenburg, 2019. "A behavioral decomposition of willingness to pay for health insurance," Tinbergen Institute Discussion Papers 19-077/I, Tinbergen Institute.
    2. Bocoum, Fadima & Grimm, Michael & Hartwig, Renate & Zongo, Nathalie, 2019. "Can information increase the understanding and uptake of insurance? Lessons from a randomized experiment in rural Burkina Faso," Social Science & Medicine, Elsevier, vol. 220(C), pages 102-111.

    More about this item


    health insurance; informal groups;


    Access and download statistics


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:wdevel:v:101:y:2018:i:c:p:54-72. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu). General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.