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Nudging Households to Take Up Health Insurance: Evidence from a Randomized Experiment in Burkina Faso

Listed author(s):
  • Bocoum, Fadima

    (Institute de Recherche en Sciences de Santé (IRSS))

  • Grimm, Michael

    ()

    (University of Passau)

  • Hartwig, Renate

    ()

    (University of Namur)

  • Zongo, Nathalie

    (Association Songui Manégré- Aide au développement Endogène (ASMADE))

In this paper we analyze the impact of a randomized information package on the understanding and uptake of community based health insurance. The information package consists of a detailed brochure which is distributed to households through home visits, a video also presented in people's homes and a personalized phone reminder. Overall, we find significant treatment effects on insurance uptake at the margin, although insurance uptake is low in general. We also find evidence for a better understanding of insurance principles among treated households, in particular in poorer households and in households with literate household heads. Finally, we see that treated households share the information they received with their neighbors and this also has positive effects on their understanding of insurance principles. We find further suggestive evidence that information sharing remains locally concentrated and does not surpass a radius of 1 km. Our findings contribute to the understanding how knowledge about the functioning of insurance can be enhanced in a context where the concept of insurance is largely unknown and where strong cultural beliefs prevail, and eventually, how insurance uptake can be increased, although the latter may take more time.

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File URL: http://ftp.iza.org/dp10744.pdf
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Paper provided by Institute for the Study of Labor (IZA) in its series IZA Discussion Papers with number 10744.

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Length: 29 pages
Date of creation: Apr 2017
Handle: RePEc:iza:izadps:dp10744
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  1. De Weerdt, Joachim & Dercon, Stefan, 2006. "Risk-sharing networks and insurance against illness," Journal of Development Economics, Elsevier, vol. 81(2), pages 337-356, December.
  2. Marcel Fafchamps, 2003. "Rural Poverty, Risk and Development," Books, Edward Elgar Publishing, number 3127.
  3. Shawn Cole & Xavier Gine & Jeremy Tobacman & Petia Topalova & Robert Townsend & James Vickery, 2013. "Barriers to Household Risk Management: Evidence from India," American Economic Journal: Applied Economics, American Economic Association, vol. 5(1), pages 104-135, January.
  4. Adam Wagstaff, 2010. "Social health insurance reexamined," Health Economics, John Wiley & Sons, Ltd., vol. 19(5), pages 503-517.
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  8. Gin, Xavier & Yang, Dean, 2009. "Insurance, credit, and technology adoption: Field experimental evidencefrom Malawi," Journal of Development Economics, Elsevier, vol. 89(1), pages 1-11, May.
  9. Schneider, Pia, 2005. "Trust in micro-health insurance: an exploratory study in Rwanda," Social Science & Medicine, Elsevier, vol. 61(7), pages 1430-1438, October.
  10. Cai, Jing & Song, Changcheng, 2017. "Do disaster experience and knowledge affect insurance take-up decisions?," Journal of Development Economics, Elsevier, vol. 124(C), pages 83-94.
  11. Jean Philippe Platteau & Darwin Ugarte Ontiveros, 2013. "Understanding and Information Failures: Lessons from a Health Microinsurance Program in India," Working Papers 1301, University of Namur, Department of Economics.
  12. Wagstaff, Adam, 2007. "The economic consequences of health shocks: Evidence from Vietnam," Journal of Health Economics, Elsevier, vol. 26(1), pages 82-100, January.
  13. Platteau, Jean-Philippe & De Bock, Ombeline & Gelade, Wouter, 2017. "The Demand for Microinsurance: A Literature Review," World Development, Elsevier, vol. 94(C), pages 139-156.
  14. Fafchamps, Marcel & Pender, John, 1997. "Precautionary Saving, Credit Constraints, and Irreversible Investment: Theory and Evidence from Semiarid India," Journal of Business & Economic Statistics, American Statistical Association, vol. 15(2), pages 180-194, April.
  15. George Schieber & Cheryl Cashin & Karima Saleh & Rouselle Lavado, 2012. "Health Financing in Ghana," World Bank Publications, The World Bank, number 11977, July.
  16. Basaza, Robert & Criel, Bart & Van der Stuyft, Patrick, 2008. "Community health insurance in Uganda: Why does enrolment remain low? A view from beneath," Health Policy, Elsevier, vol. 87(2), pages 172-184, August.
  17. Anthony Patt & Nicole Peterson & Michael Carter & Maria Velez & Ulrich Hess & Pablo Suarez, 2009. "Making index insurance attractive to farmers," Mitigation and Adaptation Strategies for Global Change, Springer, vol. 14(8), pages 737-753, December.
  18. Dong, Hengjin & De Allegri, Manuela & Gnawali, Devendra & Souares, Aurélia & Sauerborn, Rainer, 2009. "Drop-out analysis of community-based health insurance membership at Nouna, Burkina Faso," Health Policy, Elsevier, vol. 92(2-3), pages 174-179, October.
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