Helping Communities Manage risks from the ground up.

Starting July 2009, some of the world's leading experts in the field of micro health insurance have united forces under the auspices of the European Commission Research Directorate to combine implementation with impact evaluation in the field of microinsurance.

The project, which will unravel from 2009 till 2014, is called “Developing efficient and responsive community-based micro health insurance in India”, is funded by the European Commission under its 7th Framework Programme health section (FP7). In this EU-funded, 5-year collaborative project the Micro Insurance Academy partners with two top European universities (Erasmus University Rotterdam, University of Cologne) and three pioneer Indian grassroots organisations (BAIF Development Research Foundation, Nidan, Shramik Bharti) to take up a research effort unprecedented both for its academic scope and potential impact on current sectoral practices.

The consortium will be guided by an Advisory Board of eminent scholars in relevant disciplines, notably Prof. Peter Berman (Lead Health Economist, HDNHE, World Bank), Dr. Kent Ranson (Alliance for Health Policy and Systems Research WHO), Prof. Rainer Sauerborn (Chair and, Director of the Department for Tropical Hygiene and Public Health at Heidelberg University), Prof. Peter Smith (Professor of Health Policy, Imperial College Business School and Institute for Global Health), Prof. Ruth Koren (Tel Aviv University Medical School), Prof. Jacky Mathonnat (Vice-Président Auvergne university & CERDI, France) and Dr. Hengjin Dong (leader of the Junior Group of International Health Economics and Technology Assessment at Heidelberg University).

By combining the rollout of three new showcase micro insurance units (MIUs) and an unprecedented emphasis on scientifically rigorous evaluation of their impact on the lives of the target population in terms of equitable healthcare access and financial protection over several years, this project seeks to build a solid and comprehensive knowledge base for micro health insurance initiatives.

Implementation and Research - the two pillars of this project - will progress side by side in this 5-year project.

On the implementation side, the MIA will support BAIF, Nidan and Shramik Bharti to establish three Community-Based Health Insurance (CBHI) schemes in Kanpur Dehat and Pratap Districts in Uttar Pradesh, and in Vaishali Discrict in Bihar. The CBHI schemes to be implemented will be based on MIA's innovative micro insurance model, stressing inclusiveness (en-bloc affiliation against adverse selection, collaborative design of the package and community-rating mechanisms), sustainability (self-administration of the scheme) and solidarity (social-capital as a response to moral hazard and other market/insurance failures).

In a parallel effort, a continuous assessment of CBHIs' impact on the target population will be undertaken, testing the scalability and reach of the model across diverse socio-economic local patterns. Through the use of diverse methodologies (quantitative, qualitative, field observation, economic experiments, spatial data and structured data on the costs of economic implementation) the consortium will assess various dimensions of impact of the schemes as well as enhance the understanding of increasing efficiency of implementation. Some of the main questions that will be explored include whether being affiliated to an MIU improves access to healthcare and what impact on health-related financial exposure does this insurance have, due to a reduction of out-of-pocket healthcare spending among low-income rural households.

The balanced mix of skills and perspectives represented in the consortium is set to be uniquely far-reaching. Beyond answering the sectoral need for scientifically more rigorous theoretical frameworks, the project aims at offering precious policy-relevant insights into micro community-based insurance.

The findings will hopefully enable to understand cause-effect relations between insurance status and healthcare-seeking behaviours, health status and financial exposure due to catastrophic events, the impact of micro insurance on the local healthcare supply and many other areas of crucial medical and socio-economic relevance.