Increasing utilization of public health insurance programs: Evidence from an experiment in India

Unlike most social programs that involve regular delivery of benefits (such as subsidized food or monthly cash transfers), public health insurance programs are used based on need. When households face health shocks, they are often unaware of how to avail health insurance benefits. This is especially true for households in remote rural regions of developing countries where the likelihood of low awareness about public health insurance programs is higher due to low levels of literacy, distance from healthcare facilities and limited opportunities to learn from others' experiences. Conventional information, education and communication (IEC) methods such as information pamphlets and outreach through health camps are not always effective in disseminating information to these hard-to-reach populations. In this paper, we present results from a quasi-experiment that uses village-level awareness meetings to disseminate information about a public health insurance program in 61 villages of a district in southern India. We find that awareness meetings, though relatively more expensive than conventional IEC methods, not only increase utilization of the program but also provide government agencies a unique opportunity to monitor the implementation of the program in remote locations. (c) 2020 Elsevier Ltd. All rights reserved.