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Accra, Ghana October 19-23, 2009
Extending Health Insurance: How to Make It Work
DESIGN ELEMENT 8:MONITORING AND EVALUATION OF HEALTH INSURANCE SCHEMES
October 19-23
Hong Wang, MD, PhDHS202 project
Feasibility of Insurance Design and Implementation
Monitoring and Evaluation
Insurance Financing
options
Benefits package
Population coverage
Opera-tional
process
Organiza-tional
structure
Provider engage-
ment
Figure 1: Design Elements for a Health Insurance Scheme
Objectives of this element
Be familiar with indicators that scheme operators, managers, and evaluators can use to assess the performance of an insurance scheme to evaluate the achievement of its desired objectives
Understand sources of data for M&E of insurance schemes
Know how to use information to make evidence-based decisions to improve the performance of a health insurance scheme
Input Process Output Outcome
Monitoring Evaluation
Budget,Staff,
Policies
Health insurance information system, Auditing, Annual evaluation
Marketing,Premium collection
Enrollment rate, Fund collection rate
Health service utilization, Financial burden reduction
Impact
Health status improvement/Poverty reduction
Types of M&E
MonitoringContinues efforts that rely on the information system
(element 7)
Focus more on input, process, and output measurements and some of outcome indicators.EnrollmentsReimbursementsFinancial performancesUtilization and financial burden reduction
Types of M&E
Evaluation: Focus more on outcome and impactCross sectional without control
A2Intervention group
Control group
Health insurance
Types of M&E
Evaluation Case control without baseline
A2
B2
Intervention group
Control group
Health insurance
Types of M&E
Evaluation Pre-post without control
A1 A2Intervention group
Control group
Health insurance
Types of M&E
Evaluation Pre-post with control – social experimental design
A1 A2
B2B2
Intervention group
Control group
Health insurance
Types of M&E
Evaluation Experimental design
A1 A2
B2B2
Intervention group
Control group
Health insurance
Random assignment
Accra, Ghana October 19-23, 2009
Extending Health Insurance: How to Make It Work
Thank you
