Project Description

Picture: courtesy of A. Avdeenko


In two provinces of Northern Pakistan, we evaluate a large scale health insurance extension supported by the German Development Bank (KfW). In Pakistan, where patients pay about 60% of their health expenditure out of the pocket (Pakistan Ministry of Health) and where access to traditional social protection is scarce, health expenses are an important source of financial shocks. In the absence of health insurance, illnesses or accidents often induce various negative outcomes in terms of health, adult and child labor, among others.



In this project, affordable hospitalization insurance is offered to all households in five districts of Khyber Pakhtunkhwa and Gilgit-Baltistan. The insurance premium is income dependent. The evaluation component pays special attention to the lives of the most disadvantaged population groups: the poorest (identified through a poverty score) benefit from a full subsidization of their premiums. The evaluation combines difference-in-differences and regression discontinuity analyses. It focuses on health outcomes, health awareness and intra-household distribution of health service utilization.