Zlata Tanovic, VU University Amsterdam / Amsterdam Institute for International Development (AIID): "The impact of subsidized private health insurance and health facility upgrades on healthcare utilization and spending in rural Nigeria"

Abstract
This paper analyzes the quantitative impact of an intervention that provides subsidized low-cost private health insurance together with health facility upgrades in Nigeria. The evaluation, which measures impact on healthcare utilization and spending, is based on a quasi-experimental design and utilizes three population-based household surveys over a four-year period. After four years the intervention had doubled utilization of healthcare in the treatment area overall and increased healthcare use by 43 percent among the insured. Utilization of modern healthcare facilities was found to have nearly tripled after four years among the treatment group and to have increased by nearly 70 percent among the insured as a result of the intervention relative to the control group. After two years of program implementation, we find that the intervention reduced healthcare spending by about 40 percent, while after four years, spending resumed to pre-intervention levels.