1. Accra, Ghana October 19-23, 200 9 Extending Health Insurance: How to Make It Work DESIGN ELEMENT 8: MONITORING AND EVALUATION OF HEALTH INSURANCE SCHEMES October 19-23 Hong Wang, MD, PhD HS202 project

2. 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

3. 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

5. Types of M&E Monitoring Continues efforts that rely on the information system (element 7) Focus more on input, process, and output measurements and some of outcome indicators. Enrollments Reimbursements Financial performances Utilization and financial burden reduction

6. Types of M&E Evaluation: Focus more on outcome and impact Cross sectional without control A2 Intervention group Control group Health insurance

7. Types of M&E Evaluation Case control without baseline A2 B2 Intervention group Control group Health insurance

8. Types of M&E Evaluation Pre-post without control A1A2 Intervention group Control group Health insurance

9. Types of M&E Evaluation Pre-post with control – social experimental design A1A2 B2 Intervention group Control group Health insurance

10. Types of M&E Evaluation Experimental design A1A2 B2 Intervention group Control group Health insurance Random assignment

11. Accra, Ghana October 19-23, 200 9 Extending Health Insurance: How to Make It Work Thank you