Assessing the Nudge Effect of Sehat Sahulat Programme
Author: Raheel Shahab Khan

The importance of affordable and efficient healthcare is well understood. Pre-payment, which can be more economical in cushioning against catastrophic health expenditure and efficient than out-of-pocket payment, is not a well-established mode of healthcare finance in Khyber Pakhtunkhwa (KP) and all over Pakistan. This is due to lack of insurance culture which markets have failed to develop over the years. Sehat Sahulat Programme (SSP), a health insurance program by Government of KP, was launched to add and promote pre-payment as an alternative to existing modes of healthcare finance. The aim of this study is to examine household preferences for willingness to pre-pay for healthcare that SSP intended to develop. It targets respondents who do not have first-hand experience with voluntary health insurance. Survey in two districts of KP, Peshawar and Charsadda, elicited views on willingness to participate at a flat premium in SSP on voluntary basis. This study finds that 72% of the respondents were willing to participate through contributory payments. Age, household disease profile, and economic status explained their participation decision. However, a possible interaction of economic status with other social factors may dilute its explanatory power. It was also observed that reasons for not purchasing market insurance among insurance literates were predominantly informational rather than economic, which SSP addressed to a greater extent. Lastly, it was observed that making social cause of risk pooling known to respondents increased their willingness to participate by 15 percentage points. This study concludes that the important conditions on demand side—willingness to pay, solidarity, and trust on government—for a contributory arm in SSP exists in the study districts, which provides Government of KP an opportunity window to pilot it. Supervisor:- Dr Karim Khan

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Supervisor: Karim Khan

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