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The article describes the contribution of insurance in financial and social inclusion in society. The article presents a picture of past initiatives of the Indian insurance sector to promote financial and social inclusion in India, the future plans and the challenges ahead in achieving this aim. It also highlights the role of digital technology in helping the insurance sector achieve financial and social inclusion. [ABSTRACT FROM AUTHOR]

More than 90% of Indians live without any form of social protection. This results in both lost lives and uninsured financial damages. This gap has grown even wider as a result of the pandemic due to labour mobility and mass unemployment. Although some areas, such as health insurance, are expanding, this growth surge is only felt by those in the middle class and above, leaving the most at-risk group still without insurance and at risk. The general lack of financial literacy, which is a severe issue, has an impact on both how consumers view insurance products and how much faith they have in them. To safeguard against unpredictable events, it is crucial to increase awareness of how insurance works. Along with building trust, it's important to improve the financial literacy of rural and low-income populations to expand penetration. [ABSTRACT FROM AUTHOR]

Developing countries in Asia, such as Vietnam, have rural poverty behind the economic growth, and the risk gap is growing. Since the local insurance companies have left this market from the viewpoint of efficiency, it is necessary to establish the new rural living safety net. This paper shows (1) whether Vietnam will become a commercial market for insurance in the long run by quantitative market estimation. As a result, the life insurance market in Vietnam will expand to 9% of the huge Japanese market in 2040. And the commercialization of market is possible. In order to deliver the security system to poor rural areas, (2) by means of “P2P insurance” using the Insuretech method, we propose “the mutual microinsurance system” that clears in supervisory and regulatory constraints. [ABSTRACT FROM AUTHOR]

The main goal of this article was to design and implement a light livestock (sheep or goat) micro-insurance model in rural areas in the form of a cooperative insurance. In the first phase, to identify the pillars of cooperative micro-insurance (i.e., insurers, policyholders, actuary, and reinsurance), the grounded theory framework has been conducted by several in-depth interviews. In the second step, based on the pricing index method, we employed weather indices. To derive an appropriate model, we used Mashhad city’s data from period 1950 to 2018. Among all available weather indices, only “Lowest temperature”, “Highest temperature” and “Average temperature in winter, spring and summer” indices have significant impact on loss ratio. The well fitted time series model for these indices are ARIMA(0,1,1), ARIMA(0,1,1), ARIMA(0,1,1), ARIMA(0,1,1) and ARIMA(0,1,1), respectively. Moreover, the best fitted distribution for loss ratio and present value of claims are LogNormal and mixture LonNormal, respectively. Using these findings, price of the light livestock insurance coverage has been estimated. In the third phase, in the form of two types of reinsurance, stop-loss and proportional reinsurances with upper limit, the share of the main insurer (cooperative insurance fund) and the reinsurer (agricultural products insurance fund); premium and damages have been determined exactly. The results of this study showed that the use of this type of micro-insurance, in addition to eliminating moral hazards and adverse selection, will make the share of the reinsurer (Agricultural Products Insurance Fund) more homogeneous than the damages.

The article is aimed at studying the theoretical and practical aspects of factors influencing the development of voluntary health insurance (VHI) in Ukraine. The place and indicators of development of the health insurance market in Ukraine for 2012-2019 are researched. The dynamics of health insurance market indicators based on the amount of gross insurance premiums and payments is analyzed; it is proved that voluntary health insurance (continuous health insurance) is characterized by growth during the last five years. The factors that significantly influenced the development of the market and the current state of voluntary health insurance, in particular the COVID-19 pandemic, the economic crisis, high incidence rates of insured persons, the significant cost of an insurance medical policy, the lack of tax preferences for business regarding medical social packages and the lack of specialized educational institutions on the VHI, are determined. The classification of factors of influence on the development of voluntary health insurance according to the level of their occurrence is carried out, and it is determined that the following factors have the greatest force of influence on the VHI: deterioration of solvency of potential insurers; pricing in the medical market; excessive tax burden for legal entities. It is substantiated that the indisputable way of motivating the introduction of voluntary health insurance is to amend the tax legislation of Ukraine; micro insurance is proposed as a basis for the development of voluntary health insurance. Prospects for further research lie in the study of factors influencing the development of micro insurance in the country.

The main issue of this research is to design a model for the development of micro insurance in rural areas in the form of cooperatives. This research has been done in 2 steps as follows. In the first stage, using qualitative study and in-depth interviews in the form of grounded theory approach, the requirements for the development of cooperative micro-insurance were categorized into three levels: micro, meso and macro. Micro level requirements include insurer, policy holder and distribution channel; Intermediate level requirements include actuary and macro level requirements include legislation and reinsurance. In the second stage, using quantitative study and structural equation modelling, micro-insurance cooperative model was designed in rural areas and then the challenges of micro-insurance development were identified. The statistical population includes three groups of insurance experts in the Ministry of Cooperatives, Labor and Social Welfare, the Central Insurance Research Institute and the Agricultural Products Insurance Fund. The results are summarized as follows: (1) Trust in micro-insurance through appropriate training programs among low-income groups is one of the first priorities at the micro level in order to develop micro-insurance. (2) Data collection items in relation to micro insurance customers, suppliers, products and prices of micro insurance, are among the first priority at the middle level (meso) to develop micro insurance. (3) The formulation of supportive policies (tax exemptions and subsidies) for the development of micro insurance is one of the first priorities at the macro level for the development of micro insurance. In economic challenges the variable “lack of savings" in poor people as an essential component to buy insurance; In socio-cultural challenges, the variable "lack of rural participation in cooperative insurance schemes" and "lack of trust among local community networks"; In educational-extension challenges, the variables "lack of mass media attention to micro-insurance issues" and "lack of education of low-income groups through custom cases"; In technical challenges, the variable "lack of information about micro-insurance marketing among the poor"; and In the policy challenges, the variable “lack of Agricultural Products Fund attention to the micro-insurance issues" has the highest priority of developing cooperative rural micro-insurance.

Abstract Background Strategic purchasing can ensure that financial resources are used in a way that optimally enhances the attainment of health system goals. A number of low- and middle-income countries, including Kenya, have experimented with micro health insurance (MHIs) as a means to purchase health services for the informal sector. This study aimed to examine the purchasing practices of MHIs in Kenya. Methods The study was guided by an analytical framework that compared purchasing practices of MHIs with the ideal actions for strategic purchasing along three pairs of principal-agent relationships (government-purchaser, purchaser-provider and citizen-purchaser). The study adopted a qualitative descriptive case study design with 2 MHIs as cases. Data were collected through document reviews (regulation, marketing materials, websites) and semi-structured interviews with key informants (n = 27). Results The regulatory framework for MHIs did not adequately support strategic purchasing practice and was exacerbated by poor coordination between health and financial sectors. The MHIs strategically contracted health providers over whom they could exercise bargaining power, sometimes at the expense of quality. There were no clear channels for beneficiaries to provide timely feedback to the purchaser. MHIs premium payments were family-based, low-cost and offered limited benefits. Coverage was based on ability to pay, which may have excluded low-income households from membership. Conclusions Adequate policy, legal and regulatory frameworks that integrate MHIs into the broader health financing system and support strategic purchasing practices are required. The state departments responsible for finance and health should form coordinating structures that ensure that MHI’s role in universal health coverage is owned across all relevant sectors, and that actors, such as regulators, perform in a coordinated manner. The frameworks should also seek to align purchasers’ relationships with providers so that clear and consistent signals are received by providers from all purchasing mechanisms present within the health system.

The purpose of this paper is to review and compare the distinct features and practices of Sudanese and Ethiopian microfinance sector. Analysis includes general characteristics of both sectors such as institutional structures/characteristics, policies, programs, regulation, strategies, wholesale markets, technical assistance etc. Moreover, the major characteristics of microfinance institution (MFIs) in both countries are compared, and a review and comparison of some performance criteria of MFIs is made. The methodology consists of analyzing and examining issues at hand using some indicators and qualitative information. The paper come up with some recommendations regarding the constraints facing microfinance (MF) sectors in the two countries, and also suggests how the two microfinance experiences can learn from each other. The Sudanese MF experience, we argued, can give a lesson from its diversified wholesale market via the government-owned Wholesale Guarantee Agency. The paper also propagates the merits of Islamic microfinance as practiced in Sudan to Ethiopia-Muslim minorities. We argued that this can be carried out via new windows or specialized branches within the existing MFIs; no need for a new legislations or a new MFIs structure. Sudan can learn from the role and fonctions of AEMFI, to establish the Sudanese Association of Microfinance Institutions. Sudan can also learn from the Ethiopian social management system to self monitor the social impact of microfinance on their clients. The paper is constrained by the limitation of quantitative data, especially financial data, regarding the Sudanese MFIs. This hinders deep comparison of the financial performance of MFIs in the two countries. More research is required in this area. [ABSTRACT FROM AUTHOR]

David Mark Dror,1,2 Atanu Majumdar,1 Arpita Chakraborty3 1Research Department, Micro Insurance Academy, Garhi, East of Kailash, New Delhi, India; 2School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, the Netherlands; 3Centre for Economic Studies and Planning, School of Social Sciences, Jawaharlal Nehru University, New Delhi, India Introduction: This study deals with examining factors that catalyze demand for community-based micro health insurance (MHI) schemes. We hypothesize that demand for health insurance is a collective decision in the context of informality and poverty. Our hypothesis challenges the classical theory of demand which posits individual expected diminishing utility. We examine factors beyond the traditional exogenous variables. Methods: This study uses data collected through a household survey conducted among self-help groups in rural India in the states of Uttar Pradesh and Bihar before the implementation of three community-based MHI schemes. Additional information was extracted from the management information system maintained by the schemes. At the first step, we compared the estimated probability of a household joining the scheme (obtained by applying logistic regression) to the actual uptake. In the next step, we analyzed the role of consensus within groups on demand for health insurance (by applying ordinary least square regressions). Results: The results of the logistic regressions indicated that exogenous household characteristics could not explain the probability of joining health insurance. We observed that group consensus on several critical issues, such as the price of the insurance, perceptions about exposure to adverse health events, and perceptions of the quality of service of local health care providers, was the important determinant of demand for insurance. Conclusion: Based on the analysis, we reject the null hypothesis that demand is an individual decision at the household level. The analysis upholds the assumption that demand is created through a process of consensus building on perceptions of risk exposure, welfare gains from the insurance, and quality of local health care provision. Success in catalyzing demand for health insurance in the informal sector depends on encouraging group dialog. Keywords: Community-based Health Insurance, micro insurance, consensus coefficient, consensus building, demand for micro insurance, collective decision

In India, liberalisation of the economy, has created new opportunities for insurance to reach the vast majority of the poor, including these who are working in the informal sector. Micro insurance in India has valuable lessons for the rest of the world, particularly in the Regulation of the Insurance industry. Unlike micro lending - the better known side of micro financemicro insurance has been a hard sell among the world's poor. The reasons include lack of understanding of how insurance products work, general reticence of the poor to part with what little financial resources they have, and a shortage of localized risk management knowledge among providers. Micro insurance depends on innovation and co-operation. The present research paper brings to limelight to factors influencing the customers for buying micro insurance policy in Kollam district, Kerala. [ABSTRACT FROM AUTHOR]

The contribution of insurance to rural development in India cannot be underplayed. The insurance sector has made a significant contribution to rural development even though there have been issues related to penetration of insurance in rural areas and absence of covers to meet the specific needs of the villagers. A wide variety of covers are now available for the rural areas. Cattle insurance, crop insurance, tractor insurance, credit risk cover, cover for loss of profit due to untimely rain, drought or bush fire - these are some examples. Rural health insurance is also a priority area that the Government is strongly focusing on as part of Integrated Rural Development Programme (IRDP). This paper traces the contribution of insurance to rural development and chalks out the way forward by which insurance sector can continue to contribute technologyenabled interventions that will support the government's efforts to achieve rural development. [ABSTRACT FROM AUTHOR]

This paper investigates the awareness of financial inclusion among rural, economically & socially underprivileged people. In this paper an att empt has also been made to assess the working of self-help groups working in Agra district. From 6 villages and 3 self-help groups, 150 respondents were contacted personally to gather required data at random basis. The study finds that people are well aware about the financial inclusion and government's eff orts meant for it. After joining the self-help groups, the economic & social conditions have improved a lot. Saving habits and fi nancial status have improved drastically. The Self-help groups change the personality of their members significantly. This study is limited to Agra district and based on Uni-flow system of micro finance activities and schemes with reference to one bank. Therefore, a wider study would be useful to replicate the results of this study. In order to reap the full benefits of financial inclusion, it is necessary that more and more economically and socially underprivileged people should be covered. [ABSTRACT FROM AUTHOR]

Micro finance institutions also known as MFI provide financial services to the people of lower income group and of backward section of the society. MFI provide the facility of micro credit, micro saving and micro insurance to its members. The aim of this paper is to measure and analyze the profitability and liquidity ratios of Bharat Financial Inclusion Ltd. (formerly known as SKS Microfinance private Ltd,) for a period of 12 years. Various statistical methods and techniques like mean, median, skewness, kurtosis, range has been used for analyzing data collected from secondary source. It can be concluded that there is a positive correlation between profitability ratios and liquidity ratios of the Bharat Financial Inclusion Ltd. [ABSTRACT FROM AUTHOR]

Insurance underlies a collective bearing of risks. It affords the benefit of security, peace of mind, protection of property and fulfilment of needs of insured. In the recent past, insurance companies in India have embarked on the promotion of micro insurance products for the underprivileged communities. Though risk is common to every one, the economic loss affects the lower income group more severely. The outreach of micro insurance product is severely hampered by the uncertain and low income of the poor. So, the insurance companies have to understand the preferences of the low income community for the promotion of insurance policies. This paper brings to light the preference of low income customers for micro insurance policies in Kollam district, Kerala. [ABSTRACT FROM AUTHOR]

This paper attempts to look into the microfinance sector of Pakistan, its effectiveness and outreach and will further explore if microfinance has been effective enough to ensure sustainable development in the country. The purpose of the study is to examine the extent and efficiency of the microfinance sector, identify the lags in the system and propose feasible recommendations. The study examines microfinance at micro, meso and macro levels. The study highlights the performance of microfinance sector, outreach and efficiency of micro-savers, micro-insurance and assets and liabilities of the sector. Financial infrastructure and challenges to the sector are also indicated. The microfinance market lacks competition and only a few institutes can be tagged as operationally sustainable and have achieved the economies of scale. The study concluded that microfinance in Pakistan is perceived more like a social service rather a financial service. This calls for new techniques and more sustainable models to enable microfinance sector to prevail.

We define micro insurance as" . . .the protection of low-income people against specific perils in exchange for regular premium payments proportionate to the likelihood and cost of the risk involved." This definition is essentially the same as one might use for regular insurance except for the clearly prescribed target market: low-income people-generally micro insurance is for persons ignored by mainstream commercial and social insurance schemes, persons who have not had access to appropriate products". Micro-insurance products are often bundled with micro-saving and micro-credit, thereby allocating scarce resources to micro-investments with the highest marginal rates of return. Micro-insurance is the most- under developed part of micro-finance. Yet various schemes exist that are viable, benefiting both the institutions and their clients. The greatest challenge for micro-insurance lies in the combination of viability sustainability with out reach. Although introduction of sound practices-such as appropriate policy size and timely payment of installments of premium, or positive incentives to renew on time in order to avoid policy lapses-can be feasible, the ultimate effectiveness of interventions focusing on institutional transformation and sound insurance practices will vary considerably, depending on the appropriateness of the regulatory environment. To enable micro-insurance to serve as an integral part of a country's wider insurance system, catering to the needs of various communities-mainly backward downtrodden people, it is important for every insurer to adjust its costs of serving marginal clients in remote areas, collecting premiums and installments, and offering dfoorstep services. Today we have a variety of micro-finance institutions with national and local outreach. Many of them have already become corporate agents or have entered into arrangements with insurers. However, semiformal institutions including saving and credit co-operatives, NGOs and self help groups which have immense potential in carrying the message of insurance as also to solicit insurance business, need to be utilized in a manner where there true potential can be harnessed to increase insurance penetration levels. Adopting insurance companies to the requirements of the micro-economy is a first step; the task then involves linking them as wholesale institutions to the self-group, which are retailers; and finally, upgrading self-help groups e.g. to the level of financial cooperatives, or village banks. If insurers are to serve customers, who differ widely in terms of service costs and risks, the only viable inducement for them is an adequate margin; the trend in the current market is exclude small farmers, micro-entrepreneurs, and people in remote areas. Only sound social insurance, which combines a social mandate with profit making, has a chance of sustainability. The most essential features of micro-insurance schemes should be instituted mainly & absolutely focusing to operate for the persons who have not had access to appropriate insurance products for mere want of money, the requisite premium amount is not at all available at their disposal to go for insurance. Non formal finance mostly rests on local institutions which are directly accessible to all segments of the population. Self-help Groups (SHGs) are member-owned and member-controlled local institutions. They may either be financial groups, with financial intermediation as a secondary purpose such as vendor's associations, family planning groups and numerous other types of voluntary associations. The functions that need to be focused must include: providing guidance to number of that association community collecting premium installments from members, communication and exchange of experience providing linkages with banks, NGOs or donors supporting the proposal of individual members to insurance companies through recommendations. Finally setting links with the insures to ensure that the requisite utilities of micro insurance need to be duly reped by customers of the community covered under the scheme- for each &every individual member of that community is a must.-for that first of all- as per insurance requirements - Compliance of Section 64 VB-i.e. Advance payment of premium regulation is a must, and there for the insurance must pay the prmium or the renewal premium always in time. On a modest scale, various forms of life and health insurance have been successfully practiced by different institution in different states, provinces, communities in India, particularly as part of loan protections schemes. Insurers rather than the regulator have set micro-insurance procedures and services to be rendered to various communities. Since all the insurers are having obligations to operate in social & rural sector in India and all micro-insurance policies could be counted for the purposes of social obligations to be fulfilled by an insurer as per the provisions of the insurance Act, 1938 and the IRDAI Micro Insurance Regulation, 2005 made there under & setting other parameters , the author is discussing in depth analysis here in this article about tit-bits of Micro Insurance Schemes to strive in India. [ABSTRACT FROM AUTHOR]

This article describes the challenges that victims, insurers and governments face in dealing with insurance for low-probability high-consequence events in both developed and developing economies. In developed economies, given their limited experience with catastrophes, there is a tendency for all three parties to engage in short-term intuitive thinking rather than long-term deliberative thinking when making insurance-related decisions. Here, public-private partnerships can encourage investment in protective measures prior to a disaster, deal with affordability problems and provide coverage for catastrophic risks. Insurance premiums based on risk provide signals to residents and business as to the hazards they face and enable insurers to lower premiums for properties where steps have been taken to reduce their risk. To address issues of equity and fairness, homeowners who cannot afford insurance could be given vouchers tied to loans for investing in loss reduction measures. The National Flood Insurance Program provides an opportunity to implement a public-private partnership that could eventually be extended to other extreme events, while the United Kingdom's Flood Re provides a good case study. In developing economies, insurance penetration is historically very low. This requires innovative solutions to catastrophic risk insurance such as risk pooling, parametric insurance and micro insurance. Nevertheless, the uninsured and uncompensated losses of disasters remain extensive, implying the need for public-private partnerships. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to review and compare the distinct features and practices of Sudanese and Ethiopian microfinance sector. Analysis includes general characteristics of both sectors such as institutional structures/ characteristics, policies, programs, regulation, strategies, wholesale markets, technical assistance etc. Moreover, the major characteristics of microfinance institution (MFIs) in both countries are compared, and a review and comparison of some performance criteria of MFIs is made. The methodology consists of analyzing and examining issues at hand using some indicators and qualitative information. The paper come up with some recommendations regarding the constraints facing microfinance (MF) sectors in the two countries, and also suggests how the two microfinance experiences can learn from each other. The Sudanese MF experience, we argued, can give a lesson from its diversified wholesale market via the government-owned Wholesale Guarantee Agency. The paper also propagates the merits of Islamic microfinance as practiced in Sudan to Ethiopia-Muslim minorities. We argued that this can be carried out via new windows or specialized branches within the existing MFIs; no need for a new legislations or a new MFIs structure. Sudan can learn from the role and functions of AEMFI, to establish the Sudanese Association of Microfinance Institutions. Sudan can also learn from the Ethiopian social management system to self monitor the social impact of microfinance on their clients. The paper is constrained by the limitation of quantitative data, especially financial data, regarding the Sudanese MFIs. This hinders deep comparison of the financial performance of MFIs in the two countries. More research is required in this area. [ABSTRACT FROM AUTHOR]

The study evaluates the progress made in the field of financial inclusion and the impediments towards achieving universal financial inclusion .It finds that though Government has put in all efforts towards banking penetration and access but the demand side has not been addressed resulting in very little usage of the financial products . The products meant for the poor are just stripped down version of regular product developed for the urban educated masses .The study identifies the demand side drawbacks in the present model of financial inclusion and suggests ways and means to overcome them. In its attempt to address the demand side issues it studies the Global Financial Inclusion Models like BRADESCO of Brazil, MPESA of Kenya, Rakyat Bank Indonesia, Mzansi accounts of South Africa, Grameen Bank of Bangladesh etc to understand what makes them successful in their business. [ABSTRACT FROM AUTHOR]

Micro insurance as the name suggests is the insurance for the poor. Insurance Researchers believe that the determinants of micro insurance demand viz. Insurance knowledge, formal education, trust, peer effect and past shock affect insurance take up. However, as on date, research that has empirically investigated the correlation between determinants of micro insurance demand and takes up is scant. With a sample of 250 respondents, this paper seeks to explain how the determinants of micro insurance demand affects insurance take up and its subsequent renewal. The study further highlights the type of media that would be effective in enhancing the awareness level of micro insurance amongst the poor masses in India. The study focuses primarily on life micro insurance. A sample of 250 respondents from informal sector worker from a rural area in Nalbari district of Assam located in north east part of India were interviewed. The data obtained from the respondents were analyzed through application of t test and Karl Pearson's Coefficient of correlation. The study findings indicate that insurance awareness is low amongst the poor masses. The determinants of micro insurance demand have shown strong positive correlation. Insurance knowledge has significant impact in insurance take up and policy renewal rather than formal education. Television, radio and posters appear to be some of the effective media for enhancing the micro insurance awareness. The current study attempts to provide some solutions for enhancing micro insurance take up and its subsequent renewal for mutual benefit of the insurer and the insured. The research study is divided into eleven sections. The first section of the paper deals with the introduction to the subject which touches on the concept of micro insurance, IRDA's definition of micro insurance and the growth of micro insurance in India. The second section deals with the objective of the research paper. The third section deals with the methodologies that were adopted to undertake the study. The fourth section deals with the need analysis, that is, what was the necessity for undertaking the study. The fifth section deals with literature review on the factors affecting the micro insurance take up. The sixth section deals with analysis and findings. The seventh section provides a summary of the findings from the research study. The eighth section highlights the business implication of this research study. The ninth section highlights the scope for future research on micro insurance. The tenth section comes up with the conclusion of the study. Finally, the eleventh section lists the various references that were taken into consideration in preparing the research / essay paper. [ABSTRACT FROM AUTHOR]

The research paper focus on challenges and opportunities for Insurers to exploit the huge market potential that have emerged in recent years from socio-economic development in both urban and rural India. From empirical support provided, it would be evident that Indian Insurers have not been able to keep the pace with such changes in social perception and provide proper insurance solutions to the market. The insurers, especially non-life sector, require to reinvent the strategic imperatives by renewing its marketing mix by rein engineering its processes of service delivery through unorthodox and alternative distribution channels. Increased partnership and collaboration across interested stakeholders in India, especially financial institutions, both at Macro and Micro level accompanied by support from International agencies and reinsurers would be required to keep the pace of changing scenario. By realigning its strategic spread to wide across nations by right delivery systems and distribution channels, both the life and non-life insurers would enhance competitive advantage to strengthen its roots of insurance business fundamentals by advantages of law of large numbers, and risk diversity. [ABSTRACT FROM AUTHOR]

Abstract Background Microinsurance or Community-Based Health Insurance is a promising healthcare financing mechanism, which is increasingly applied to aid rural poor persons in low-income countries. Robust empirical evidence on the causal relations between Community-Based Health Insurance and healthcare utilisation, financial protection and other areas is scarce and necessary. This paper contains a discussion of the research design of three Cluster Randomised Controlled Trials in India to measure the impact of Community-Based Health Insurance on several outcomes. Methods/Design Each trial sets up a Community-Based Health Insurance scheme among a group of micro-finance affiliate families. Villages are grouped into clusters which are congruous with pre-existing social groupings. These clusters are randomly assigned to one of three waves of implementation, ensuring the entire population is offered Community-Based Health Insurance by the end of the experiment. Each wave of treatment is preceded by a round of mixed methods evaluation, with quantitative, qualitative and spatial evidence on impact collected. Improving upon practices in published Cluster Randomised Controlled Trial literature, we detail how research design decisions have ensured that both the households offered insurance and the implementers of the Community-Based Health Insurance scheme operate in an environment replicating a non-experimental implementation. Discussion When a Cluster Randomised Controlled Trial involves randomizing within a community, generating adequate and valid conclusions requires that the research design must be made congruous with social structures within the target population, to ensure that such trials are conducted in an implementing environment which is a suitable analogue to that of a non-experimental implementing environment.