The 153 Village Development Committees (VDCs) in the 6 districts will be randomly assigned to treatment and control group where the treatment VDCs will receive enrollment encouragement intervention. Approximately half of these VDCs will be randomly assigned to a treatment group that will receive the promotion and other half will be assigned to a control group which will not receive any such promotion.
The differences in take-up rates between the treatment and control VDCs is the estimates of the effect of the encouragement mechanisms on the take-up rate.
In addition to the primary data collection at the household level, existing data sources including the Health Management Information System (HMIS) which provides regular monitoring data, service tracking surveys, and household surveys will be used. The recently conducted Nepal Living Standard Survey and Nepal Demographic and Health Survey will be used to match the districts and verify the robustness of the evaluation design. Data from HMIS will also be used for regular monitoring of the implementation of the intervention.
The evaluation will also include the collection of cost data, which will be combined with the impact estimates to assess the cost-effectiveness of the intervention and fiscal implications of taking it to scale.
The evaluation will assess the intervention impact along four indicators:
- utilization of inpatient care
- utilization of outpatient care
- out-of-pocket expense
- drug stockout.
