Health BehaviorNCT07313631
Impact Evaluation of Access to Free Low-Cost Health Insurance in Nigeria's Taraba State
A study testing No-Cost Health Insurance in people with Health Behavior and Economic Problems, run by World Bank at 1 site in Nigeria.
Trial summary
The objective of this study is to examine the impact of a free health insurance offer on healthcare use, spending, self-reported health, and economic participation of women in Taraba state of Nigeria. Read more about this study
- Who is it for?
- Ages 18 years and older, women onlyHealthy volunteers can take part
- Conditions the study is for
- Health Behavior, Economic Problems, Health Status
- What is being tested?
- No-Cost Health Insurance
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 4,000 participants
- Where
- 1 siteNigeria
- Study dates
- 1 Oct 2023to 30 Dec 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- Women only
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Members of one of 1,000 randomly selected women's groups operating in Bali local government area in Taraba State, Nigeria.
Who cannot join
- At least 18 years old.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Women's Insurance for State Health - An Impact Evaluation of Health Insurance Provided Under the Basic Health Care Provision Fund in Taraba State, Nigeria
The objective of this study is to examine the impact of a free health insurance offer on healthcare use, spending, self-reported health, and economic participation of women in Taraba state of Nigeria.
Read the detailed description
This study aims to evaluate a health-insurance intervention implemented under the World Bank-funded Nigeria for Women Project (NFWP) in Taraba State. Women in Women Affinity Groups (WAGs) received an offer for a free, 12-month policy under the Taraba State Health Insurance Agency's Basic Minimum Package of Health Services (BMPHS), which covers essential primary and secondary care, including consultations, preventive services, maternal and child health, mental health, emergency care, and laboratory services, normally priced at ₦12,000 annually. We are using a randomized controlled trial design in Bali Local Government Area (LGA). Using administrative data on WAG enrollment, we randomly assigned 1,000 WAGs (stratified by ward and mean participant age) to either treatment (n=500) or control (n=500). Within each WAG, four women were randomly selected to enroll in the study, yielding 4,000 participants (2,000 insured; 2,000 controls). The study focuses on outcomes related to healthcare utilization, health status, out-of-pocket expenditures, and women's economic participation. The findings are expected to inform policy on expanding health insurance coverage as a strategy to improve women's health and promote their economic empowerment.
- Being tested
- No-Cost Health Insurance
- Keywords
- Health insurance, Care-seeking behavior, Healthcare utilization, Nigeria
- Medical subject headings
- Health Behavior
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
No-Cost Health InsuranceOther
Provision of a free, 12-month insurance policy from the Taraba State Health Insurance Agency that covers the Basic Minimum Package of Health Services (BMPHS), including outpatient and inpatient consultations, preventive and reproductive health services, maternal and child health care, mental health care, emergency services, and laboratory testing.
| Study group | Role | What they receive |
|---|---|---|
| Treatment (Health insurance offer) | Experimental | Randomly-selected members of selected Women Affinity Groups (WAGs) randomized to the treatment arm receive an offer for a free, 12-month health insurance policy under the Taraba State Health Insurance Agency's Basic Minimum Package of Health Services (BMPHS), covering essential primary and secondary care (including consultations, preventive services, maternal and child health, emergency care, mental health, and laboratory services). Receives: Other: No-Cost Health Insurance |
| Control (No insurance offer) | No intervention | Members of WAGs randomized to the control arm do not receive the insurance coverage offer during the study period and continued with usual access to care without project-provided coverage. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Respondent has health insurance
Zero if not no health insurance, 1 if has health insurance.
Measured: 6 months, 9 months, 11 months post treatment.
Has health insurance card
Zero if respondent has no health insurance card, 1 if they have a health insurance card.
Measured: 6 months, 9 months, 11 months post treatment
Respondent has successfully used health insurance for consultations, diagnoses, medications, or tests.
Zero if respondent has not successfully used health insurance for consultations, diagnoses, medications, or tests. 1 if the respondent has successfully used health insurance for consultations, diagnoses, medications, or tests.
Measured: 6 months, 9 months, 11 months.
Sought treatment for most recent illness
Zero if respondent did not seek care for most recent illness. 1 if respondent did seek care for most recent illness
Measured: 6 months, 9 months, 11 months.
Number of health facility visits in last 3 months.
Reported number of health facility visits outside the home in the last 3 months.
Measured: 6 months, 9 months, 11 months.
Most recent health facility visit was to a public sector facility
Zero if last care event was in a private facility, 1 if last care seeking event was in a public facility
Measured: 6 months, 9 months, 11 months.
Money for health care is a key barrier
Zero if "getting money needed for advice or treatment" is not listed as a barrier. 1 if "getting money needed for advice or treatment" listed as a barrier.
Measured: 6 months, 9 months, 11 months.
Most recent birth was in a health facility
Zero if most recent birth was not in a government or private health facility. 1if most recent birth was in a government or private health facility. Limited to births in last 3 months.
Measured: 6 months, 9 months, 11 months.
Child has received any vaccinations
Zero if children aged under 12 months has not received any vaccinations. 1 if child has received at least one vaccination.
Measured: 6 months, 9 months, 11 months.
Total cost of most recent healthcare
Total cost of most recent healthcare visit, winsorized at the 1% and 99% levels.
Measured: 6 months, 9 months, 11 months.
Most recent care episode reflects catastrophic health expenditure
1 if most recent healthcare visit expenditure represents represents greater than 10% of household consumption
Measured: 6 months, 9 months, 11 months.
Total indebtedness from healthcare or illness-related expenses
Total amount of money owed for medical expenses, winsorized at the 1% and 99% levels.
Measured: 6 months, 9 months, 11 months.
Respondent is depressed
Score equal to or greater than 10 on Center for Epidemiologic Studies Depression Scale.
Measured: 6 month, 9 month, 11 month.
Perceived health status
Response to the following question: Think about your health over the last 3 months, including any long-term illnesses, hospital or clinic visits, or other ailments, how would you rate your health on a scale of 1-10 where 1 is very low health and 10 is very healthy with no ailments?
Measured: 6 months, 9 months, 11 months.
Number of productive days lost to severe illness in the past 3 months
Reported number of productive days lost to severe illness in the past 3 months
Measured: 6 months, 9 months, 11 months
Secondary outcomes (17)
Has ever tried to use health insurance
Zero if respondent has never tried to use health insurance, 1 if respondent has tried to use health insurance
Measured: 6 months, 9 months, 11 months post treatment
Number of antenatal care visits
Number of antenatal care visits for any births in last 3 months
Measured: 6 months, 9 months, 11 months.
Most recent health facility care event visit was to a secondary/tertiary care facility (hospital)
1 if most recent health facility care event visit was to a secondary/tertiary care facility (hospital). 0 if visit was to a primary care facility or informal care facility.
Measured: 6 months, 9 months, 11 months.
Received lab test as part of antenatal care in most recent pregnancy
1 if received any lab tests as part of antenatal care in most recent pregnancy from births in last year. 0 otherwise.
Measured: 6 months, 9 months, 11 months.
Child has received OPV
1 if child born in last 12 months and age-eligible for OPV vaccine has received it. 0 if child born in last 12 months and age-eligible for OPV vaccine but has not received it.
Measured: 6 months, 9 months, 11 months.
Child has received BCG vaccine
1 if child born in last 12 months and age-eligible for BCG vaccine has received it. 0 if child born in last 12 months and age-eligible for BCG vaccine but has not received it.
Measured: 6 months, 9 months, 11 months.
Child has received measles vaccine
1 if child born in last 12 months and age-eligible for measles vaccine has received it. 0 if child born in last 12 months and age-eligible for measles vaccine but has not received it.
Measured: 6 months, 9 months, 11 months.
Economically active in the last 7 days
1 if respondent reports working, either paid or unpaid, in the last 7 days. This includes: work as an employee for a wage, salary, commission or any payment in kind; running a non-farm business; help in any kind of nonfarm business; work on your own farm or household agricultural activities; and unpaid apprentice work.
0 if no work in the last 7 days.
Measured: 6 months, 9 months, 11 months.
Hours engaged in economic activities in the last 30 days
Total number of hours reported towards economic activities in the last 30 days. Calculated as days worked in a given activity times hours spent in a given activity, summed over activities.
Measured: 6 months, 9 months, 11 months.
Total income over past 30 days.
Reported income from all economic activities over the last 30 days, winsorized at the 1% and 99% levels.
Measured: 6 months, 9 months, 11 months.
Total value of current savings
Total value of current savings, winsorized at the 1% and 99% levels.
Measured: 6 months, 9 months, and 11 months post treatment.
Total value of current borrowing
Value of all outstanding borrowing owed for food, medical expenses, loans, social occasions, school fees, businesses, and other. Winsorized at the 1% and 99% levels.
Measured: 6 months, 9 months, and 11 months post treatment.
Household decision making
1 if the respondent feels she has input into most or all household decisions, 0 if she has input into none, few, or some decisions.
Measured: 6 months, 9 months, and 11 months post treatment.
Respondent makes decisions about savings
1 if respondent can make their own personal decisions regarding savings (at least to a small extent). 0 if respondent can not make their own personal decisions regarding savings
Measured: 6 months, 9 months, 11 months post treatment.
Health insurance knowledge
Number of questions correct about what health insurance does/does not cover:
Health insurance covers the registration fee at a health facility. Health insurance covers the consultation fee you pay to see a doctor or nurse. Health insurance covers the cost of laboratory tests. Health insurance covers the cost of medicines or drugs. Health insurance covers the cost of treatment.
Measured: 6 months, 9 months, 11 months.
Trust in state government
1 if respondent has trusts state government (a great deal of trust or trust somewhat), 0 if no trust at all or trust just a little.
Measured: 6 months, 9 months, 11 months post treatment
Trust in local government authority
1 if respondent has trusts local government authority (a great deal of trust or trust somewhat), 0 if no trust at all or trust just a little.
Measured: 6 months, 9 months, and 11 months post treatment.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 Jan 2026
- Study start1 Oct 2023
- Primary completion30 Aug 2027 (estimated)
- Study completion30 Dec 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Health BehaviorStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Cluster-randomized controlled trial at the Women Affinity Group (WAG) level; 1,000 WAGs randomly assigned (stratified by ward and age strata) into treatment or control (500 each), with four women sampled per group (4,000 total participants).
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 4,000 participants (actual)
Sponsor and investigators
- Lead sponsor
- World Bank
- Sponsor type
- University, hospital or other
- Collaborators
- Harvard School of Public Health (HSPH)
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07313631
- Sponsor's protocol ID
- NFWP_Taraba_HealthInsurance
- Status last verified
- Oct 2025
- First submitted
- 17 Dec 2025
- Last updated
- 2 Jan 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: We will share a de-identified dataset with all collected IPD.
Study at a glance
From the registry record, last updated by the sponsor on 2 Jan 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Women's Insurance for State Health - An Impact Evaluation of Health Insurance Provided Under the Basic Health Care Provision Fund in Taraba State, Nigeria
- ClinicalTrials.gov ID
- NCT07313631
- Acronym / sponsor ID
- NFWP_Taraba_HealthInsurance
- Keywords
- Health insurance, Care-seeking behavior, Healthcare utilization, Nigeria
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 4,000 participants (actual)
- Lead sponsor
- World BankUniversity, hospital or other
- Collaborators
- Harvard School of Public Health (HSPH)
- Study start
- 1 Oct 2023 (actual)
- Primary completion
- 30 Aug 2027 (estimated)
- Study completion
- 30 Dec 2027 (estimated)
- First posted
- 2 Jan 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The objective of this study is to examine the impact of a free health insurance offer on healthcare use, spending, self-reported health, and economic participation of women in Taraba state of Nigeria.
Detailed description
This study aims to evaluate a health-insurance intervention implemented under the World Bank-funded Nigeria for Women Project (NFWP) in Taraba State. Women in Women Affinity Groups (WAGs) received an offer for a free, 12-month policy under the Taraba State Health Insurance Agency's Basic Minimum Package of Health Services (BMPHS), which covers essential primary and secondary care, including consultations, preventive services, maternal and child health, mental health, emergency care, and laboratory services, normally priced at ₦12,000 annually. We are using a randomized controlled trial design in Bali Local Government Area (LGA). Using administrative data on WAG enrollment, we randomly assigned 1,000 WAGs (stratified by ward and mean participant age) to either treatment (n=500) or control (n=500). Within each WAG, four women were randomly selected to enroll in the study, yielding 4,000 participants (2,000 insured; 2,000 controls). The study focuses on outcomes related to healthcare utilization, health status, out-of-pocket expenditures, and women's economic participation. The findings are expected to inform policy on expanding health insurance coverage as a strategy to improve women's health and promote their economic empowerment.
Study design
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
- Model description
- Cluster-randomized controlled trial at the Women Affinity Group (WAG) level; 1,000 WAGs randomly assigned (stratified by ward and age strata) into treatment or control (500 each), with four women sampled per group (4,000 total participants).
| Arm | Type | Receives |
|---|---|---|
| Treatment (Health insurance offer) | Experimental | Other: No-Cost Health InsuranceRandomly-selected members of selected Women Affinity Groups (WAGs) randomized to the treatment arm receive an offer for a free, 12-month health insurance policy under the Taraba State Health Insurance Agency's Basic Minimum Package of Health Services (BMPHS), covering essential primary and secondary care (including consultations, preventive services, maternal and child health, emergency care, mental health, and laboratory services). |
| Control (No insurance offer) | No intervention | –Members of WAGs randomized to the control arm do not receive the insurance coverage offer during the study period and continued with usual access to care without project-provided coverage. |
Who may qualify
- Ages
- 18 years and older
- Sex
- Female only
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (1 listed)
- Members of one of 1,000 randomly selected women's groups operating in Bali local government area in Taraba State, Nigeria.
Key exclusion criteria (1 listed)
- At least 18 years old.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| No-Cost Health InsuranceProvision of a free, 12-month insurance policy from the Taraba State Health Insurance Agency that covers the Basic Minimum Package of Health Services (BMPHS), including outpatient and inpatient consultations, preventive and reproductive health services, maternal and child health care, mental health care, emergency services, and laboratory testing. | Other | Treatment (Health insurance offer) |
Primary outcome
Respondent has health insurance
Time frame: 6 months, 9 months, 11 months post treatment.
Zero if not no health insurance, 1 if has health insurance.
Has health insurance card
Time frame: 6 months, 9 months, 11 months post treatment
Zero if respondent has no health insurance card, 1 if they have a health insurance card.
Respondent has successfully used health insurance for consultations, diagnoses, medications, or tests.
Time frame: 6 months, 9 months, 11 months.
Zero if respondent has not successfully used health insurance for consultations, diagnoses, medications, or tests. 1 if the respondent has successfully used health insurance for consultations, diagnoses, medications, or tests.
Sought treatment for most recent illness
Time frame: 6 months, 9 months, 11 months.
Zero if respondent did not seek care for most recent illness. 1 if respondent did seek care for most recent illness
Number of health facility visits in last 3 months.
Time frame: 6 months, 9 months, 11 months.
Reported number of health facility visits outside the home in the last 3 months.
Most recent health facility visit was to a public sector facility
Time frame: 6 months, 9 months, 11 months.
Zero if last care event was in a private facility, 1 if last care seeking event was in a public facility
Money for health care is a key barrier
Time frame: 6 months, 9 months, 11 months.
Zero if "getting money needed for advice or treatment" is not listed as a barrier. 1 if "getting money needed for advice or treatment" listed as a barrier.
Most recent birth was in a health facility
Time frame: 6 months, 9 months, 11 months.
Zero if most recent birth was not in a government or private health facility. 1if most recent birth was in a government or private health facility. Limited to births in last 3 months.
Child has received any vaccinations
Time frame: 6 months, 9 months, 11 months.
Zero if children aged under 12 months has not received any vaccinations. 1 if child has received at least one vaccination.
Total cost of most recent healthcare
Time frame: 6 months, 9 months, 11 months.
Total cost of most recent healthcare visit, winsorized at the 1% and 99% levels.
Most recent care episode reflects catastrophic health expenditure
Time frame: 6 months, 9 months, 11 months.
1 if most recent healthcare visit expenditure represents represents greater than 10% of household consumption
Total indebtedness from healthcare or illness-related expenses
Time frame: 6 months, 9 months, 11 months.
Total amount of money owed for medical expenses, winsorized at the 1% and 99% levels.
Respondent is depressed
Time frame: 6 month, 9 month, 11 month.
Score equal to or greater than 10 on Center for Epidemiologic Studies Depression Scale.
Perceived health status
Time frame: 6 months, 9 months, 11 months.
Response to the following question: Think about your health over the last 3 months, including any long-term illnesses, hospital or clinic visits, or other ailments, how would you rate your health on a scale of 1-10 where 1 is very low health and 10 is very healthy with no ailments?
Number of productive days lost to severe illness in the past 3 months
Time frame: 6 months, 9 months, 11 months
Reported number of productive days lost to severe illness in the past 3 months
17 secondary outcomes
Has ever tried to use health insurance
Time frame: 6 months, 9 months, 11 months post treatment
Number of antenatal care visits
Time frame: 6 months, 9 months, 11 months.
Most recent health facility care event visit was to a secondary/tertiary care facility (hospital)
Time frame: 6 months, 9 months, 11 months.
Received lab test as part of antenatal care in most recent pregnancy
Time frame: 6 months, 9 months, 11 months.
Child has received OPV
Time frame: 6 months, 9 months, 11 months.
Child has received BCG vaccine
Time frame: 6 months, 9 months, 11 months.
Child has received measles vaccine
Time frame: 6 months, 9 months, 11 months.
Economically active in the last 7 days
Time frame: 6 months, 9 months, 11 months.
Hours engaged in economic activities in the last 30 days
Time frame: 6 months, 9 months, 11 months.
Total income over past 30 days.
Time frame: 6 months, 9 months, 11 months.
Total value of current savings
Time frame: 6 months, 9 months, and 11 months post treatment.
Total value of current borrowing
Time frame: 6 months, 9 months, and 11 months post treatment.
Household decision making
Time frame: 6 months, 9 months, and 11 months post treatment.
Respondent makes decisions about savings
Time frame: 6 months, 9 months, 11 months post treatment.
Health insurance knowledge
Time frame: 6 months, 9 months, 11 months.
Trust in state government
Time frame: 6 months, 9 months, 11 months post treatment
Trust in local government authority
Time frame: 6 months, 9 months, and 11 months post treatment.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 2 Jan 2026.
- Individual participant dataSharing planned: Yes. We will share a de-identified dataset with all collected IPD.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing No-Cost Health Insurance in people with Health Behavior and Economic Problems, run by World Bank at 1 site in Nigeria.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 2 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Nigeria. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Respondent has health insurance (time frame: 6 months, 9 months, 11 months post treatment.). The study lists 15 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Jan 2026.