RCT on Information Dosage for Health Insurance Uptake in Guinea-Bissau

Last registered on March 16, 2026
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Pre-Trial

Trial Information

General Information

Title
RCT on Information Dosage for Health Insurance Uptake in Guinea-Bissau
RCT ID
AEARCTR-0018046
Initial registration date
March 13, 2026

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published
March 16, 2026, 7:03 AM EDT

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Locations

Country
Guinea-Bissau
Region

Primary Investigator

Name
Carine Canonici Costa
Affiliation
Contact Primary Investigator

Other Primary Investigator(s)

PI Name
Giacomo Catania
PI Affiliation
Contact Investigator
PI Name
Aliu Bá Jau
PI Affiliation
BELAB
Contact Investigator
PI Name
Sié Barro
PI Affiliation
Contact Investigator

Additional Trial Information

Status
On going
Start date
2025-12-13
End date
2026-03-21
Keywords
Behavior, Health, Welfare
Additional Keywords
Insurance
JEL code(s)
I13, I15, C93
Secondary IDs
Prior work
This trial does not extend or rely on any prior RCTs.
Abstract
This study tests whether short information videos can increase interest in and demand for a new voluntary health insurance scheme in Guinea-Bissau. We will survey about 1,200 adults in urban areas and randomly assign them to watch different versions of a brief insurance information video. Version 1 talks about health insurance in general and the benefits and risks associated with its adoption, version 2 describes a plan with national coverage, and version 3 highlights both national and international coverage, including cross-border care. Immediately after the video, we will measure how interested people would be in enrolling, how much they say they would be willing to pay for different insurance products, and how their beliefs and trust in insurance change. We will also track whether people make follow-up phone calls to a project hotline and re-contact them by phone after around two months to see whether any changes in demand and beliefs persist over time.
External Link(s)

Registration Citation

Citation
Barro, Sié et al. 2026. "RCT on Information Dosage for Health Insurance Uptake in Guinea-Bissau." AEA RCT Registry. March 16. https://doi.org/10.1257/rct.18046-1.0
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Experimental Details

Interventions

Intervention(s)
Intervention Start Date
2025-12-13
Intervention End Date
2025-12-26

Primary Outcomes

Primary Outcomes (end points)
Midline demand outcomes (immediately post-intervention):
Ordinal interest in enrolling in health insurance (q38_interest, 0–4 scale).
Binary “high interest” indicator (q38_interest ≥ 3).
Willingness to pay (WTP) for Product A and Product B (full coverage), based on the max WTP elicitation for each product.

Midline beliefs and trust:
An insurance perceptions and trust index constructed from items on perceived protection, complexity, waste, and distrust of insurance companies.

Behavioral outcome:
Indicator for at least one inbound call to the project hotline within a two-week window after the interview.

Endline outcomes (≈2 months later), defined as analogues of the midline measures:
Interest in enrolling (ordinal and high-interest indicator).
WTP for Product A and Product B (comparable to midline).
Perceptions and trust index constructed on the same basis as at midline.
Primary Outcomes (explanation)
Willingness to pay (WTP):
For each respondent, we construct continuous WTP.

Perceptions and trust index:
Items q34_value_protection, q34_complicated, q34_waste, and q34_distrust_companies are recorded on a common response scale; negatively framed items are reverse-coded so that higher values indicate more pro-insurance attitudes. We then construct an Anderson-style standardized index aggregating these items, used as the primary perceptions outcome.

Secondary Outcomes

Secondary Outcomes (end points)
Perceived ability to pay (affordability confidence).
Stated main concern about subscribing to health insurance.
Stated product preference between Product A (reimbursement) and Product B (direct payment).
Salience of cross-border care and perceived quality of care, especially for the arm with international coverage.
Interest in being recontacted if the insurance product is implemented.
Selected post-intervention intentions regarding health service use, when explicitly elicited as responses attributable to the information exposure.
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
This study embeds an individual-level randomized controlled trial in a baseline survey of about 1,200 adults in four urban areas of Guinea-Bissau (Bissau, Canchungo, Bafatá, Gabú). After completing baseline questions, respondents are randomly assigned to one of three short information videos: a control video with general information about health insurance practices, a video that additionally describes a scheme with national coverage, or a video that adds emphasis on international coverage and cross-border care. Immediately after viewing the assigned video, respondents answer a short module on interest in enrolling, willingness to pay for two insurance product modalities (reimbursement vs. direct payment), and perceptions and trust in insurance. Approximately two months later, respondents are re-interviewed by phone to measure persistence of changes in demand and beliefs.
Experimental Design Details
Not available
Randomization Method
Randomization is implemented by the survey software at the individual level using programmed randomization logic within the baseline questionnaire (variable rand_treat mapping to treat_group for Control, T1, T2).
Randomization Unit
The unit of randomization is the individual respondent.
Was the treatment clustered?
No

Experiment Characteristics

Sample size: planned number of clusters
N/A
Sample size: planned number of observations
The planned sample size is approximately 1,200 individual respondents, stratified across four main urban areas (Bissau; Canchungo; Bafatá; Gabú).
Sample size (or number of clusters) by treatment arms
The study anticipates approximately equal allocation across the three information arms. With a total planned sample of about 1,200 individuals, this implies roughly:

≈ 400 individuals in Control (general information video).

≈ 400 individuals in Treatment 1 (general information + national coverage).

≈ 400 individuals in Treatment 2 (general information + national and international coverage).
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
Supporting Documents and Materials
IRB

Institutional Review Boards (IRBs)

IRB Name
Comitê Nacional de Ética em Pesquisa na Saude
IRB Approval Date
2026-02-03
IRB Approval Number
57/CNEPS/INASA/2026
Analysis Plan

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