Summary

Lack of knowledge about medicines and health insurance is a major barrier to accessing healthcare, especially in low-income countries. Many villagers in rural Cambodia ask for unnecessary intravenous (iv) injections from doctors regardless of illness, and prefer to seek care from private providers who are willing to provide these injections. Because private providers are not covered by insurance and many villagers do not understand the value of health insurance, people continue to become poorer by incurring unnecessary health expenditures. The proposed study will develop an educational tool to inform people about injection practices and health financing. Greater awareness is likely to build people’s trust in the health system. Our goal is to empower people to make informed decisions about medications and insurance, prevent them from seeking inappropriate and unnecessary care, and stop them from becoming poor due to illness. The specific objectives of the project are: (1) develop an educational tool for injection practices and health insurance; (2) assess changes in people’s trust, knowledge and injections/insurance seeking behaviors over time; and (3) evaluate the effectiveness of the educational tool comparing the intervention and control districts. This proposal combines the strengths of the International Health Department and the Center for Communication Programs at JHSPH with the Center for Pharmaceutical Outcomes and Policy at JHMI, and an established relationship with a local partner in Cambodia. Findings from the proposed study will contribute to building informed trust by educating people in Cambodia about injections and insurance, and will provide the key preliminary data for future federal grant applications to pilot the new educational module in other low-income country settings.