Spatial Research Methodology Supplementing Cluster Randomized Controlled Trials: Learning from a Study of Community-Based Health Insurance Schemes in India

Abstract

Most of the cluster randomized controlled trials (CRCTs) are conducted in a geographical area, but the present CRCT evaluation model does not capture “place” component. CRCTs reported without providing the information on spatio-temporal changes taking place at the experiment site, during the course of intervention, present only a part of the picture and also pose a great difficulty in finding out causal relationship between the intervention and outcome. We conclude that a complete evaluation model should have tools to capture people, place and time. Usually, “people” are captured using quantitative tools and “time” component is taken using different waves of data collection, “place” dimension needs to be integrated to make CRCT evaluation more comprehensive and effective. This research article reports the spatial methodological protocol followed in a project that assesses the impact of community-based health insurance schemes in rural India and demonstrates various advantages of incorporating spatial tools in the evaluation model. Results highlight the potential for applying this methodology in other studies.