The main objective of the guide is to encourage promoters and operators and support their efforts to conduct a systematic feasibility study prior to the establishment or further development of a scheme. In spite of their dynamic nature, health micro-insurance schemes, in general, are quite fragile. They do not possess the hindsight and experience needed for an accurate determination of the financial risks they face. The financial safeguards of such schemes – reserves, reinsurance – and their promoters' level of competence in the area of insurance are presently still limited. Given such a context, the foundations of these schemes – that is, the assumptions upon which they are based – must be particularly firm. A scheme will have greater chances of surviving, and subsequently of developing, if it is well designed from the outset. Therefore, conducting a feasibility study appears to be essential. The impetus for producing this guide grew out of two observations: in order to ensure the sustainability and viability of a health micro-insurance scheme, it is important to define its characteristics in terms of its particular context. The feasibility study is a key contributing factor – though not the only one – to the success of a scheme; the promoters involved must have a coherent set of methods and tools at their disposal in order to carry out this type of study. The guidebook provides step-by-step instructions and useful tools for designing a health micro-insurance scheme and for determining its organization and operating rules. It neither deals with the relevance of setting up a scheme, nor provides a precise and systematic explanation of how a scheme functions, and it is not sufficient for conducting the various operations of a scheme once it has been set up (e.g. detailed explanation of the day-to-day management).