Firstly, when developing a plan, it is important for the donors and those implementing the project to look to success stories to see what can be learned.  There are plenty of cases of successful projects, perhaps most notably the development of community-based health insurance into the national healthcare financing plan in Rwanda.  The Rwanda example also illustrates the importance of involving the government, both at a country-wide level and the community level, at an early stage and getting commitment from them before implementation of any rural insurance scheme.