Open source Health Insurance Management Information System (OpenIMIS)


Health related costs often represent a massive financial burden for poor households. Lack or inexistence of social protection mechanisms imply that ill and injured people have no choice but to pay out-of-pocket for services and care. Health insurance schemes potentially prevent households from falling into a poverty trap. SDC and BMZ have developed the only open-source software for fully managing a social health protection scheme. This tool will be further promoted and implemented in LMICs.

Región/País Tema Período Presupuesto
A nivel mundial
Salud
Governance
Fortalecimiento del sistema sanitario
Tecnología de la información y las comunicaciones (TIC)
01.09.2020 - 31.08.2023
CHF  2’510’000
Contexto

Worldwide 150 million suffer from catastrophic health expenditure every year and 100 million people are pushed into poverty because of health-related out-of-pocket payments. Therefore the gradual expansion of health coverage and financial protection to more population segments is essential. Many low and middle-income countries are developing different types of social health protection schemes. Operationalising bigger funds with national outreach or expanding smaller schemes require reliable and cost-effective Information Communication Technology (ICT)-based information management systems. Yet, most of these countries do not have sufficient financial and technical capacity to implement, customise and manage complex ICT systems.

Social protection as well as digitalization are priority themes for the Swiss development cooperation. OpenIMIS is an open-source software easily adaptable to various social protection schemes and therefore contributing to SDC institutional efforts. 

This second phase will launch a catalytic fund in order to select candidate countries for the adaption and implementation of OpenIMIS. 

Objetivos

National health financing schemes for UHC provide coverage for healthcare to a large part of society.

The overall goal is to reduce poverty and to prevent people from falling into poverty by including vulnerable populations into social health protection schemes. Their integration will be facilitated through the development, implementation and continuous improvement of a Health Insurance Management Information System based on open source technology (openHIMIS) because more efficient, transparent and cost-effective management increases the schemes’ capacities to extend their coverage to hitherto excluded poorer populations.

Grupos destinarios Direct beneficiaries are social protection schemes in low- and middle-income countries. Ultimately, people covered by these schemes, including poor populations working in the informal as well as formal sector. 
Efectos a medio plazo

1.   The openIMIS Initiative is strengthened (through new members and
      capacities built).

2.   The openIMIS software is further developed with new functionalities,
      and in-line with security standards.

3.   The introduction of openIMIS is prepared in selected partner countries

Resultados

Resultados previstos:  

1.   Internationally relevant organisations are represented
     in the Steering Group meetings.

2.  Capacities on implementing openIMIS are strengthened.

3.  Regular updates of the openIMIS software are made available.

4.  The number of overall openIMIS implementations is increasing


Resultados de las fases anteriores:  

-    In Tanzania 6279 health facilities uses IMIS to identify CHF clients and
     submission of claims. More than 800’000 actively insured members by      the end of 2019. OpenIMIS is currently implemented nation-wide.

-    In Nepal 870’000 persons are insured using OpenIMIS, covering
     35 districts. USD 5.2 million have been paid back to health facilities.

-   The master version of IMIS was released as open-source software
    under a General Public License in 2018.

-   Co-funded by BMZ and SDC, the global openHIMIS initiative was
    launched in 2016. Since then, the software is regularly updated and
    adapted by a community of practice.

-   Pilot initiatives have been conducted in various countries in order
    to adapt openIMIS to local needs.


Dirección / Officina Federal responsable COSUDE
Crédito Cooperación al desarrollo
Contrapartes del proyecto Contraparte del contrato
Institución estatal extrangera


Otras contrapartes
German Federal Ministry for Economic Cooperation and Development (BMZ); Social Protection Systems Programme of the European Union (EU-SPS)
Coordinación con otros proyectos y actores Providing for Health (P4H), Health Promotion and System Strengthening Project (HPSS)
Presupuesto Fase en curso Presupuesto suizo CHF    2’510’000 Presupuesto actual suizo ya emitido CHF    805’000
Fases del proyecto Fase 2 01.09.2020 - 31.08.2023   (Fase en curso) Fase 1 01.06.2016 - 31.03.2021   (Completed)