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.

Pays/région Thème Période Budget
Monde entier
Santé
Governance
Renforcement des systèmes de santé
Technologies de l’information et de la communication (TIC)
01.09.2020 - 31.08.2023
CHF  2’510’000
Contexte

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. 

Objectifs

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.

Groupes cibles 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. 
Effets à moyen terme

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

Résultats

Principaux résultats attendus:  

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


Principaux résultats antérieurs:  

-    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.


Direction/office fédéral responsable DDC
Crédit Coopération au développement
Partenaire de projet Partenaire contractuel
Institution étatique étrangère
  • National State Institute North


Autres partenaires
German Federal Ministry for Economic Cooperation and Development (BMZ); Social Protection Systems Programme of the European Union (EU-SPS)
Coordination avec d'autres projets et acteurs Providing for Health (P4H), Health Promotion and System Strengthening Project (HPSS)
Budget Phase en cours Budget de la Suisse CHF    2’510’000 Budget suisse déjà attribué CHF    805’000
Phases du projet Phase 99 01.09.2020 - 31.12.2023   (Phase en cours) Phase 2 01.09.2020 - 31.08.2023   (Phase en cours) Phase 1 01.06.2016 - 31.03.2021   (Completed)