Fondation Pierre Fabre

IMIS aims to professionalise health insurance in South Kivu, providing it with an information system

Main beneficiary countries:
Tanzania - Nepal - Cameroon - Congo - Kinshasa

About the sponsor

Swiss Tropical and public health institute (Swiss TPH)

Swiss Tropical and Public Health Institute is a world leader in the field of healthcare, and is especially dedicated to low- and middle-income countries. It offers research, services, education and training to improve health and well-being through a better understanding of diseases and healthcare systems. From the laboratory to the clinic, through a cross-cutting approach encompassing innovation, validation and application, the Institute aims to provide new diagnoses, treatments and vaccines directly to individuals and communities. Each stage of the approach is marked by a spirit of mutual learning, in collaboration with partners in more than 100 countries. More than 800 employees and students work at Swiss TPH on infectious and non-communicable diseases, environmental and social health, as well as healthcare systems and interventions. Their expertise extends from the laboratory to the field, from theory to practice, from molecular to spatial, and from genes to healthcare systems. As a department of Swiss TPH, the goal of SCIH is to strengthen healthcare systems and improve access to health services in low- and middle-income countries, paying special attention to vulnerable groups.

Sector: Organizational: Communities, public authorities, NGOs, associations, foundations, etc.

Country of origin: Switzerland

The organisation has:

0
Full-Time Equivalent
26
Employees
0
Volunteer
5
Service providers

Initiative overview

Healthcare themes targeted

  • Primary healthcare
  • Healthcare from health-centre level to the referral hospital

Stage of development:

  • Pilot project/testing/trials

Area where initiative is utilised

  • International (in several countries)

Initiative start date

  • 04/03/2017

Financing

Financing method

  • Public (grant/subsidies, call for proposals/call for tender, etc.)

Economic model(s)

  • Subsidies

About the initiative

The initiative addresses issues related to the quality of data collection, the transparency of financial transactions and weakness in fraud control encountered by insurance systems that still operate with “paper-based procedures”.

Few benefits of IMIS:

  • It’s a comprehensive system for managing a health insurance scheme (enrolment, renewal, claims management, feedback, reporting)
  • It provides a way to standardize operations of a health insurance scheme while starting up as well as for scaling up across multiple sites
  • It uses easily accessible technology (android mobile phones) – easy to implement, scale and further innovate
  • IMIS targets specifically the challenges of informal sector schemes, both urban and rural
  • it takes processing closer to clients (cuts down transaction time), applies a cost effective mechanism for establishing identity and eligibility, and supports an ‘active’ enrolment structure 
  • IMIS is able to operate multiple products, multiple insurance models, multiple structures, and multiple business rules, with the possibility to implement verification mechanisms, etc.
  • On line and offline (both computer and mobile phone) capability to adjust to available infrastructure
  • The system is managed through a central server which can allow for gradual roll out (geographically or feature wise) in a modular way; and for centralized or decentralized management of schemes
  • The system allows “portability” for clients (e.g. clients from district A can utilize the membership card also in District B, and claims are charged to the “home” district)
  • The license is open source.

The implementation of the IMIS pilot in the Democratic Republic of Congo (DRC) is part of Phase III of the Health System Support Programme, PASS South Kivu funded by the Swiss Cooperation (SDC). Swiss TPH and GIZ were commissioned to implement the project with similar roles, but in different areas. Towards the end of Phase III, it was decided to allocate part of the budget to strengthen community health insurance through a project to revitalise health insurance. Thus, the establishment of an information system has been identified as the priority to strengthen the development of health insurance in South Kivu, by:

  • strengthening improvement of operational procedures management
  • making data more reliable for risk monitoring for better knowledge and adaptation of the insurance product
  • providing more transparency regarding the management of affiliation, contribution and reimbursement data by each promoter.

In April 2017, a team of three consultants from Swiss TPH was commissioned to set up IMIS in six healthcare zones in South Kivu, with a limited pilot focusing on the configuration of systems, the test of affiliation registration and the encoding and validation of repayments. Implementation of the pilot began in April with eight insurance mutuals, with a first mission in June 2017 to set up the system and train the users. It will be finished by the end of December 2018. The PASS project is entering its final phase. For the moment, investment continuity for the implementation of IMIS remains uncertain while local partners are interested in continuing development and extending the pilot to insurance mutuals in their network. Thus, financial and technical assistance is needed to maintain continuity in the development of this project.

Fields of application:

Financial access to care, microinsurance

Target audience

  • Entire population
  • Insurance mutual project staff and health authorities under the Ministry of Health and Welfare

Initiative objectives

  • Reduce poverty and impoverishment, by including a broader and poorer segment of the population in the social protection system.

Key figures

16000 Number of beneficiaries since launch

Materials used

  • Smartphone
  • Computer

Technologies used

  • Internet
  • Mobile app (Android, iOS, Windows Phone, HTML5, etc.)

Offline use

Yes

Open Source

Yes

Open Data

No

Independent evaluation

No

Partners

REMUSACO Réseaux de mutuelles de santé

Organizational: Communities, public authorities, NGOs, associations, foundations, etc.

BDOM Uvira

Organizational: Communities, public authorities, NGOs, associations, foundations, etc.

Mutuelle de Tushiriki

Organizational: Communities, public authorities, NGOs, associations, foundations, etc.

Partners

Collaborators

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