Open source Health Insurance Management Information System

Worldwide 100 million people are pushed into poverty every year because of health-related out-of-pocket payments, and 150 million suffer from catastrophic health expenditure. 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.

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.

Main direct beneficiaries of openHIMIS will be social health protection schemes in low- and middle-income countries since it will help them better manage their business operations. Ultimately, scheme members, including poor populations working in the informal sector, will benefit from well managed funds and schemes as HIMIS will enable the latter to e.g. calculate different types of benefit packages tailored to the needs of the respective client groups.

1. Open source Health Insurance Management Information system or specific modules are adapted and implemented in countries, and integrated into national ICT health information systems.
2. An active community of open source developers continuously advances the openHIMIS software core, modules and country specific adaptation in exchange with software users.
3. In-country capacities are strengthened in order to adapt, utilise and maintain the open-source software according to country-specific needs.

Expected results:  

1. The openHIMIS source code is publically accessible under an open source license for country-specific customisation (by January 2017).
2. Modular and interoperable HIMIS is developed on an open-source technology platform.
3. Communities of open source software developers and users are established (by mid-2017).
4. A feedback exchange between developers and users is facilitated regularly.
   Local capacities are built up in customising, implementing and managing openHIMIS.

Results from previous phases:  

OpenHIMIS will be based on innovative Insurance Management Information System (IMIS), developed in the context of a SDC bilateral programme in Tanzania and replicated in Nepal and Cameroon. In the Tanzanian pilot region, the cumulative coverage rate of the supported district-based health insurance schemes increased from 4% to 23% of the population in only four years, also thanks to the new system.

During the entry phase a master version of IMIS was created based on the three existing country versions. It will be released as open-source software under a General Public License by January 2017. Moreover functional requirements for further developing the master version to a modular and interoperable open-source software solution were defined. Finally, a road map for the openHIMIS initiative was developed.

German Federal Ministry for Economic Cooperation and Development (BMZ); Social Protection Systems Programme of the European Union (EU-SPS)

Providing for Health (P4H), Health Promotion and System Strengthening Project (HPSS)

Phase 1 01.06.2016 - 31.03.2021   (Completed)