Open source Health Insurance Management Information System (openHIMIS)


Many middle- and low-income countries strive to set up or expand national, district- or community- based health insurance schemes. For effective business processes bigger schemes require appropriate health insurance information management systems. Yet, countries have insufficient capacities to set up and manage such systems. The initiative aims to develop an open source, hence affordable and cost-effective ICT-based system with no restrictions on its use, change or distribution.

Country/region Topic Period Budget
Global
Health
Health system strengthening
01.06.2016 - 31.12.2022
CHF 4'171'000
Background

Many middle- and low-income countries are striving to extend universal health coverage (UHC) to hitherto excluded citizens. UHC is defined as ensuring that all people and communities receive the quality health services they need, without being exposed to financial hardship. In order to gradually extend UHC to more population segments, many countries are (further) developing national health insurance funds as well as voluntary community or district-based health insurance schemes. However, operationalising bigger funds with national outreach and expanding smaller schemes require appropriate health insurance information management systems to facilitate effective business processes and data management. In light of the complexity behind managing beneficiaries, benefit packages and premiums, claims, accounting and finance of bigger health insurance schemes, reliable and cost-effective ICT-based solutions are indispensable.

However, most of the low and middle-income countries do not have sufficient financial and technical capacity to properly design, adapt, implement, and manage complex ICT-based systems. An innovative, affordable and cost-effective ICT solution is the development of an open source health insurance management information system (openHIMIS). Open source is a computer software with its source code made available with a license in which the copyright holder provides the rights to copy, modify, and distribute the software or its content to anyone and for any purpose. It is an explicit feature of open-source solution that it may put no restrictions on the use or distribution by any organisation or user. However, with a General Public License users may copy, modify and distribute the software under the condition that further developments are put under the same license.

Based on an innovative Insurance Management Information System which was developed and implemented in the frame of a SDC bilateral program in Tanzania, SDC aims to develop and adequately implement an open source HIMIS. Such software will enable insurance schemes to make their management more efficient, transparent and cost-effective. SDC will enter a strategic partnership with the German Federal Ministry for Economic Cooperation and Development (BMZ), the German Agency for International Cooperation (GIZ), the Swiss Tropical and Public Health Institute and other technical partners, whose combined resources present a comparative advantage with strong Swiss components and increase the chances for scalability and impact.

The intervention strategy is built around three poles that are formulated as main expected results: an open-source health insurance management information system (openHIMIS) will be developed that will be taken up, adapted and localised by governments and organisations implementing and managing health insurance schemes in low- and middle-income countries. In order for countries to use and manage the open-source solution, systemic, institutional and individual capacities will be built and strengthened. Last but not least, a thriving community of practice encompassing the system users from countries and organisations, academic institutions and the open-source licence holder needs to be established. The community will share and exchange on adapted, localised versions, as well as thematise challenges related to their implementation and management. This continuous process will steadily improve the “generic” open-source software and inform the needs in capacity strengthening at country and local level.

Directorate/federal office responsible SDC
Credit area Development cooperation
Project partners Contract partner
Foreign state institution
  • National State Institute North

Implementing partner
Multiple Local Partners

Estimated operational start of intervention (Main Credit Phase 1):

(Main Credit Phase 1):
1.11.2016 

Budget Current phase Swiss budget CHF   4'171'000 Swiss disbursement to date CHF   0
Project phases Phase 99 01.06.2016 - 31.12.2022   (Current phase) Phase 1 01.06.2016 - 31.12.2017   (Current phase)