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Institutional context
Community-based insurance schemes, known as mutuelles, are supported by provincial health officials in South Kivu as a way to boost utilisation of health services in rural areas. In exchange for a modest monthly contribution, members of households registered with a mutuelle are entitled to primary health care services at any health center or hospital in the network.
How the scheme uses openIMIS
Since 2017 openIMIS is used to manage enrolment, premium collection, identification and claims processing management for 9 mutuelles. Staff at the mutuelles use the web-based user interfaces of openIMIS to check the insurance status of beneficiaries, to submit reimbursement requests and to prepare reports about the operation of the scheme.
The Health System Support Program (Programme d'Appui au Système de Santé dans la Province du Sud Kivu - PASS), funded by the Swiss Agency for Development and Cooperation (SDC), has provided technical support for the implementation of openIMIS.
Full project scope