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Country/Region | Nepal | |
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Program type | Health Insurance Scheme | |
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Current status | 62 of 77 districts in Nepal are covered by the scheme | |
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Cooperation partner | Health Insurance Board (HIB) Nepal, German Development Cooperation | |
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Implementation support | Technical Assistance: GIZ Support to the Health Sector Programme (S2HSP) & Swiss Tropical and Public Health Institute (Swiss TPH) | |
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Health scheme implemented since | | |
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OpenIMIS implemented since | 2016 | |
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Implementation Support | | |
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Name of openIMIS focal point | | |
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Participation in the last implementer committee meeting | | |
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Total number of health scheme employees | | |
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Total number of employees using openIMIS | | |
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Total number of employees not trained on openIMIS | | |
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Number of health insurance products managed by the health scheme and using openIMIS | | |
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Follow up of main indications for each product: | |
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Number of households covered | | |
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Number of insured people | | |
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Average size of a household | | |
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Household contribution amount | | |
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Individual contribution | | |
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Average amount paid for a claim | | |
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Specifications of the openIMIS used: | |
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Version | | |
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Has anything been modified (customization) | | |
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What standards are used to code services, items, diagnosis and products | | |
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Three main lessons learned by using openIMIS: | |
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One | | |
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Two | | |
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Three | | |
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Recommendations for Developers Committee: | |
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What to improve | | |
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What to add | | |
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What to remove | | |
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More information here.
Training Resources
A number of creative resources have been developed in Nepal towards building capacity of various actors on openIMIS. Following are some useful examples.
Manuals
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View file |
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name | IMIS Manual First Part.pdf |
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openIMIS Application Manual
(Part 2)
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View file |
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name | IMIS Manual Second Part.pdf |
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openIMIS
Mobile Applications' Manual
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View file |
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name | Mobile Phone Application Manual.pdf |
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Infographics
The following infographics depict the Standard Operating Procedures of the National Social Health Insurance scheme of Nepal.
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Overall SOPs
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Enrollment
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View file |
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name | ENROLMENT PROCESS.pdf |
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Health Service Utilization
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View file |
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name | HEALTH SERVICE UTILIZATION PROCESS.pdf |
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Overall SOPs (in Nepali)
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View file |
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name | Short Overall System.pdf |
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Health Service Utilisation
(in Nepali)
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Enrollment (in Nepali)
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Change family details (in Nepali)
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View file |
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name | Change in family detail.pdf |
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Videos
A typical Enrolment Process
Excerpt |
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Social Health Insurance in NepalScheme DesignBenefit packageContribution
Business ProcessesEnrolment Insuree verification Service provision Claiming from facilities Claim review openIMIS ImplementationCustomizationConfigurationsDeploymentUser base
Manuals |
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