Overview
Scheme Features / Caractéristiques du régime:
Health scheme implemented since / Le régime de santé implémenté depuis | 2008 |
|---|---|
openIMIS Implemented since / openIMIS implémenté depuis | 2013 |
Name of openIMIS focal point / Personne de contacte pour openIMIS | Atohmbom Yuh George |
Total number of health scheme employees / Nombre d’employés du régime de santé | 50 |
Total number of employees using openIMIS / Nombre d’employés utilisant openIMIS | 10 |
Total number of employees not trained on openIMIS / Nombre d’employés non-qualifiés pour openIMIS | 15 |
Number of health insurance products managed by the health scheme and using openIMIS / Nombre de produits d’assurance géré par le régime et openIMIS | 5 |
Product Features / Caractéristiques du produit:
Number of households covered / Nombre de familles couverte | 5655 |
|---|---|
Average size of a household / Taille moyenne d’une famille | - |
Household contribution amount / Cotisation par famille | N/A |
Individual contribution / Cotisation individuelle | 5,000 FCFA |
Average amount paid for a claim / Somme moyenne payé pour une prestation | - |
Specifications of the openIMIS used / Spécifications de l’openIMIS utilisé:
Version | - |
|---|---|
Has anything been modified (customization) / Modifications | - |
What standards are used to code services, items, diagnosis and products / Quels standards sont utilisés pour coder les services, médicaments, diagnostiques et produits | - |
Three main lessons learned / Trois leçons principales tirées:
One | A digital tool to support the implementation of an insurance scheme is indispensable |
|---|---|
Two | A comprehensive digital tool like the openIMIS greatly improves on a responsible financial management |
Three | Need for continuous capacity building |
Recommendations for Developers Committee / Recommendations pour le commitée des dévelopeurs:
What to improve / Améliorations | Improve on a simplified method on the installation and implementation of the offline version of the openIMIS |
|---|---|
What to add / Additions | Need to be able to generate and print beneficiary cards from the openIMIS |
What to remove / Eliminations |
Overview on the ground
In 2013, Bamenda Ecclesiastical Provincial Health Assistance (BEPHA) Cameroon decided to customize IMIS, developed in Tanzania, to manage its insurance schemes in various dioceses. BEPHA Cameroon received IMIS and its complete source code for customization through a bilateral agreement, including a no-cost license, from the Swiss Development Cooperation. Swiss TPH has been supporting the system’s technical implementation by BEPHA including initial customization, system setup and user training. At present, only the web-based component of the system is in use but a pilot for the mobile phone component is expected to begin shortly.
Each of the five diocese-level schemes (across North West and South West regions) has teams that use the system for beneficiary enrollment and claims management. All data entry is currently done at the Diocesan office, and BEPHA agents are present at some health facilities to support client verification and claims processes.
Configuration
Each scheme involves different products for different client groups (at least three per scheme), but there is a tendency to harmonize a single benefit package across all schemes (variations might still exist during the transition period). The harmonized benefit package covers:
· Contribution: 5,000 FCFA per person
· Benefit package: an individual within a year of enrollment can claim for up to 3 outpatient consultations (each up to 15,000 FCFA), 1 surgery (up to 70,000 FCFA), 1 delivery (up to 15,000 FCFA), 2 hospitalizations (each up to 25,000 FCFA) and one ante-natal check-up (up to 10,000 FCFA)
· Co-payment of 25% is paid by insured members and the rest is covered by the scheme without an exchange of cash
· Services provided only by health facilities empanelled with the scheme operator(including private, charitable and government facilities)
System set-up
Central Server
Hosted in the cloud
Server firewall
Back-up to another cloud server
Windows Server 2012
Microsoft SQL Server 2017
Dedicated development/training server (also hosted in the cloud)
Only web interface is used for management of all data
Android phones for enrolment, renewals, enquiry and claims submission - to be piloted for use by agents and health center staff
IT team: Exact Software Ltd. (basic maintenance support on application remotely), 1 systems administrator and local data entry operators