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Overview

Country/Region

Tanzania - Mainland

Scheme Operator

President’s Office Regional Administration and Local Government (PORALG)

Scheme type

Community Health Fund (Government run Voluntary Health Insurance programme)

Implemented since

2012

Implementing Partner(s)

Swiss Tropical and Public Health Institute (https://openimis.atlassian.net/wiki/pages/resumedraft.action?draftId=835682333 )

Supporting Partner(s)

Financial Assistance: Swiss Agency for Development and Cooperation

Version

v1.5.1 (build 2021.4.12.1030)

Functionalities used

  • Beneficiary Management

  • Claims Management

  • Claims Review

  • Reports

Coverage

26 regions

Number of beneficiaries

3,092,118

Note

4,560,657 individuals registered in CHF-IMIS till date.

Number of users

43,000

Number of health facilities

6,270

Last update

July 2021

Scheme Features

Health scheme implemented since

2001

Name of openIMIS focal point

 

Total number of health scheme employees

Structure: Currently 2 full time at national level + 26*3 positions per region (some full but mostly part time) + 183*3 positions per district (some full but mostly part time) + 1 EO per village (commission based - currently over 16,000)

Total number of employees using openIMIS

 Over 22,000 user accounts (each staff above and over 6000 health facility staff claim admin accounts)

Total number of employees not trained on openIMIS

 

Number of health insurance products managed by the health scheme and using openIMIS

 26 (1 per region)

Product Features

Number of households covered

312,033

Note

622,804 families registered in CHF-IMIS till date.

Average size of a household

4.9 is the national average and in iCHF family up to 6 members are enrolled for the set contribution amount

Household contribution amount

30,000 TZS per household (150,000 TZS in Dar es Salaam)

Individual contribution

n/a

Average amount paid for a claim

Last Update

July 2021

Specifications of the openIMIS used:

Version

v1.5.1 (build 2021.4.12.1030)

Has anything been modified (customization)

Many features continue to be added and provided in the Github repository for Tanzania

What standards are used to code services, items, diagnosis and products

ICD 9 originally and then shifted to ICD 10 since 2019.


Overview on the ground

IMIS was originally developed in Tanzania (2012) under the SDC funded Health Promotion and System Strengthening (HPSS) project implemented by the Swiss Tropical and Public Health Institute ( Swiss TPH ). The systems development in Tanzania is ongoing. The system was initially piloted in one region but later expanded to 26, so that all regions in the mainland Tanzania are now using openIMIS.

The implementation project from SwissTPH has supported the government roll-out of IMIS in all  regions of the Tanzanian mainland. All regions in Tanzania have been asked to implement the new iCHF (Improved Community Health Funds) model in the country using CHF IMIS as the IT backbone for running CHF operations. All components of openIMIS (online, offline and android applications) are being used in the implementation. The country continues to develop the system based on stakeholder needs and is working to integrate openIMIS into its IT landscape. 

The server is installed and maintained by PORALG and the project team supports the government’s roll-out and implementation activities. Each region (initially district) operates its own CHF scheme through openIMIS. Enrollments and renewals are handled by village-based enrollment officers. Each health facility (existing staff) undertakes verification and claims submissions for the patients they treat and regional-level teams then manage payment to each facility.

Scheme Details

National Product (some variations exist e.g. in Dar es Salaam):

  • Contribution: 30,000 TSH for a family of 6

  • Benefit Package: All services offered at government health facilities (dispensaries, health centers and hospitals)

  • No co-payment required

  • Cashless system for beneficiaries

System Deployment

  • Central Server

    • Hosted at and managed by PORALG (Dodoma)

    • Server firewall

    • Back-up in recovery site in Dar es Salaam

    • Windows Server 2016

    • Microsoft SQL Server 2016

    • Dedicated Virtual Machine (VM) for Web Server (Web Application and Web Services)

    • Dedicated VM for database server

    • Dedicated VM for AR IMIS server

    • Dedicated VM for development and training

  • Android phones for enrollment and renewals; used by enrollment assistants

  • Claims submitted to CHF through web interface, Android phones or on paper (subsequently entered through web interface by CHF staff) by health facilities

  • IT team: Exact Software Ltd. (Programing team of 2 - 5 junior programmers, 3 senior programmers/Project Manager), Swiss TPH/HPSS project team (Product Manager, Systems Architect, Senior Insurance Informatics Specialist, IT Systems Analyst and regional IT officers)

Integration and interoperability

The system is currently being integrated with other government systems including:

·       SMS gateway solution to allow enrollment, renewals and payment confirmations to clients.

·       GEPG (Government e-Payment Gateway) solution. 

·       USSD gateway for mobile requests (enquiring, renewal, request control numbers for mobile or bank payments).

Discussions are ongoing for integration of IMIS with the government's GoTHOMIS (Government of Tanzania Hospital Management Information System) system to link health facility claims coming directly to IMIS, as well as the CHF accounting system. In the next phase of the project, integration with other systems will be undertaken based on government-identified priorities.

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