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Overview

Country/Region

Ethiopia

Solution

Social Health Insurance (SHI)

Program Operator

Ethiopian Health Insurance Agency (EHIA), under Ministry of Finance

Program type

Community-based Health Insurance (Government run Voluntary Health Insurance programme)

Implemented since

pilot 2021 (tbc)

Implementing Partner(s)

m4h in consortium with HISP (South Africa)

Supporting Partner(s)

Financial Assistance: European Commission (EU), commissioned by Ethiopian Ministry of Finance

Version

Functionalities used

  • ..

Coverage

Pilot implementation in Tigray Woreda (Tigray District), Kilite Awelaelo

Number of beneficiaries

49.301 beneficiaries enrolled (9.413 households), 23.409 beneficiaries served

Note

Number of users

Number of health facilities

20 Kebeles (….), 7 Health Centers, 3 Hospitals

Last update

January 2025 (based on presentation of Ethiopia delegation during study tour to Nepal)

Scheme Features

Health scheme implemented since

2021 (tbc)

Name of openIMIS focal point

 

Total number of health scheme employees

Total number of employees using openIMIS

 

Total number of employees not trained on openIMIS

 

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

 

Product Features

Number of households covered

9.413

Note

Average size of a household

xxx is the national average and in xxx family up to y members are enrolled for the set contribution amount

Household contribution amount

xxx per household

Individual contribution

n/a

Average amount paid for a claim

Last Update

Specifications of the openIMIS used:

Version

Has anything been modified (customization)

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

Implementation details

Context info: https://m4health.pro/project/digitalisation-of-health-insurance-services-in-ethiopia/

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