I           OVERALL OBJECTIVE

            To assess the feasibility of using the open source insurance management information system (openIMIS) in order to strengthen and systematize the management and monitoring of the scheme operator.

II          SPECIFIC OBJECTIVES

            1) Assess local needs and process in place, including project analysis and developing detailed understanding of workflows, roles and responsibilities; and understanding of other existing digital tools under use.

            2) Present openIMIS to stakeholders and demonstrate the functionalities, its suitability and clarify the questions to demonstrate possible implementation of openIMIS for the scheme/programme in question.

            3) Present openIMIS to interested partners, raise awareness and familiarize the various agencies with the tool, its added value and present the global approach.

            4) Develop the roadmap to pilot the tool according to the findings of the feasibility assessment

1          PREPARATORY WORK AND METHODOLOGY

1.1       Drafting and validation of the Terms of Reference for the assessment

1.2       Planning the schedule of the study

1.3       Finalizing the budget

1.4       Finalizing team composition

1.5       Organizing logistics

1.6       Adjustment of the feasibility assessment template and tools accordingly

1.7       Consultations with implementation agency for preliminary data collection and fine tuning of approach

1.8       Undertake feasibility mission (onsite/offsite)

• Remote data collection (including interaction with technical persons of the Implementation team in country)

• On site (if possible) and otherwise off site to the extent possible - additional data collection - reviews of reports and documents from the scheme

• Discussion with Project partners

• Interviews with key personnel/actors from the scheme

• Discussion with key stakeholder

• Analysis of data and operations

• Prepare presentations ( tables,diagrams,graphs) to present to key stakeholders

• Presentation of key findings

• Summarizing the results of the data collection

1.9       Compilation of finding and report writing

1.10     Revision based on feedback and submission of final feasibility assessment report

2          SCOPE OF THE ASSESSMENT

2.1       Assess the current state of the scheme operator

2.1.1    Understanding schemes structure and functions

2.1.2    Understanding of legal and institutional environment relating to implementation of openIMIS

2.1.3    Understanding principal processes within the scheme and products managed

• Assess principal processes of registration, enrolment, submission and processing claims

• Assess principal processes of premium collection and cash benefit payment

2.1.4    Assessment of the application of the information system currently used

• Assess the HR but also infrastructural capacities to implement current ICT infrastructure

• Assess the level of support provided by the existing information system

• Review the current end-top-end data flow

• Identify gaps which openIMIS can plug in (stand alone or complementary to existing ICT)

• Assess current technical actors (including where available identified local IT vendors) and skills required to implement openIMIS

• Assess infrastructure needs (computers, phones, server), software, licenses (if applicable), etc. required to implement openIMIS

2.1.5    Presentation of available openIMIS solution to the main stakeholders

2.1.6    Assess compatibility of openIMIS solution with the needs of the health insurance scheme and identify its Strengths, Weaknesses, Opportunities and Threats (SWOT) features in respect to the current situation.

2.2       Map the institutional environment and costing for implementation

2.2.1    Mapping future implementation structure (structure, actors, processes and role and responsibilities)

• Identify and classify the future implementers and characterize them through their role within the system: who  will be in charge of data's collection, recording and control; in charge of maintenance

• Incorporate inputs from implementation agency to finalize implementation structure and identify various actors (including IT vendor, cellular providers, electronic payment platform providers (Banks and Tech companies, etc.)) and running cost elements (capacity building, ICT equipment, HR, etc.) needed based on the estimated coverage

• As per agreement on implementation structure and approach definition of gaps in openIMIS requiring modifications

2.2.2    Development of cost model for envisioned structure (to set it up and running cost)

2.3       Identification of key steps for implementing and rolling out the envisioned structure of openIMIS

2.3.1    Study conclusions (including recommendations on feasibility of implementing openIMIS and its sustainability)

3          FINAL ASSESSMENT REPORT

3.1       Definition of key steps for implementation

3.1.1    Model estimating the running cost of openIMIS

3.1.2    Model estimating the set up cost for openIMIS