Tanzania (Zanzibar) / Health Insurance

iStock/Zeljko Santrac

The scheme in context

The Revolutionary Government of Zanzibar (RGoZ) is committed to providing quality health care for all its citizens with the goal of achieving Universal Health Coverage. Since 2019 PharmAccess has been working with the Ministry of Health Social Welfare, Gender Elderly and Children (MoHSWGEC) of Zanzibar to support the review of its health financing model, the establishment of quality improvement structures and the implementation of digital health strategies.

To improve the efficiency of resource allocation, the Government of Zanzibar developed a digital health strategy to make data available in a timely manner and improve transparency, efficiency and effectiveness of the health care delivery process. One element of this is the digitalization of health utilization data and the establishment of a national client registry.

How the scheme uses openIMIS

The Government of Zanzibar agreed to use openIMIS to do the following:

Register all the residents in Zanzibar (about 1.6 million residents) and provide each resident a unique identification number.
Collect utilization data at facility level. With these, supplies delivered to facilities will be easily tracked as well as the services provided.
Collect household socio-economic data (e.g. supporting eligibility criteria definition for certain health services in the future)

The customization and initial set up of openIMIS are both configured to enable end users to access the system on the web and on mobile devices. Community Health Volunteers (CHVs) are trained to use the App installed on mobile phones to collect demographic, poverty mapping data and other enrollment details of the household members. Up on completion of enrollment the CHV issues a card with unique identification number, known as Kadi ya Matibabu. This card has a QR code and is used to identify the holder when seeking services at a health facility. With this approach, it is possible to collect utilization data at each facility, to determine the type of services provided, socioeconomic characteristics of those using the service, and total cost of services provided. It also identifies areas of under or overuse of services.

From February 2022, as part of the process to support establishment of a functional Zanzibar Health Services Fund (ZHSF), the government of Zanzibar in collaboration with PharmAccess Tanzania will customize the openIMIS to accommodate requirements for health insurance management. To align with the government’s plans to enroll the formal sector by April 1^st, the initial plan is to start with registration of formal sector employees by March 2022.

Full project scope

To learn more about the implementation of openIMIS, including the configuration and system set up, visit the wiki page

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