DRC

Overview

Country/Region

Democratic Republic of Congo (DRC)

Solution

Health Insurance

Program Operator

Réseau des mutuelles de Santé Communautaires (RAMESCO), Réseau d’appui des Mutuelles de Santé (RAMS), Mutuelle de Tushikiri Afia Yetu

Program type

community-based health insurance

Implemented since

2017

Implementing Partner(s)

Swiss TPH, GIZ InS

Supporting Partner(s)

Financial Assistance: Swiss Agency for Development and Cooperation

Version

-

Functionalities used

  • Beneficiary Management

  • Claims Management

  • Claims Review

  • Reports

Coverage

South Kivu

Number of beneficiaries

-

Number of users

-

Number of health facilities

-

Last update

July 2021

Scheme Features

Health scheme implemented since

-

Implemented since

2017

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

-

Health facilities using openIMIS

-

Product Features

Number of households covered / Nombre de familles couverte

-

Number of households covered / Nombre de familles couverte

-

Average size of a household / Taille moyenne d’une famille

-

Household contribution amount / Cotisation par famille

-

Individual contribution / Cotisation individuelle

-

Average amount paid for a claim / Somme moyenne payé pour une prestation

-

Specifications of the openIMIS used:

Version

-

Version

-

Has anything been modified (customization)

-

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

-

 

More information here.

 

Overview

Scheme Features / Caractéristiques du régime:

Country/Region / Pays/Région

DRC - South Kivu Region

Scheme type / Type de régime

Health Insurance Scheme

Cooperation partner / Partenaire de cooperation

Réseau des mutuelles de Santé Communautaires (RAMESCO), Réseau d’appui des Mutuelles de Santé (RAMS), Mutuelle de Tushikiri Afia Yetu

Implementation Support / Support d’implémentation

Swiss Tropical and Public Health Institute, GIZ International Service (InS)

Health scheme implemented since / Le régime de santé implémenté depuis

 

openIMIS Implemented since / openIMIS implémenté depuis

2017

Name of openIMIS focal point / Personne de contacte pour openIMIS

 

Total number of health scheme employees / Nombre d’employés du régime de santé

 

Total number of employees using openIMIS / Nombre d’employés utilisant openIMIS

 

Total number of employees not trained on openIMIS / Nombre d’employés non-qualifiés pour openIMIS

 

Number of health insurance products managed by the health scheme and using openIMIS / Nombre de produits d’assurance géré par le régime et openIMIS

 

Product Features / Caractéristiques du produit:

Number of households covered / Nombre de familles couverte

 

Number of households covered / Nombre de familles couverte

 

Number of beneficiaries / Nombre de bénéficiaires

 

Average size of a household / Taille moyenne d’une famille

 

Household contribution amount / Cotisation par famille

 

Individual contribution / Cotisation individuelle

 

Average amount paid for a claim / Somme moyenne payé pour une prestation

 

Specifications of the openIMIS used / Spécifications de l’openIMIS utilisé:

Version

 

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

 

Two

 

Three

 

Recommendations for Developers Committee / Recommendations pour le commitée des dévelopeurs:

What to improve / Améliorations

 

What to improve / Améliorations

 

What to add / Additions

 

What to remove / Eliminations

 

 

More information here.

 

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