Cameroon - BEPHA / Implementation Details

Overview on the ground

In 2013, Bamenda Ecclesiastical Provincial Health Assistance (BEPHA) Cameroon decided to customize IMIS, developed in Tanzania, to manage its insurance schemes in various dioceses. BEPHA Cameroon received IMIS and its complete source code for customization through a bilateral agreement, including a no-cost license, from the Swiss Development Cooperation. Swiss TPH has been supporting the system’s technical implementation by BEPHA including initial customization, system setup and user training. At present, only the web-based component of the system is in use but a pilot for the mobile phone component is expected to begin shortly.

Each of the five diocese-level schemes (across North West and South West regions) has teams that use the system for beneficiary enrollment and claims management. All data entry is currently done at the Diocesan office, and BEPHA agents are present at some health facilities to support client verification and claims processes. 

Configuration

Each scheme involves different products for different client groups (at least three per scheme), but there is a tendency to harmonize a single benefit package across all schemes (variations might still exist during the transition period). The harmonized benefit package covers:

·       Contribution: 5,000 FCFA per person

·       Benefit package: an individual within a year of enrollment can claim for up to 3 outpatient consultations (each up to 15,000 FCFA), 1 surgery (up to 70,000 FCFA), 1 delivery (up to 15,000 FCFA), 2 hospitalizations (each up to 25,000 FCFA) and one ante-natal check-up (up to 10,000 FCFA)

·       Co-payment of 25% is paid by insured members and the rest is covered by the scheme without an exchange of cash

·       Services provided only by health facilities empanelled with the scheme operator(including private, charitable and government facilities)

System set-up

1. Central Server

2. Hosted in the cloud

3. Server firewall

4. Back-up to another cloud server

5. Windows Server 2012

6. Microsoft SQL Server 2017

7. Dedicated development/training server (also hosted in the cloud)

8. Only web interface is used for management of all data

9. Android phones for enrolment, renewals, enquiry and claims submission - to be piloted for use by agents and health center staff

10. IT team: Exact Software Ltd. (basic maintenance support on application remotely), 1 systems administrator and local data entry operators