Session I: Summary of inputs

Enabel’s digital strategy and openIMIS

 Jan Kennis, D4D Lead Expert / Enabel

 The Belgian Development Agency Enabel took to the floor to present the initiative which is focused on 4 digital pillars  ̶  i) digital skills, ii) digital rights, iii) digital governance and iv) entrepreneurship and its link with digitalisation. Their support for digital transformation as clearly pointed out by Jan Kennis spreads across many different sectors of interest with digital health being one of their primary sectors.

Enabel supports the implementation of openIMIS in three countries: Niger, Mauritania and Tanzania (Zanzibar), through two different implementing approaches.

• On the one hand digital health components are included in (existing) health programmes. The openIMIS implementation in Niger illustrates this case.

• On the other hand, Enabel facilitates innovation in their programmes through the Wehubit (grants) programme, which allows to invest in digital social innovation in its partner countries. A presentation by PharmAccess shows the modalities of this approach.

Enabel’s openIMIS Implementation in Niger

 Doferegouo Soro, Technical Assistant in Health Financing / Enabel, Niger

The implementation of openIMIS in Niger which is supported by Enabel and implemented through the Ministry of Health and Sanitation was presented by Soro Doferegouo. He highlighted key reasons why openIMIS was the best fit for the scheme.

• The fact that it is opensource, reduces the cost of implementation and the risk of developing proprietary solution which normally will be time and cost consuming.

• The interoperable nature of openIMIS which allows it to work easily with other platforms like DHIS2. This meant reduction of the workload for the health workers.

• The adaptive feature of openIMIS which makes it suitable for several schemes. openIMIS covers the core functions of the scheme to be implemented, it fits with the goal of delivering health insurance mainly to the informal sector.

• openIMIS is still functional in areas of low or poor internet access.

Lessons Learnt from the implementation of openIMIS in Niger

Soro Doferegouo continued by outlining the lessons learned from the implementation of openIMIS in Niger. For a seamless implementation of openIMIS;

• A proper design of the desired scheme should already be put in place. “openIMIS is an IT platform which cannot replace the designing process of a scheme”.

• The support from the community especially the software developers was essential in the setting up of the openIMIS implementation.

• The involvement of local experts and other resources was also very important in the successful implementation of openIMIS in the scheme.

• It is crucial to consider the digital maturity (skills) of the end-user who will navigate through the system and support it with adequate capacity development measures.

The developers of the project team (local software developers at the Ministry of Health and Sanitation and developers under contract from BlueSquare) are part of the openIMIS Toumai - French-speaking -  community of practice. This way they can contribute to the development of the digital public good, but also find peers supporting them during further steps of implementation and scale-up.

Way Forward

The use of openIMIS is still in the testing phase till February 2022 during which any challenges such as bugs will be fixed. There is a plan to extend the use of openIMIS to two other districts and to link it to DHIS2 and openMRS in order to reduce workload for staff at health facilities. The last aspect on interoperability as pointed out by Soro Doferegouo is to advocate for the Ministry of Health to adopt the openIMIS solution in their new free health care initiative which will be launched in 2022.

PharmAccess on implementation in Zanzibar

 Heri Marwa, Country Director / PharmAccess, Tanzania

After the COVID-19 pandemic started, the government of Zanzibar decided to design a new health financing policy. The new scheme “Transforming Health Systems in Zanzibar” which is funded by Enabel and implemented through the Ministry of Health, Social Welfare, Elderly, Gender and Children has been ongoing since 2020. It covers more than 435,000 residents from 5 out of the 22 districts in Zanzibar. The government 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 utilisation 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)

Dr. Heri Marwa emphasised that Zanzibar had the chance to learn from the openIMIS implementation in Tanzania mainland and could identify the following advantages of using openIMIS for its own implementation:

• Open source approach fits with Zanzibars e-governance policy

• Easily customisable

• Easy usability even for beginners with no prior knowledge (e.g. volunteers who take over registration can handle it)

• Reduction of workload for the health workers.

• Roll-out (scale-up to more districts) is relatively cheaper, as it can be supported by mobile devices (mobile phone, tablets)

Way Forward

• Expect to scale up and cover all 11 districts in Zanzibar by July 2022.

openIMIS Coordination Desk support

Saurav Bhattarai, Advisor, openIMIS Coordination Desk / GIZ

Saurav Bhattarai starts his remarks underlining the wealth of knowledge and experience on the implementation level as demonstrated by the previous presentations: “This knowledge, the experience on the ground and the ability to share it with a community is what made openIMIS, what it is today.” To have all this knowledge shared there is a role for a community of practice. The openIMIS coordination desk facilitates and coordinates the exchange. Coordination starts from the governance structure of the openIMIS initiative.

The coordination desk of openIMIS operationalises the defined strategic direction, administrates budgets and oversees the activities of the involved working groups. It coordinates between the implementers and developers committee and facilitates the continuous exchange with users. It also maintains a lot of knowledge tools around the community e.g. wiki, website and collaboration tools. The aim of the coordination desk is to grow and foster the community. It manages new software developments, promotes the use and further development of openIMIS. The most recent of such developments is the new openIMIS anniversary release with impressive features such as the AI module for claims adjudications.

Furthermore, the coordination desk provides capacity development through our regional hubs, structured trainings, webinars and an e-learning course (to be launched in 2022) as well as ad-hoc capacity development support.

Presentation (PDF, for download)

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