International Labour Organisation, Nepal office

Background info:

• Social Security Fund (SSF) Nepal was established in 2011, but practically activities at SSF only started in 2017, originally the IT system was designed before even the schemes were designed

• ILO has been working with SSF and Ministry of Labour, supporting Social Security Fund (SSF) Nepal in digitalisation of social protection schemes - providing technical assistance in different areas:

  • 2015-2018: during formation of the system and design of the schemes;

  • forming internal procedures based on the design of the schemes to start implementing them

  • Since 2020 Nepal is part of a global project in partnership between ILO, EU and UNICEF on social protection finance management, which works in 8 countries to support different areas of social security; iIn Nepal ILO is very focused on supporting the SSF and working on the schemes for the formal sector; UNICEF is focused on child grants (girls insurance scheme to ensure girls go to school until they graduate)

  • ILO with SSF has been engaging in systems review, business process support; after the operations started production of communication material for awareness raising; support in design of schemes for informal sector (voluntary) including costing of the scheme

• “Strengthening Social Protection Management Information Systems (MIS) Findings from a Systems Review of the Social Security Fund, Nepal” Systems Review of the Social Security Fund, Nepal, Briefing note | 26 January 2022, by ILO https://www.ilo.org/kathmandu/whatwedo/publications/WCMS_835843/lang--en/index.htm , based on the “Systems Review Report: Technical Assistance to SSF on Systems Review,” by Pudashine, Kumar

Discussion, Q&A

Supporting scheme design and openIMIS implementation for formal and informal sector

• with the systems review and the outlook of an increasing number of registration ILO could also provide recommendations e.g. taking the chance to look at enhanced IT systems – pointing at openIMIS

• ILO could refer to existing implementation of openIMIS in Nepal for health insurance claims management and for the employment injury insurance scheme at SSF, the idea was to go beyond the existing utilisation of openIMIS to also use it for registration / beneficiary management and payment functionalities

• As part of a comprehensive system analysis these options of expanding utilisation of openIMIS were looked at

• After planning of openIMIS implementation (for extended functionalities) ILO undertook a business process mapping – where they see chances to improve the efficiency of the scheme and robustness of some processes (e.g. compliance, payment of contributions) while implementing the software

• Support in scheme design for employment injury insurance (EII); cooperation with GIZ bilateral programme on implementation; regarding utilisation of openIMIS for employment injury insurance ILO conducted a business process review

• ILO work with openIMIS has started with new project to expand use of openIMIS beyond the employment injury insurance

• “Extending contribution-based social security schemes for workers in the informal economy and self-employed in Nepal”; report | 23 February 2023

https://www.ilo.org/kathmandu/whatwedo/publications/WCMS_869013/lang--en/index.htm

Extension of openIMIS to cover all business processes

• all Social Security Fund schemes are managed IT-based

  • working with 3(-4) layers of systems: presentation layer, business layer, integration layer and data layer

  • public portal can be accessed by employer and contributor, also via mobile app

  • some Electronic Health Record (EHR) systems have been integrated with SSF scheme IT system; EHR for 46 hospitals integrated

  • integration layer covers e.g. payment system, mobile wallet, Electronic Health Record / Medical Record system, openIMIS

  • regarding interoperability: all these systems in the integration layer have their own specific purpose with regards to business processes e.g. openIMIS currently only used for claim management, SSF has their own beneficiary management system (SoSys), which is exchanging data with openIMIS, using FHIR API to integrate

• ILO is supporting SSF with an IT team and technical advice to help converting all business processes from existing systems to openIMIS

Challenge of fragmented social security system in Nepal

• social protection schemes are overseen by different ministries (eg. Health Insurance Board schemes for informal sector by Ministry of Health, Social Security Fund schemes for formal sector by Ministry of Labour); these ministries and their respective implementing agencies have different mandates

• regarding informal sector health insurance scheme by HIB and now by SSF now overlap can be seen; until recently the overlap was not very obvious as SSF was mainly focused on the formal sector, HIB was working mainly with the informal sector;

• policy level and implementing agencies acknowledge the challenge of fragmentation and risk of overlaps

• recently an integrated social protection framework has been formalised by the National Planning Commission (NPC), not formalised yet by the Cabinet

• adequate timing for integration – with eye mark on progress / situation of HIB and SSF would be important; would need leadership from the highest level as providers see each other as competitors

• role sharing and complementary approaches between public and private health insurance not established yet as concept of health insurance overall is still young

• recommendation to develop a multi-tier scheme between SSF schemes and Employment Provident Fund, EPF (for employees from public sector / civil service), to have schemes building on each other e.g. for pension schemes

… on the role of ILO in awareness raising for formal sector schemes:

Question: Do you see there is more need to convince the employers or the employees

• background: idea of contributory social security is still very new in Nepal

• ILO conducted employers’ perception survey; ‘hurdle’ for employers to join SSF less concerns on cost (paying share of the contribution), but rather general awareness on existence and benefits of schemes are

• therefore ILO support on robust outreach work eg. produce videos and material that can be disseminated broadly, work with employers and workers association to basically orient them on social security contributions, discussing and introducing the fundamentals of social security

• on employee side there is a special of employees in financial sector who receive attractive benefit packages (as part of the salary) who might be more difficult to convince of benefits of additional health insurance scheme

• growing service-oriented thinking at SSF can be observed in efforts to establish offices in provinces

… on the role of ILO in the design of the scheme for (in)formal sector (level of consultation)

• ILO conducted a costing analysis for the informal sector schemes and provided recommendations on the benefit packages

• “Extending contribution-based social security schemes for workers in the informal economy and self-employed in Nepal”; report | 23 February 2023

https://www.ilo.org/kathmandu/whatwedo/publications/WCMS_869013/lang--en/index.htm

• one of the key challenges for SSF schemes in formal and informal sector is outreach beyond Kathmandu Valley – to reach remote areas and people decentralisation of services by SSF is important;

• for work in the informal sector important to engage local governments and provincial governments, for them to play a role in the operations, the outreach, act as a front desk etc. – to make SSF visible to people

Briefing on openIMIS - CORE-MIS merger and implications:

• WB since COVID19 has been developing a tool, called CORE-MIS, on unconditional cash transfers, public works and some training aspects around public works.

• with the merger decision both teams agreed to merge the functionalities of CORE-MIS, into the openIMIS software platform – in consequece openIMIS will have a broadened social protection focus – main difference / advances:

  • openIMIS supported enrolment; after the tool is merged it is possible to ingest large lists of people (e.g. survey data, excel lists), apply some kind of targeting mechanism and then assign them different social benefits like health insurance, employment injury insurance .. and in perspective also unconditional cash transfers and public works

  • big functionality push with option for the tool to act as a social registry

Participants

• Suravi Bhandary (Ms), National Project Coordinator, International Labour Organisation Nepal      

• André Felip Bongestabs (Mr), Specialist, Local Strategies for Decent Work, International Labour Organisation Nepal

• Alexander SCHRADE (Mr), Senior Policy Officer, Division Health, Social Protection and Population Policy Division / German Federal Ministry of Economic Cooperation and Development (BMZ)

• Olivier PRAZ (Mr), Senior Policy Advisor, Global Programme Health / Swiss Agency for Development and Cooperation (SDC)

• Saurav Bhattarai (Mr), Component Lead openIMIS, Programme Social Protection Innovation and Learning, Gesellschaft fuer Internationale Zusammenarbeit (GIZ)

• Konstanze Lang, Advisor openIMIS, Global Programme Social Protection Innovation and Learning, Gesellschaft fuer Internationale Zusammenarbeit (GIZ)

• Helen Witte (Ms), Technical Advisor, Support to the Health Sector Strategy / GIZ Nepal