AI is already changing our lives in so many ways, but how can we unlock its true potential to revolutionize health insurance in partner countries? To discuss and learn about this topic, representatives from Cambodia, Nepal, Tanzania, Kenya, Ghana and Nigeria have been working together over the last 3 months, throughout an online learning exchange and a subsequent transfer workshop in Nairobi, Kenya. While being guided by AI trainers, the 12 participants from Health Insurances, National Health Insurance Authorities and Social Security Agencies exchanged on concrete opportunities and challenges in their country settings. With their reflections and conclusions they contributed to generate an e-learning course on AI in Health Insurance Claims Management & Fraud Control, which will be open to public after its launch in summer 2025.

The Bhela call provides the stage to share country cases on AI in Health Insurance from Nepal, Cambodia and Tanzania with the openIMIS community. The Country cases will be presented by colleagues from supporting GIZ bilateral programmes: Purushottam Sapkota (Nepal), Rahma Mshana (Tanzania) and Sengchheang Chhun (Cambodia).

 The learning exchange and workshop have been organised by Amref Health Africa & ICD Amref, with support through GIZ Global Alliances for Social Protection. A 2nd cohort of this Amref-GIZ activity is currently being prepared.

For more info check out GIZ-Amref Learning Exchange on AI in Health Insurance

Co-ordinates

Date: 02 April 2025

Time: 10.00 AM (UTC +1)

Room: MS Teams  Join the meeting

Participants: (kindly only add yourself, not others):

• @El Pacific Binagha

• …

Schedule

Testimonials from Q&A:

Question by Simona Dobre (AI trainer) after introduction of country cases Nepal, Cambodia, Tanzania:

How can you leverage the collaboration between Nepal, Cambodia and Tanzania after the learning exchange in order to advance your work in the AI domain?

• Mr. Sengchheang Chhun, GIZ bilat. Program Cambodia: “The lessons learnt and benefits of collaborating with other countries became obvious through the learning program already, thanks to openIMIS and Amref. We have most of the time exchanged on the 2 countries, especially Nepal and Cambodia, in terms of how Nepal achieved the implementation of AI, but also obstacles on the way such as data quality and challenges in deployment of AI to the production system. We were keen to learn how to support and guide the government as the operator of the health insurance. Moving forward, we of course need to think through the next steps for Cambodia and we will surely keep on exchanging with the Nepal team and the trainers of the learning program.”

• Ms. Mhsana, GIZ bilat. Program Tanzania: “I can see the potential of the Tanzania team collaborating with our Nepal colleagues, especially on claim adjudication and machine learning algorithm. If it is possible, we would like to replicate the solution used in Nepal by using Tanzania National Health Insurance data to train the model.”

• Mr. Purushottam Sapkota, GIZ bilat Program Nepal: “Happy to help Cambodia and Tanzania! We are here and ready to support.”