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Comoros - Health Insurance

Comoros - Health Insurance

Overview

Country/Region

Comoros

Solution

Health Insurance

Description

The openIMIS platform serves as the digital backbone of the Generalized Health Insurance (AMG) program, a national health financing scheme. By pooling contributions and public funding, the AMG program reduces out-of-pocket payments and aims to expand access to care for the Comorian population, especially the most disadvantaged, protecting families from financial hardship due to illness.

Program Operator

Assurance Maladie Généralisée (AMG)

Program type

Health Insurance (objective: national UHC program),

combining contributory insurance & state-funded contribution for poorest

Implemented since

July 2022, pilot phase officially launched in December 2025

Implementing Partner(s)

Consortium team

  • AEDES – lead organization

  • Swiss TPH – Health Financing and openIMIS technical expertise

Other partners

  • Y-note – IT development

  • Build-out Initiative for Development (BID) – Health Financing expertise

  • Local IT Partner: Etech

Supporting Partner(s)

Financial Assistance: Agence Française de Développement (AFD), locally managed by UTGAM (Technical Unit for Health Insurance
Management)

Version

…

Functionalities used

 

Coverage

pilot on island of Mohéli

Number of beneficiaries

Target figure: The pilot phase covers seven districts, covering 63,610 households (about 318,000 people).

 

Number of users

 

Number of health facilities

 

Status

Last update

Feb 2026

Scheme Features

Health scheme implemented since

 

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

 

Product Features

Number of households covered

 

Number of households covered

 

Note

 

Average size of a household

 

Household contribution amount

 

Individual contribution

 

Average amount paid for a claim

 

Last Update

 

Specifications of the openIMIS used:

Version

 

Version

 

Has anything been modified (customization)

  • One membership card per family
    • New facilities type: pharmacy, laboratory
    • Some services require pre-authorization
    • Claim review will be done by FENAMUSAC

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

 

 

 

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