Managing health insurance and social protection schemes.

Past and Current Partners

Digital Square (Global Goods in Health), OpenHIE (Standards for health information exchange), GovStack (Whole-of-Government Digital Platform Architecture), DCI (Standards for Digital Convergence in Social Protection), DPG Alliance

Active Countries
Nepal, Tanzania, Cameroon, Niger, Mauritania
Thematic area(s)
Health, Inclusive Growth
Open Source, Digital Public Good
Organisation Name
openIMIS Initiative

The Problem

The success of social protection schemes depends on highly efficient implementation of multiple, complex business processes. Scheme operators (Health Insurance, Social Protection) in low- and middle-income countries struggle to achieve efficiencies in these schemes when they lack access to appropriate digital technologies. openIMIS aims to solve this problem by providing the social protection institutions with a flexible, open-source solution that they can use to manage their schemes, increase efficiency and help increase the reach of Universal Health Coverage (UHC) and universal social protection (USP) to their beneficiaries. The openIMIS initiative has been working with scheme operators of various scheme types; from health insurance, accident insurance, to unconditional cash transfers since 2016.

The Solution

Digital Public Good for managing health insurances and other social protection schemes

How it works?

  • Step 1: Working with the scheme operators (public or private) to deploy openIMIS to manage the scheme.
  • Step 2: openIMIS provides various ways of enrolling people into the scheme: "digitally" for those having access or through door-to-door visits in which enrollment assistants go to rural households to collect information.
  • Step 3:Once enrolled, access to digital tools is not required for the beneficiaries to receive benefits under the scheme. Instead, beneficiaries provide their identification, which is verified by the service provider after which a service (health, cash transfer, or other) is provided. The cost for the services is reimbursed to the provider based on a claim submitted by the provider through openIMIS.
  • Step 4: Important details regarding the scheme and benefits are announced over various channels (social Media, TV, radio, etc.)
Digital X Solution OpenIMIS

Bridging the digital divide

openIMIS was designed for countries with connectivity issues. Though the main software is running on a server hosted by the scheme operator, access is possible through a mobile app even from remote places with intermittent connectivity. Additional features integrate the use of paper-based tools such as pre-printed insurance cards with QR codes to allow for unique identifiers even in offline mode.

Impact and highlights

  • Helped the Government of Nepal manage the health insurance of over 5 million beneficiaries.
  • Helped the Government of Tanzania manage the health insurance of over 3 million beneficiaries.

Plans for expansion

The openIMIS Initiative is constantly looking for opportunities to support providers of social protection schemes with new implementations through one of the many consulting firms that are part of the openIMIS developer and implementer committees.