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Open source health insurance software

A large proportion of people worldwide have little or no access to affordable healthcare. Many countries have no or insufficient health coverage for their population. Providing affordable and accessible healthcare for all has become one of the main priorities for many low- and middle-income countries over the recent years. Universal health coverage (UHC), including financial risk protection, is explicitly reflected as a target in the UN Sustainable Development Goals.

As there is no one-size-fits-all approach to providing healthcare for all, every country needs to develop their unique strategy, approaches and tools to achieve the goal of UHC. Taking into account the complexity of a health system as whole with all its different functions such as the provision of health care services, resource generation, financing, and stewardship, well-designed and tailored information and communication technology (ICT) must play a major role across the system. This includes the role of ICT as an essential tool for the effective management of health financing schemes but also as an instrument to further strengthen the evidence base for health policy and planning. The sustainable implementation of a comprehensive ICT infrastructure into countries’ health systems aims at an all-encompassing approach to data management.

Scenarium supported the openHIMIS initiative, a collaboration between GIZ and the Swiss Development Cooperation, with the aim of filling an existing gap in the health data management landscape. This comprises the data sphere involving patient, payer and provider. The initiative aims to advance the development, implementation and continuous improvement of a comprehensive management information system for health financing. This shall be based on open source technology that can be adopted by a variety of low- and middle-income countries and adapted to their specific needs on their path towards UHC through its modular structure and interoperability.

Thinking strategically, Scenarium provided their expertise during the inception phase by collaboratively designing a project concept and conducting an inception workshop with a wide range of representatives and stakeholders culminating in a roadmap for the initiative.

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