The Democratic Republic of Congo / Health Insurance

The scheme in context

Community-based insurance schemes, known as mutuelles, are supported by provincial health officials in South Kivu as a way to boost utilization of health services in rural areas. In exchange for a modest monthly contribution, members of households registered with a mutuelle are entitled to primary health care services at any health center or hospital in the network.

How the scheme uses openIMIS

Since 2017 openIMIS has been used to manage enrollment, premium collection, identification and claims processing management for nine mutuelles. Staff at the mutuelles use the web-based user interfaces of openIMIS to check the insurance status of beneficiaries, to submit reimbursement requests and to prepare reports about the operation of the scheme. 

Swiss TPH and GIZ International Services provide technical support for the implementation of openIMIS, with funding from the Swiss Agency for Development and Cooperation.