SDG 1: No Poverty

• Target 1.3 – Implement nationally appropriate social protection systems and measures for all, including floors, and by 2030 achieve substantial coverage of the poor and the vulnerable.
  • Indicator 1.3.1 – Proportion of population covered by social protection floors/systems, by sex, distinguishing children, unemployed persons, older persons, persons with disabilities, pregnant women, newborns, work-injury victims and the poor and the vulnerable

*The Digital Public Good openIMIS supports social protection programs like health insurance, improving financial resilience for vulnerable populations.

SDG 2: Zero Hunger

• Target 2.1 – By 2030, end hunger and ensure access by all people, in particular the poor and people in vulnerable situations, including infants, to safe, nutritious and sufficient food all year round
  • Indicator 2.1.1 – Prevalence of undernourishment  
  • Indicator 2.1.2 – Prevalence of moderate or severe food insecurity in the population, based on the Food Insecurity Experience Scale (FIES)

*openIMIS can contribute to food security e.g. by linking up with climate risk monitoring systems. This integration enables timely responses to climate-related shocks, such as droughts, by delivering cash transfers or food aid, thereby ensuring vulnerable populations maintain access to adequate nutrition even during crises.

SDG 3: Good Health and well-being

• Target 3.8 – Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all
  • Indicator 3.8.1 – Coverage of essential health services

*It enhances health insurance management, ensuring better access to healthcare services and advancing universal health coverage.

SDG 5: Gender Equality

• Target 5.c – Adopt and strengthen sound policies and enforceable legislation for the promotion of gender equality and the empowerment of all women and girls at all levels
  • Indicator 5.c.1 – Proportion of countries with systems to track and make public allocations for gender equality and women’s empowerment

*By enabling inclusive health and social programs, openIMIS helps ensure women and vulnerable/targeted groups have equal access to healthcare services.

SDG 8: Decent Work and Economic Growth

• Target 8.2 – Achieve higher levels of economic productivity through diversification, technological upgrading and innovation, including through a focus on high-value added and labour-intensive sectors
  • Indicator 8.2.1 – Annual growth rate of real GDP per employed person
• Target 8.3 – Promote development-oriented policies that support productive activities, decent job creation, entrepreneurship, creativity and innovation, and encourage the formalization and growth of micro-, small- and medium-sized enterprises, including through access to financial services
  • Indicator 8.3.1 – Proportion of informal employment in total employment, by sector and sex
• Target 8.5 – By 2030, achieve full and productive employment and decent work for all women and men, including for young people and persons with disabilities, and equal pay for work of equal value
  • Indicator 8.5.1 – Average hourly earnings of female and male employees, by occupation, age and persons with disabilities  
  • Indicator 8.5.2 – Unemployment rate, by sex, age and persons with disabilities

*openIMIS supports employment injury insurance management, ensuring financial protection for workers in case of workplace accidents. By promoting its open-source software, openIMIS encourages the local private sector to adopt and customize the system, fostering innovation and business development. This enables local companies to create sustainable business models around openIMIS, boosting economic growth while enhancing workplace safety and decent work conditions.

SDG 10: Reduced Inequalities

• Target 10.1 – By 2030, progressively achieve and sustain income growth of the bottom 40 per cent of the population at a rate higher than the national average
  • Indicator 10.1.1 – Growth rates of household expenditure or income per capita among the bottom 40 per cent of the population and the total population
• Target 10.2 – By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status
  • Indicator 10.2.1 – Proportion of people living below 50 per cent of median income, by sex, age and persons with disabilities

*The system supports equitable access to healthcare and social security, reducing inequalities within countries.

SDG 17: Partnerships for the Goals

• Target 17.16 – Enhance the Global Partnership for Sustainable Development, complemented by multi-stakeholder partnerships that mobilize and share knowledge, expertise, technology and financial resources, to support the achievement of the Sustainable Development Goals in all countries, in particular developing countries
  • Indicator 17.16.1 – Number of countries reporting progress in multi-stakeholder development effectiveness monitoring frameworks that support the achievement of the Sustainable Development Goals

openIMIS thrives on a multi-stakeholder community, fostering collaboration among governments, NGOs, and international organizations (bi- and multilateral organisations, international development banks etc.) to advance health and social security systems.

• In Nepal, the Health Insurance Board (HIB) and the Social Security Fund (SSF) collectively serve over 13 million people. This way, vulnerable populations, including those in informal employment who are often excluded from conventional health insurance schemes, can receive essential health coverage.
• IMIS, adapted from the Tanzania and Cameroon implementations, was used from the very beginning to manage all core business processes of the insurance scheme – from beneficiary management to claims adjudication.
• The management of such large numbers of beneficiaries is facilitated by an open-source software called openIMIS, which supports the various processes around enrolment, verification, health service provision and claims management, and data analysis. Being open source with a strong community of practice for support, the openIMIS implementations in Nepal are successfully managed and further developed by local teams.
• The SSF manages health insurance contributions for employees, so that workers benefit from structured health protection.
• For the informal sector, which typically includes day laborers and small-scale farmers, the HIB extends health insurance services using openIMIS, effectively reducing the disparity in healthcare access and including those who are economically vulnerable.
• For both HIB and SSF, openIMIS with its Fast Healthcare Interoperability Resources (FHIR) Application Programming Interface (API) has enabled health institutions (service providers) to shorten the time between service utilization, significantly reducing paper-based administration, claim submission and and allowing claims to be processed more efficiently. Almost 70% of empanelled hospitals are already transmitting claim data from their hospitals systems onto openIMIS utilizing FHIR standards.
• An AI-supported module has been developed which an pre-check invoices daily; not only to improve efficiency, but also to ensure more timely access to care for beneficiaries, and reimbursements to health facilities.

For informal sector: looking at 24 countries – among them Nepal and HIB provided services

Extending social protection to workers in the informal economy,  Inclusive social protection for all, published in Sep 2023, weblink (PDF) https://www.social-protection.org/gimi/Media.action;jsessionid=bHQRmAcg_BLafyMbB_PsvW-1npvYumaJv4mvpdd9CSn7gB5_BLe8!-765179005?id=19387

How Nepal’s bold new social security system inspired a delegation from Bangladesh. How Nepal’s bold new social security system inspired a delegation from Bangladesh – Healthy DEvelopments

Nepal has become a hub for openIMIS implementors to gain knowledge about the system usage. Nepal has hosted multiple study tours for different countries.

Access to basic health care; Subsidized health insurance

Health Insurance Board (Nepal),

Social Security Fund (Nepal)

Standards and Interoperability Lab (SIL) Nepal

ILO Nepal

BMZ-funded bilateral program:

• Support to the Health Sector Strategy in Nepal II“ and Support to Gender Equality and Social Inclusion in the health sector (S2GESI)
• Global program„Global Alliances for Social Protection” / Gesellschaft für Internationale Zusammenarbeit

Multi-sectoral governance

Governance structure on global level:  openIMIS Initiative’s Governance Structure – openIMIS – openIMIS Wiki (atlassian.net)

openIMIS, is provided on a global level in partnership of its funders – the German Federal Ministry for Economic Cooperation and Development (BMZ), the Swiss Agency for Development and Cooperation (SDC) and the EU – with implementation partners like the International Labour Organization (ILO), the World Bank and World Food Program (WFP).

Beneficiary figures as of Sep 2024:

• Social Health Insurance (informal health insurance), nationwide in 77 (out of 77) districts / Health Insurance Board Nepal: 7.171.843 beneficiaries; Nepal – Health Insurance Board – openIMIS – openIMIS Wiki (atlassian.net)
• Social Security Scheme for formal sector (incl. employment injury insurance, pension scheme) / Social Security Fund (SSF): 6.000.000 beneficiaries; Nepal – Social Security Fund – openIMIS – openIMIS Wiki (atlassian.net)

Generally, openIMIS is an open-source software – it is free to download, customise and use by anyone.

• openIMIS is a digital public good which powers versatile solutions for the management of health financing and social protection programs. It can be easily configured to support various workflows across the social protection delivery chain. Designed to be interoperable with other information systems, openIMIS draws upon and contributes to Digital Public Infrastructure.  
• For both HIB and SSF, openIMIS is inter-linked with multiple health care providers through API to process claims on time. HIB has connected it’s openIMIS to multiple mobile wallets and national payment gateway, which has enabled easier renewal of their policies for beneficiaries. HIB is in final stage to connect openIMIS to National ID system, this will enable unique beneficiaries /patient identification and automatic verification.
• A module is being developed in Nepal which will ensure that newly born babies will be the part of social protection system after their birth; by enabling interoperability with Birth registration management system (BRMS) and Civil registration and vital statistics (CRVS).

https://openimis.org/; https://www.bmz.de/en/issues/digital-transformation/digital-public-goods-and-infrastructure/openimis-215870;