Brookside A Dec 09, 2019 Panel
Sustainable Financing for Digital Health 12:00 - 13:15

This panel will bring together the following four moderated presentations on sustainable financing:

  1. Total Cost of Ownership at Scale - Budgeting to reach 200,000,000 beneficiaries with an ICT solution in India
  2. openIMIS: the open source tool for the digitalisation of health financing

  3. Prioritizing Sustainable Digital Health Financing in a Politically Transitioning Economy - Lessons and Experience from Nepal

  4. Using the power of mobile technology to revolutionise health financing: what the world can learn from Africa

Using the power of mobile technology to revolutionise health financing: what the world can learn from Africa
12:00 - 13:15
Individuals in sub-Saharan Africa often struggle to afford healthcare, let alone quality services, due to barriers including lack of investments in health facilities, inadequately trained staff as well as geographic disparities and transportation challenges; women face the disproportionate additional barrier of gender. Since 2015, through a digital health platform (coined M-TIBA in Kenya) featuring a mobile phone enabled ‘wallet’, CarePay (a Kenyan social enterprise), Safaricom (the largest mobile network provider) and Amsterdam based non-profit PharmAccess have worked to provide millions of low income individuals and families with access to affordable, quality healthcare. M-TIBA connects patients, providers and payers to ensure quality, affordable health care, through channeling of ring fenced healthcare funds directly into the mobile ‘wallets’ of patients, who use these funds to access care at selected health facilities. These facilities are supported by PharmAccess’ ‘SafeCare’ methodology, a set of standards designed to support facilities in improving the quality of their services. In addition, the Medical Credit Fund (MCF), a subsidiary of PharmAccess, provides much needed loans to enable facilities to invest in infrastructure. M-TIBA enables and empowers individuals to take responsibility for their own health; with a simple mobile registration (no smart phone necessary), individuals can save and pay for their health care, including population specific needs such as MNCH. For providers, the platform provides real time data collection tools to support clinics in managing their business and service delivery, whilst governments can better identify and target financial support. This session will discuss how M-TIBA capitalises on mobile technology to create cashless clinics in Kenya and Nigeria, reaching those until now excluded. It will discuss how PharmAccess works with governments to incorporate M-TIBA within their national health insurance aspirations and create more transparent, effective health systems, key to achieving UHC.
Prioritizing Sustainable Digital Health Financing in a Politically Transitioning Economy - Lessons and Experience from Nepal
12:00 - 13:15
The Female Community Health Volunteers program in Nepal was introduced in the late 1980s. Over time, their roles have evolved to agents bridging the gap between health facilities and the community. Since 2012, Medic Mobile, a global non-profit technology organization, has been empowering these frontline health workers with digital tools to better coordinate their work for equitable and safe motherhood. The recent federalization that paved the way for the decentralized allocation of economic resources has allowed local governments to have more control over the financing of services including health. Despite their autonomy, local governments lack financial as well as technical expertise. Realizing these limitations, Medic Mobile’s strategy in Nepal has evolved with time to provide support to the local governments to help them recognize their health needs and prioritize maternal and child health. By providing tailored, free and open-source tools, we have not only supported those last-mile health workers but also the local governments to plan their health activities using data generated by the system, an important by-product of our tool. Stepping away from a conventional project-based approach to a more longer-term program based-partnership requires a certain level of stakeholder ownership and financial negotiation. In this presentation, we will be showcasing how we have initiated and maintained partnerships and deployment, gained the confidence of various stakeholders, and established strategies to ensure government ownership of the program. We will share valuable insights especially into institutional strategies for the financial sustainability of digital health in Nepal; where were are now and what we aim to achieve. These insights and lessons presented will enable policymakers, digital health practitioners and others to learn from Medic Mobile’s experiences, and adapt these learnings for their own contexts as they explore the financing of national scale of digital health programs.
openIMIS: The open source software for managing payer-provider mechanisms!
12:00 - 13:15
openIMIS is an open-source software tool for the digitalisation and efficient management of health financing workflows. Currently being used to manage a variety of health protection schemes in Nepal, Tanzania, Cameroon, Chad, and DRC, openIMIS offers seamless connections between beneficiaries, health service providers, and payers. The software is designed for a variety of business processes ranging from enrolling beneficiaries at the community level to generating electronic claims at health facilities to the automated and human-led adjudication of claims at the offices of the payer institution. This appy hour session will be designed to showcase to the user how easy it is to use openIMIS for the various processes in a health protection scheme. For the developer audience, there will be material available to inform them about the openIMIS technical roadmap and to encourage them to join the community of practice. Through a local instance of openIMIS, we will demonstrate how Android apps can be used to enroll beneficiaries and provide ID cards in the communities. Additionally, the workflows around claim entry and processing will also be demonstrated through a live demonstration of the openIMIS system.
Total Cost of Ownership at Scale - Budgeting to reach 200,000,000 beneficiaries with an ICT solution in India
12:00 - 13:15
Over the past few years, Dimagi has worked with the government of India to deploy a mobile application built on the CommCare platform to over 300,000 nutrition workers in rural and urban communities across the country. The nutrition workers active on the application span eight states in India and submit around 2 million forms a day for the 200,000,000 beneficiaries currently registered in the system. The Indian government continues to scale the nutrition application with the goal of reaching all 1.4 million nutrition workers in India, who collectively serve over a billion people across the country. This radical scale up represents an absolute departure for the mhealth sector where funding limitations and implementation challenges have historically limited the size of most projects. However as the sector matures, more large scale projects are likely and they are necessary to ensure universal health care for the billions of people served by a front line health worker. In this session we explore the costs associated with scaling an mhealth solution to 300,000 users, considering the vast sums required for servers, hardware, training and technical support. We compare our budget estimate at the project's inception to our total spend to date to identify the biggest budgetary surprises and mistakes. We use our learnings to propose a Total Cost of Ownership model for scaled mhealth programs that can be adopted and modified by governments and implementers committed to digital transformation of healthcare in developing countries. (Dimagi is a technology company whose mission is to enable substantial worldwide impact by creating digital products that support global development efforts and help accelerate the end of extreme poverty. )
Presentations submitted by speakers
Download Presentation Submitted by Lilian Olson

Director of Strategy
Digital Square/PATH
Senior Technical Advisor
Medic Mobile
Chief Operating Officer
Dimagi, Inc.
Director of Partnerships
Inter-American Development Bank
Sector Specialist, Digital Health
Digital Health Advisor
Medical Teams International
Information Systems Director
Product Manager


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