USAID INTEGRATED HEALTH PROGRAM (IHP)
CONSULTANCY TO SUPPORT THE FHIS IN THE DESIGN OF AN ICT PLATFORM FOR THE MANAGEMENT OF HEALTH INSURANCE OPERATIONS
Program Activity: consultancy services to provide technical assistance to the FHIS for the designed deployment of a web base and mobile ICT application suitable to improve the efficiency in its operations.
The integrated health program (IHP) is a USAID-funded five years project with the goal to contribute to state levels reduction in child and maternal morbidity/ mortality and to increase the capacity of health systems (public and private) to sustainable support quality PHC Services.
The F.C.T. Health insurance scheme (FHIS) is responsible for administrating and regulating the social health insurance scheme in the territory and engages with internal and external stakeholders. In the rollout of the informal sector scheme. The FHIS is fully operational with beneficiaries enrolled and receiving health care services through the scheme and the basic health care provision fund. The services of third-party administrators (TPAs) have also been engaged to handle some of the aspects of its operations including provider management and quality insurance. In addition, a web based information communication technology (ICT) application has been developed for the management of key aspects of the scheme’s operations. However, there are limitations to the existing ICT platform, particularly in areas of enrollment, premium payment, claims management, and provider management which contributes to inefficiencies in its operation.
This is to be carried out by an experienced ICT expert to review the existing ICT platform, develop a web-based and mobile application platform, and to build the capacity of the relevant teams in the utilization of the platform for the operationalization of the health insurance scheme.
ROLES AND RESPONSIBILITIES
The specific responsibility of the consultant include:
Identify and collate all relevant documents, templates, and tools for the FHIS operations.
Review collated documents, tools, and business processes to identify key processes, sub-processes, process owners, and process operators
Review existing web base and app platform for health insurance available in the private and public sector in FCT and other states to determine if there are models that can be adopted
Develop a summary flow chat for each key process using the suitable flowcharting software and recommended updates/technical specifications necessary to achieve the goals of the consultancy.
Based on the outcome of the reviews of the FHIS ICT blue print, design a web-based ICT platform that would include modules for the following health insurance operation enrolment (which will include features for biometric capturing, self and third-party registration, premium payment and ID card production), beneficiary management, pre-authorization and claims management, TPA management, provider management and data analytics. Support would also be provided to transfer existing database into the newly designed platform.
Design a mobile ICT application with features that enable enrollment, premium payment, access to benefit packages, and customer support among others. The mobile application will allow access to enrollees and TPAs.
Facilitate the conduct of user testing for the designed web-based and mobile application solutions.
Develop operational manuals for the design web-based and mobile application solutions
Develop operational manuals for the design web- base and mobile application solutions
Organize training of trainers for FHIS staff, TPAs, and selected health care providers to facilitate the roll-out and the designed web-based and mobile ICT applications
Proposed ICT solutions must make provision for a robust security architecture that complies with ICT requirements of the national health insurance authority (NHIA) and other national data protection regulations.
The proposed solutions must be scalable, quality assurance tested, require minimum maintenance costs, have sufficient cloud storage capability, and be interoperable with the NHIA ICT framework to allow for data sharing.
The designated ICT solution should comply with current national and international data privacy policies.
Experience developing ICT (web-based) systems for health insurance management is an added advantage.
Good understanding of current health financing reform initiatives in Nigeria especially the sub–national level.
Proving capacity building, competency–based training experience.
Please note: payments are made based on delivery-approved deliverables. All deliverables must be of high quality and submitted in Microsoft Word and in PDF format. The deliverable would not be considered final until approved by the chief of party (CoP).
Period of performance of the consultancy: May 1 – September 29, 2023
For more details concerning this consultancy and other associated application tools. Please visit the link below: FHIS IT Consultancy To7
Please follow the instructions as contained in the request for application (RFA) and submitted to
This consultancy application closes on May 5, 2023. 5:00pm (WAT). No late application would be received after the deadline.Save this Tender