Digital payments to boost worker motivation in healthcare

Dr Andrew Bakainaga, the World Health Organization (WHO) country advisor, has asked government to fully embrace digital payment to minimise on the risks associated with cash.

Dr Bakainaga, a public health and epidemiology specialist, said eCash payment reduces corruption tendencies associated with cash.

“Using digital payment, the processes of bureaucracy within the cash payment will drastically reduce since the system is more efficient and robust to deliver motivation and the incentive that is due to the workers,” he said.

He was speaking during the dissemination of the preliminary findings from the Digital Health Payment Initiative and Research (DHPI-R) in Africa project, at the sidelines of the three-day annual scientific health conference in Entebbe on September 21.

The project commissioned a cluster randomised control study that was conducted by Makerere University School of Public Health during the second round of polio mass vaccination campaign last year to compare health workers’ motivation, satisfaction and performance as well as vaccination coverage in areas where campaign health care workers are paid using eCash instead of physical cash.

The study randomized 54 districts and enrolled 2665 health care workers that participated in the mass polio vaccination campaign from November 4 to November 10,2022 and was collected from February 6, 2023 to March 10.

Makerere School of Public Health in partnership with the ministry of Health and ministry of Finance supported 27 districts to operationalize eCash payments while the other 27 district payments received basic guidance.

According to Dr Juliet Aweko, the DHPI-R project coordinator at Makerere University School of Public Health, the study compared the motivation, satisfaction, and performance of vaccination health care workers in areas where they are paid using eCash instead of cash.

It also explored how gender norms and relations influence health workers’ response to payment systems (eCash versus cash payments) and how these affect the health workers’ performance and motivation in polio vaccination campaigns.

According to preliminary overall results, the median period of payment was 40 days post the polio campaign and only half, (1,335) of the total 2665 health care workers received payment via eCash. The majority (57%) of the ecash payments were conducted in the intervention districts, the districts that were supported.