Adoptability of digital payments for community health workers in peri-urban Uganda: A case study of Wakiso district.

Autor: Kembabazi V; Department of Health Policy, Planning and Management, Makerere University School of Public Health, Kampala, Uganda., Tigaiza A; Department of Health Policy, Planning and Management, Makerere University School of Public Health, Kampala, Uganda., Opio C; Department of Health Policy, Planning and Management, Makerere University School of Public Health, Kampala, Uganda., Aweko J; Department of Health Policy, Planning and Management, Makerere University School of Public Health, Kampala, Uganda., Nakafeero M; Makerere University School of Public Health, Kampala, Uganda., Makumbi FE; Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda., Ediau M; Department of Health Policy, Planning and Management, Makerere University School of Public Health, Kampala, Uganda., Kiracho EE; Department of Health Policy, Planning and Management, Makerere University School of Public Health, Kampala, Uganda., Tusubira AK; Department of Community Health and Behavioral Sciences, Makerere University School of Public Health, Kampala, Uganda.; The Medical Research Council/Uganda Virus Research Institute (MRC) & London School of Hygiene and Tropical Medicine (LSHTM) Uganda Research Unit, Entebbe, Uganda., Waiswa P; Makerere University School of Public Health, Kampala, Uganda.; Global Public Health, Karolinska Institute, Stockholm, Sweden.; Busoga Health Forum, Jinja, Uganda.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2024 Aug 15; Vol. 19 (8), pp. e0308322. Date of Electronic Publication: 2024 Aug 15 (Print Publication: 2024).
DOI: 10.1371/journal.pone.0308322
Abstrakt: Background: Whereas digital payments have been identified as a solution to health payment challenges, evidence on their adoptability among Community Health Workers (CHWs) is limited. Understanding their adoptability is crucial for sustainability. This study assessed the adoptability of digital payments for CHWs in Wakiso district, Uganda.
Methods: A convergent parallel mixed-methods study was conducted between November and December 2022, in Wakiso district, Uganda. We surveyed a random sample of 150 CHWs using a structured questionnaire and conducted key informant interviews among three purposively selected Digital payment coordinators. The study utilized the Technology Acceptance Model (TAM) framework to assess the adoptability of digital payments among CHWs. Factor analysis was performed to extract composite variables from the original constituting variables. Using the median, the outcome was converted to a binary variable and logistic regression was conducted to assess the association between the TAM constructs and adoptability of digital payments by CHWs. Quantitative data was analyzed using STATA 14, while qualitative data was transcribed verbatim and analyzed using ATLAS.ti 22.
Results: Nearly all participants (98.0%; n = 49) had previously received payments through mobile money, a digital payment method. (52%; n = 78) of CHWs said they intend to use digital payment modalities. Perceived risk of digital payments was associated with 83% lower odds of adoptability of digital payment modalities (OR = 0.17;95%CI:0.052, 0.54), while perceived trust had nearly three times higher odds of adoptability of digital payment modalities (OR = 2.82;95%CI:1.41, 5.67). Qualitative interviews showed that most CHWs reported positive experiences with digital health payments, including effectiveness and completeness of payments except for delays associated with mobile money payments across payment providers. Mobile money was reported to be easy to use, in addition to fostering financial responsibility compared to cash.
Conclusion: CHWs in Wakiso district intend to use digital payment modalities, particularly mobile money/e-cash. Perceived risk of the payment method and trust are key determinants of adoptability. Synergized efforts by both payment providers to manage payment delays and mitigate risks associated with digital payments could attenuate perceived risk and build trust in digital payment modalities.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 Kembabazi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje