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A research agenda for digital payments of health workers in large-scale health campaigns in sub-Saharan Africa

Bibliographic Data

ID21878908
AuthorsPeter Waiswa (0000-0001-8221-902X, Karolinska Institutet), Juliet Aweko (0000-0001-7448-6726, Makerere University), Charles Opio (0009-0007-4469-6969, Makerere University), Maggie Ssekitto Ashaba (0009-0000-0782-0886, Makerere University), Uchenna Igbokwe (0009-0001-1729-7360, Solina Group (Nigeria)), Eric Aigbogun (0000-0001-8230-2771, Solina Group (Nigeria)), Zahra Mboup (Cheikh Anta Diop University), Souleymane Ndiaye (Universite Cheikh Anta Diop, Dakar, Senegal), Seyni Ndiaye (0000-0002-5008-3399, Cheikh Anta Diop University), Adama Faye (0000-0002-7849-2469, Cheikh Anta Diop University), Andrew Bakainaga (World Health Organization - Uganda), Elizabeth Ekirapa Kiracho (0000-0001-6938-2068, Makerere University)
Year2026
Volume10
IssueSuppl 4
Pagese017476
Publication date2026-02-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueBMJ Global Health (JOURNAL)
Journal identifiersISSN: 2059-7908 • E-ISSN: 2059-7908
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2024-017476
PMID41692491
OpenAlexW7128946774
LanguageEN
References cited16

INTRODUCTION: Digital payments are increasingly favoured over cash for remunerating healthcare workers in large-scale health campaigns due to perceived advantages in efficiency and security. However, evidence to guide their scaling and optimisation is limited. This study aimed to identify and prioritise a global research agenda for digital payments in health campaigns in sub-Saharan Africa (SSA). METHODS: We employed the Child Health and Nutrition Research Initiative methodology. In stage 1, we defined the context and criteria (answerability, feasibility, sustainability/equity, impact). In stage 2, 420 stakeholders were engaged via an online survey, generating 450 research questions, which were refined to a final pool of 35. In stage 3, these 35 questions were scored by 63 experts against the predefined criteria. Research Priority Scores (RPS) and Average Expert Agreement (AEA) were computed for ranking in stage 4. RESULTS: The overall RPS for the 35 questions ranged from 38.6% to 6.0% (mean 28.2%, SD 6.4%). The AEA ranged from 67.2% to 82.7% (mean 77%, SD 3.4%), indicating strong consensus. RPS and AEA showed a strong positive correlation (r=0.989, p<0.01). The top-ranked research questions were: (1) Minimum requirements for health systems to digitise payments responsibly (RPS 38.6%); (2) Optimisation of digital payments to enhance campaign effectiveness in SSA (RPS 36.8%); (3) Incentives for digital payment adoption in the healthcare sector (RPS 36.1%); (4) Cost-benefit analysis of digital payments vs cash (RPS 36.3%) and (5) Coverage of mobile money agents and its impact on uptake and satisfaction (RPS 34.0%). CONCLUSIONS: This study provides an expert-consensus roadmap for research on digital payments in health campaigns. Addressing these priorities will generate critical evidence to develop robust, equitable and effective digital payment systems, ultimately strengthening health systems and improving health outcomes in SSA

Digital health · Global health · Health promotion · Health services research · Payment · Public health · Global Maternal and Child Health · Healthcare Systems and Reforms · Mobile Health and mHealth Applications · Health Policy

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