AI Article Synopsis
- Researchers studied how Community Health Workers (CHWs) in a refugee settlement in Uganda performed when paid in cash versus digitally.
- They found that CHWs did better with cash payments because digital payments often had delays, making them feel less motivated.
- Most people involved preferred cash payments to avoid issues with the timing and reliability of digital payments.
Article Abstract
Background: There is inadequate evidence about the influence of digital and cash payment modalities on the performance of Community Health Workers (CHWs) in underserved communities, such as refugee settlements.
Objective: To compare the performance of CHWs when paid in cash or digitally in Kyaka II refugee settlement, Uganda.
Methods: A comparative cross-sectional mixed methods design was used. Secondary data comprising 247 CHW reports during a six-month period of cash and digital payments were analyzed using Stata v14. Eleven focus group discussions, four in-depth interviews, and ten key informant interviews were conducted among the settlement stakeholders to explore perceptions of the payment methods. Qualitative data were analyzed thematically using Atlas.ti v9.
Results: CHWs performed better when paid cash than digital payments ( = 5.28; df = 246; < 0.001). During the cash payment period, at least secondary education (APR 1.71 CI: 1.14-2.58) and having a side occupation (APR 1.58; CI: 1.13-2.21) were positively associated with performance. For digital payments, being male (APR 0.58; CI: 0.34-0.98), serving longer than 9 years (APR 0.87; CI: 0.82-0.93), and being allocated more than 60 households per month (APR 0.31; CI: 0.19-0.52) were negatively associated with CHW performance. Qualitative data revealed that most stakeholders preferred cash due to inconsistent and delayed digital payments.
Conclusion: CHWs preferred and performed better with cash payments because digital payments were associated with delays and payment shortfalls that demotivated them. Implementers should invest towards averting digital payment shortfalls in remote settings to enhance CHW motivation and performance.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346319 | PMC |
| http://dx.doi.org/10.1080/16549716.2024.2375867 | DOI Listing |
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