An immunization worker stands up to collect her wages in her mobile wallet in the Democratic Republic of Congo. Credit: WHO
Campaigns in Africa to stop polio and other diseases have a more sustainable and motivated workforce thanks to WHO’s collaboration with countries and partners to pay frontline health workers through their mobile phones instead of cash.
“Over 80 percent of workers say they prefer digital payments,” said Ahmed Hamani Djibo, head of WHO’s Digital Finance Team.
WHO has been a leader among international organizations in moving away from the clumsy and less secure practice of disbursing cash wages. Over the past few years, the Organization launched its Digital Finance Team and joined the Better Than Cash Alliance, an 80-member United Nations partnership with a mandate to advance the digitization of payments and expand financial inclusion – activities that support the Goals of Sustainable Development of the UN.
Since it was established in 2020, the WHO Digital Finance Team has designed and implemented digital payment solutions in 24 countries in Africa, including, last year, in Benin, Botswana, Madagascar, Rwanda, Togo and Zimbabwe.
“WHO has successfully digitized payments for more than two million health workers across Africa,” said Tidhar Wald, Managing Director, Better Than Cash Alliance. “With these inspiring results, WHO is taking a clear leadership role in accelerating digital transformation in the delivery of health outcomes globally.”
A polio immunization team at work in the Democratic Republic of Congo. Credit: WHO
“A really big change in speed”
Workers surveyed in Côte d’Ivoire, Liberia and Tanzania said they valued the security of not carrying cash, the convenience of no longer having to travel to a disbursement location to collect their wages and above all, the speed of payment – so as short as half an hour after finishing work compared to waiting for weeks or even months.
The surveys, funded by the Bill & Melinda Gates Foundation, linked on-time compensation to better employee morale and retention.
“There’s really a big difference in speed,” said Jean-Luc, a health worker interviewed in the Democratic Republic of Congo (DRC) at the end of a polio immunization campaign. “Yesterday we finished cleaning the campaign and received a text notification the next evening. I will pay my child’s school fees. Now we can relax.”
Digital payments also save time and money for health campaign organizers, including the burden and expense of transporting large sums of money and filling out paperwork.
“When you have 300 to 500 volunteers to pay, doing accounts and signing invoices takes a lot of time,” said Saïdi, a DRC polio team leader.
WHO first used new digital payments in polio immunization campaigns in Côte d’Ivoire. Although vaccine-derived polio outbreaks were on the rise, vaccination campaigns were struggling to get off the ground. In the first quarter of 2020, almost half of polio campaigns in the WHO African Region were delayed, saw workers leave work or suffered other adverse effects stemming from delays in cash disbursements.
As WHO and partners worked to develop key aspects of a digital payment ecosystem (registering workers in a database, verifying their profiles with the mobile network operator and more) the benefits of a cashless approach became more apparent .
“There is substantial evidence that digitizing payments can support people, especially women, to access financial services and increase control over their earnings,” said Maria May, Senior Program Officer, Inclusive Financial Systems, at the Foundation Gates. “Over the past four years, the World Health Organization has used the growing presence of mobile money across Africa to ensure that brave vaccinators on the front lines of polio outbreak campaigns are paid in full, quickly and securely.
Alain Labrique, director of the WHO Department of Digital Health and Innovation, said that “digital payments are one of the key pillars of the Digital Health Public Infrastructure, currently strongly encouraged within the WHO guidelines for member states on Digital Transformation” . WHO sees digital payments as a foundation for many more digital development activities, along with Data Exchange and Digital ID Infrastructure. He added that “we are delighted to work with partners in the digital space and add our voice to this celebration of WHO joining the Better Than Cash Alliance”.