Department of Health Policy, Planning and Management, Makerere University School of Public Health, Kampala, Uganda.
Makerere University School of Public Health, Kampala, Uganda.
PLoS One. 2024 Aug 15;19(8):e0308322. doi: 10.1371/journal.pone.0308322. eCollection 2024.
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.
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.
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.
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.
虽然数字支付已被确定为解决医疗支付挑战的一种方案，但关于社区卫生工作者（CHWs）对其接受程度的证据有限。了解其接受程度对于可持续性至关重要。本研究评估了乌干达瓦基索地区 CHWs 对数字支付的接受程度。
2022 年 11 月至 12 月期间，在乌干达瓦基索地区进行了一项 convergent parallel 混合方法研究。我们使用结构化问卷对 150 名随机抽取的 CHWs 进行了调查，并对三名有针对性选择的数字支付协调员进行了关键知情人访谈。研究利用技术接受模型（TAM）框架评估 CHWs 对数字支付的接受程度。采用因子分析从原始构成变量中提取综合变量。使用中位数将结果转换为二进制变量，并进行逻辑回归以评估 TAM 结构与 CHWs 对数字支付的接受程度之间的关系。使用 STATA 14 分析定量数据，使用 ATLAS.ti 22 对定性数据进行转录和分析。
几乎所有参与者（98.0%；n=49）之前都通过移动货币收到过付款，这是一种数字支付方式。（52%；n=78）的 CHWs 表示他们打算使用数字支付方式。数字支付的感知风险与数字支付方式接受程度的 83%的较低可能性相关（OR=0.17；95%CI：0.052，0.54），而感知信任与数字支付方式接受程度的可能性几乎高出三倍（OR=2.82；95%CI：1.41，5.67）。定性访谈显示，大多数 CHWs 报告了对数字健康支付的积极体验，包括支付的有效性和完整性，但除了移动货币支付的延迟外，各支付方之间也存在差异。移动货币被报告为易于使用，此外与现金相比，还培养了财务责任感。
瓦基索地区的 CHWs 打算使用数字支付方式，特别是移动货币/电子现金。支付方式的感知风险和信任是接受程度的关键决定因素。支付方共同努力管理支付延迟并减轻与数字支付相关的风险，可以降低感知风险并建立对数字支付方式的信任。
