Effect of Digital Payment to Campaign Health Workers on Vaccination Coverage

NCT05684081 | Unknown

• 1 other identifier: MaKSPH_BMGF_INV03047_2022
• Study Type: interventional
• Target: 2,700
• Locations: 1 country
• Sites: 1

Brief Summary

Introduction: Good quality OPV campaigns can interrupt and possibly prevent transmission of the polio virus. Health care worker performance and motivation are prerequisites for the success of such campaigns. Complete, transparent and timely payments are, in turn, prerequisites for the sustenance of health care worker motivation and thereby efforts. To date, most such health care workers have been paid in cash, with chronic payment issues that have negatively affected campaign quality and vaccination coverage. Cash-based payments are often plagued with multiple delays in funds disbursements, cash leakages, and a lack of accountability and financial transparency. These difficulties have prompted a transition to digitized payments that are perceived to be faster, more convenient, traceable, reliable, easier and more reasonable to set up. The roll-out phase of these digital payment interventions has not been quantitatively evaluated and the effect of digital payments on the motivation, satisfaction and performance of health workers is not known. Therefore, this study will compare digitized payment of polio vaccination campaign health care workers with cash-based payment with regards to health care worker motivation, satisfaction and performance. Findings from this study may inform the operationalization of digital financial systems, and the transition towards cross-campaign digital payments. Primary Objectives:

1. 1.To compare the motivation, satisfaction and performance of vaccination health care workers in areas where they are paid using mobile money versus in cash,
2. 2.To explore how gender norms and relations influence health workers' response to payment systems (mobile money versus cash payments) and how these affect the health workers' performance and motivation in polio vaccination campaigns and
3. 3.To compare vaccination campaign quality in areas where health care workers are paid using mobile money versus in cash
4. 4.To compare vaccination coverage in areas where campaign health care workers are paid using mobile money versus in cash.
5. 5.To estimate the incremental cost of the intervention.

Conditions

Polio

Outcome Measures

Primary Outcomes (1)

• Vaccination campaign health care worker motivation, performance and satisfaction based on self reports on a scale of 1-5

  Assessing the health workers motivation, performance and satisfaction based on self report on a scale of 1-5.

  At least one week post payment of immunization health workers

Secondary Outcomes (1)

• Vaccination coverage

  At least one week post payment of immunization health workers

Study Arms (2)

INTERVENTION

EXPERIMENTAL

Refers to the intervention arm i.e. ECASH payment of health workers

Behavioral: Digital payment

CONTROL

NO INTERVENTION

Refers to status Quo or no intervention i.e. payment using cash

Interventions

Digital payment BEHAVIORAL

The proposed intervention is designed to support the implementation of polio campaigns through digital payments

INTERVENTION

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adults aged 18 and above
• History of participation in the most recent polio vaccination campaign in Uganda
• Member of the district leadership team

You may not qualify if:

• \) Non-consenting adults

Sponsors & Collaborators

• Makerere University: lead
• Bill and Melinda Gates Foundation: collaborator

Study Sites (1)

Ministry of Health Facilities in 54 districts/municipalities in Uganda

Kampala, 256, Uganda

Location

Related Publications (1)

• Waiswa P, McConnell M, Aweko J, Mukuye DD, Opio C, Ashaba MS, Bakainaga A, Ekirapa-Kiracho E. The effect of supporting districts to operationalise digital payments for vaccination campaign workers: a cluster randomised controlled trial during the 2022 polio vaccination campaign in Uganda. BMJ Glob Health. 2025 Sep 10;10(Suppl 4):e016666. doi: 10.1136/bmjgh-2024-016666.

  PMID: 40935396 DERIVED

MeSH Terms

Conditions

Poliomyelitis

Condition Hierarchy (Ancestors)

Myelitis; Central Nervous System Infections; Infections; Enterovirus Infections; Picornaviridae Infections; RNA Virus Infections; Virus Diseases; Central Nervous System Diseases; Nervous System Diseases; Spinal Cord Diseases; Neuroinflammatory Diseases; Neuromuscular Diseases

Study Officials

• Victoria Nankabirwa, PhD

  Makerere University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: This is an unblinded study.
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: The intervention consists of direct cash payment to vaccination campaign health workers using government of Uganda Ecash platform on IFMIS

Study Record Dates

• First Submitted: November 17, 2022
• First Posted: January 13, 2023
• Study Start: July 1, 2022
• Primary Completion: October 30, 2023
• Study Completion: December 30, 2023
• Last Updated: February 8, 2023

Record last verified: 2023-02

Data Sharing

• IPD Sharing: Will not share

Locations

UG (1)