{
  "abstract": "Introduction Health workers frequently experience inconsistent and inefficient payment processes of their allowances, with potential implications for their motivation, performance and retention and consequently the effective delivery of essential immunisation services. Digitisation of payments has been proposed as a potential improvement to the payment process. This study assesses health workers’ experiences following the digitisation of payments.Methods A mixed-methods study was conducted, combining quantitative and qualitative approaches. Quantitative data were collected via a survey of 1510 health workers across 12 provinces (seven intervention, five comparison) between August and October 2023. Additionally, thematic analysis was applied to qualitative data from 57 in-depth interviews with officials and health workers.Results Health workers in provinces implementing mobile payments reported higher work motivation (50.7%) and job satisfaction (7.9%) compared with those in comparison provinces (38.67% and 2.7%, respectively). Positive payment experiences were also more frequent in mobile money provinces (14.50% vs 1.36%). Qualitative insights highlighted that timely payments reduced financial stress and enhanced focus on core responsibilities. However, challenges such as technological barriers and the need for tailored training were noted, particularly for workers in remote areas or with lower digital literacy.Conclusion Digital payments were linked to higher health worker motivation and satisfaction and perceptions of reliability and reducing administrative burdens. Future research should incorporate longitudinal data and randomised controlled trials to better assess the causal impact of digital payments. Expanding qualitative research to include a broader range of stakeholders will provide deeper insights into the contextual factors influencing the effectiveness of digital payment systems. Addressing these gaps is crucial for refining and scaling digital payment interventions in diverse healthcare settings.",
  "authors": [
    {
      "affiliations": [
        "Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA",
        "Alma, Centre de Recherche en Systèmes de Santé, N’Djamena, Chad"
      ],
      "name": "Esias Ka Nanbe Bedingar"
    },
    {
      "affiliations": [
        "Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA"
      ],
      "name": "Catherine Wambura"
    },
    {
      "affiliations": [
        "Solina Centre for International Development and Research, Abuja, Nigeria"
      ],
      "name": "Demilade Osoteku"
    },
    {
      "affiliations": [
        "Vaccination Directorate, Ministry of Public Health and National Solidarity, N’Djamena, Chad"
      ],
      "name": "Antoinette Demian Mbailamen"
    },
    {
      "affiliations": [
        "Project Management Unit, Ministry of Public Health and National Solidarity, N’Djamena, Chad"
      ],
      "name": "Adawaye Chatte"
    },
    {
      "affiliations": [
        "Livestock Research Institute for Development, Ministry of Livestock, N’Djamena, Chad"
      ],
      "name": "Mahamat Fayiz Abakar"
    },
    {
      "affiliations": [
        "Solina Centre for International Development and Research, Abuja, Nigeria"
      ],
      "name": "Uchenna Igbokwe"
    },
    {
      "affiliations": [
        "Solina Centre for International Development and Research, Abuja, Nigeria"
      ],
      "name": "Armand Nandoumabe"
    },
    {
      "affiliations": [
        "Solina Centre for International Development and Research, Abuja, Nigeria",
        "The University of Alabama at Birmingham School of Public Health, Birmingham, Alabama, USA"
      ],
      "name": "Briend Donanty Kilone"
    },
    {
      "affiliations": [
        "Solina Centre for International Development and Research, Abuja, Nigeria",
        "National Primary Healthcare Development Agency, Abuja, Nigeria"
      ],
      "name": "Muyi Aina"
    },
    {
      "affiliations": [
        "Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA"
      ],
      "name": "Margaret McConnell"
    }
  ],
  "title": "Digital payments of health workers within vaccination campaigns: a mixed-methods study in Chad",
  "uid": "bdb628b0-7b55-5735-bfbc-035079ad3978"
}