Factors associated with Senegalese health workers’ willingness to receive mobile digital payments: cross-sectional study

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INTRODUCTION: Although Senegal began digitising servants' salaries in 2004, payments to community health workers have not yet followed suit. This study explored factors associated with health professionals' and community health workers' willingness to receive payments via mobile digital systems. METHODOLOGY: We carried out a cross-sectional study, from October to December 2023 among healthcare staff and community health workers using telephone surveys. At national level, one district per medical region was selected by random draw for the study. In each district, data were collected from all health workers agreeing to participate, using a questionnaire instrument derived from pre-existing conceptual frameworks for the acceptability of technological innovations in healthcare. We conducted a descriptive analysis, followed by a bivariate analysis with a 5% alpha risk and a multivariate analysis. RESULTS: We recruited 2965 healthcare workers (of whom 70.1% were women), including community health workers (70.8%) and health professionals (29.2%). The arithmetic mean age was 42.7 years (SD 11.2 years). 98.6% of the sample had access to a smartphone and 80% had internet access. Healthcare workers reported a high willingness (88.2%) to be paid by mobile digital systems.Factors negatively associated with this willingness included contractual professional status (adjusted OR (AOR) 0.46, 95% CI 0.23 to 0.93), having been in practice for more than 10 years (AOR 0.45, 95% CI 0.28 to 0.72), perceived difficulties in using technology (AOR 0.43, 95% CI 0.23 to 0.81) and carrying out additional administrative procedures. On the other hand, the simplification of payment processes (AOR 3.45, 95% CI 1.86 to 6.32) and positive opinion from health authorities (AOR 1.85, 95% CI 1.17 to 2.94) were positively associated with willingness. CONCLUSION: We found that individual, socioprofessional and contextual factors are associated with health workers' willingness to receive full digitisation of payments. Seamless integration of these systems into existing organisational structures could strengthen worker buy-in.

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