The poliovirus invades the nervous system and can cause total paralysis in hours. It can strike people of any age but mainly affects children under five. Polio can be prevented by vaccines, but it is not curable. Unlike most diseases, polio can be eradicated.
With vaccination efforts and strong leadership of global initiatives, cases of wild poliovirus have been reduced by 99.9% since 1980. The year 2020 marked a notable advancement toward eliminating polio, as the World Health Organization declared the African Region free from the wild poliovirus. Afghanistan and Pakistan are the only two remaining polio-endemic countries in the world.
Although we are close to eliminating polio, the fight is not over and challenges remain, including the most recent one of sustaining routine immunization as part of essential health services during the Covid-19 pandemic. Moreover, recent outbreaks in 21 countries, including Uganda, call for tightening of the measures aimed at eradicating the virus.
Research into new ways to facilitate the eradication of polio is paramount. The new polio eradication strategy 2022- 2026 by the Global Polio Eradication Initiative (GPEI) aims to achieve and sustain a polio-free world through a focus on urgency and accountability.
Emphasis is put on empowering the frontline workers, increasing vaccine acceptability and transforming campaign effectiveness among others. The five-year strategy elevates efforts in the highest-risk countries and promotes health service integration, surveillance improvement, and community engagement to enhance campaign quality.
As a result, many countries, including Uganda, have stepped up their polio surveillance. They are also rolling out mass vaccination campaigns to protect children from the debilitating virus. In Uganda and plans are underway to roll out the second round of the polio vaccine following the first door-to-door campaign which took place in January.
To reach zero polio and have effective campaign delivery, many countries in sub-Saharan Africa and beyond have embraced the use of electronic/digital payments to have the desired campaign outcomes.
So, while the world is close to 99% polio eradication, this final stretch to achieve zero cases may be difficult. However, it’s important to note that reliable health systems are crucial for effective disease surveillance and outbreak response.
Research has proved that Digital Financial Services (DFS) provide health programs with opportunities to accelerate progress toward global health goals and outcomes. One may ask; what does it take to make digital payments work for campaign health workers? What are the opportunities and challenges of using digital payments? Who are the actors involved in the entire process within sub-Saharan Africa?
Recognizing the potential of digital financial services, the Digital Health Payment Initiative and Research in Africa (DHPI-R) project, through the Makerere University School of Public Health and the University of Dakar in Senegal are running a three-year project and its aim is identifying how, and under what circumstances, digital worker payments can support effective campaign delivery.
A robust digital payment system will enable governments and key stakeholders to adopt quick, convenient, reliable, and effective methods to pay frontline health workers involved in the immunization of children during outbreaks. The project is supported by the Bill and Melinda Gates Foundation.
Many governments are committed to accelerating the adoption and uptake of digital payments for healthcare workers based on its potential to increase financial inclusion, timeliness, transparency, and accountability during health campaigns and provide economic benefits to communities.
Pathfinder Kenya, Aponjon, and the ASHA program found that mobile money improved the transparency and monitoring of payments to community health workers by ensuring that payments are sent safely and promptly.
Therefore, the project seeks to promote the use of mobile money in health programs, both as a catalyst for uptake in campaigns and to strengthen health systems to drive motivation and satisfaction amongst campaign health workers.
Through a randomized clinical trial study (RCT), the digital payment project will assess the effectiveness of digital payments in the upcoming polio campaign in Uganda.
We are currently working with the Ministry of Health and Ministry of Finance around sub-Saharan Africa to enhance efforts to digitize payments for health workers by fostering and supporting evidence-based and evidence-driven decision-making.
jamoit@musph.ac.ug
The author is a communications officer digital payments project
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