Digital readiness assessment of Africa’s frontline health workers for government payments

• Jul 26, 2025
• 2 min

Vaccine-derived polio outbreaks were rising across Africa, yet vaccination campaigns faced significant challenges. In the first quarter of 2020, nearly half of the polio campaigns in the WHO’s Africa region were postponed or disrupted due to payment delays for campaign workers. Many countries continued to rely on public finance management systems (PFMS), which often led to inefficiencies. Digital payments emerged as a potential solution to streamline payments for health workers and build a broader tech-enabled ecosystem for vaccination campaigns.

MSC assessed four African countries—Burkina Faso, Ethiopia, Côte d’Ivoire, and South Sudan—to evaluate their readiness for biometric-enabled digital payments for polio campaign workers. MSC used its digital readiness assessment (DRA) framework to examine infrastructure readiness (digital identity, payment systems, agent networks, and digital ecosystems) and program readiness (digital beneficiary databases and program design). The study also analyzed financial inclusion indicators, health worker density, and existing payment methods to recommend a holistic government-to-person (G2P) payment approach.

MSC provided key recommendations to optimize public financial management (PFM) processes through digital architecture. Immediate recommendations sought to strengthen existing systems, institute KYC processes, and facilitate cash-in and cash-out (CICO) networks to ensure smoother payments. Long-term recommendations emphasized the development of digital foundational IDs for health workers, which could link bank accounts to digital identities, and the integration of an interoperable payment system with the national payment switch.

The study provided a strategic roadmap for each country to transition toward efficient digital payment mechanisms, ensure timely compensation for health workers, and strengthen the vaccination ecosystem. The initiative enabled secure and transparent digital transactions to enhance polio campaign effectiveness and lay the groundwork for future health interventions in Africa.