Lee Pyne-Mercier, Krishna Jafa, Susan Maigua, Jennifer Muli, Elijah Gichinga, Antony Khaemba, Nitusima Kataraia, Aisha Mohammed, Frank Kamangadazi Tembo, Imran Esmail, Giulia V R Besana, Heiko Hornung, Ali Makame Zubeir
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引用次数: 0
Abstract
Background: Community health workers (CHWs) are essential for achieving universal health coverage and reaching the Sustainable Development Goals. Paying CHWs for their work increases their motivation and effectiveness, and is recommended by the World Health Organization and advocacy organizations such as the Community Health Impact Coalition. Many implementing organizations currently pay CHWs using mobile money or other digital means. However, most payment systems are designed without the involvement of CHWs.
Objective: In this implementation report, we describe efforts to improve efficiency, accuracy, and user experience of the CHW payment process of the Jamii ni Afya project in Zanzibar.
Methods: We applied Medic's design process to develop new functionality for the open-source Community Health Toolkit. We reviewed documentation and engaged with users to understand their needs and experiences with the current payment system. This information formed the basis of technical specifications, which were developed into a revised workflow. The workflow was iteratively tested and refined. Several steps that were managed offline, such as resolving payment discrepancies, were formalized and incorporated into the workflow. We conducted user acceptance testing to assess functionality and user experience.
Unlabelled: The workflow was able to accurately translate programmatic data into payment information for each CHW and securely transmitted this information to a payment service provider. User acceptance testing revealed that CHWs felt the revised payment system provided them with more information and gave them a greater sense of control. Program staff felt the workflow would increase the efficiency and accuracy of the payment process, while simplifying the resolution of payment discrepancies.
Conclusions: Engaging users in the design and optimization of digital payment systems has the potential to improve the efficiency and accuracy of digital payment systems while enhancing satisfaction among all users, contributing to improved sustainability and impact of CHW programs. Definitive conclusions will depend on evaluation of the system after implementation.
背景：社区卫生工作者对于实现全民健康覆盖和实现可持续发展目标至关重要。世界卫生组织和社区卫生影响联盟等倡导组织建议向卫生保健员支付报酬，以提高他们的工作积极性和效率。许多实施机构目前使用移动货币或其他数字手段向卫生工作者支付费用。然而，大多数支付系统的设计都没有卫生工作者的参与。目的：在本实施报告中，我们描述了为提高桑给巴尔Jamii ni Afya项目卫生保健支付流程的效率、准确性和用户体验所做的努力。方法：应用Medic的设计流程为开源社区健康工具包开发新功能。我们审查了文档，并与用户接触，以了解他们对当前支付系统的需求和体验。这些信息构成了技术规范的基础，这些技术规范被开发成修订后的工作流程。对工作流进行了迭代测试和改进。离线管理的几个步骤，例如解决付款差异，被形式化并合并到工作流程中。我们进行了用户验收测试来评估功能和用户体验。未标记：工作流能够准确地将编程数据转换为每个CHW的支付信息，并将此信息安全地传输给支付服务提供商。用户接受度测试显示，chw认为修改后的支付系统为他们提供了更多信息，并赋予了他们更大的控制感。项目工作人员认为，该工作流程将提高付款过程的效率和准确性，同时简化付款差异的解决。结论：让用户参与数字支付系统的设计和优化有可能提高数字支付系统的效率和准确性，同时提高所有用户的满意度，有助于提高CHW项目的可持续性和影响。最终结论将取决于系统实施后的评价。
期刊介绍：
JMIR Medical Informatics (JMI, ISSN 2291-9694) is a top-rated, tier A journal which focuses on clinical informatics, big data in health and health care, decision support for health professionals, electronic health records, ehealth infrastructures and implementation. It has a focus on applied, translational research, with a broad readership including clinicians, CIOs, engineers, industry and health informatics professionals.
Published by JMIR Publications, publisher of the Journal of Medical Internet Research (JMIR), the leading eHealth/mHealth journal (Impact Factor 2016: 5.175), JMIR Med Inform has a slightly different scope (emphasizing more on applications for clinicians and health professionals rather than consumers/citizens, which is the focus of JMIR), publishes even faster, and also allows papers which are more technical or more formative than what would be published in the Journal of Medical Internet Research.
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