Associations between digital financial services and health campaign workers' perceived satisfaction, motivation and performance in Nigeria.

Background: Understanding the association between digital payment services and health worker outcomes is critical to improving public health outcomes and optimising health workforce efficiency. This study examined the link between digital payment systems and health campaign workers' perceived satisfaction, motivation and performance in Nigeria.

Methods: A national survey was conducted among 821 polio immunisation workers who participated in campaigns. A structured electronic questionnaire which had sections on sociodemographic characteristics and digital payments was used to elicit information from participants. Campaign workers' self-reported satisfaction, motivation and performance were assessed using standardised tools for examining these outcomes. Linear mixed model regression analysis was used to examine the factors associated with health worker's motivation, satisfaction and performance. Predictors of these outcomes during periods of cash and digital payment methods were assessed, with statistical significance set at the 5% level.

Results: This cross-sectional study included 821 health campaign workers in Nigeria, with a mean age of 37.13 years (SD=11.06). Regarding digitised payments, mean scores across all constructs were generally high: general motivation (16.34±2.58; maximum=20), job satisfaction (20.33±3.16; max=25), intrinsic job satisfaction (12.87±1.62; max=15), organisational commitment (16.99±1.96; max=20), conscientiousness (15.68±1.71; max=20), timeliness and attendance (13.35±1.55; max=15) and perceived performance (20.54±2.97; max=25). Overall, the combined motivation, satisfaction and performance score was higher among workers paid via digital methods compared with those paid in cash (104.14±9.34 vs 68.43±50.75). In multivariable linear regression, being female (β=1.83; 95% CI=0.28 to 3.38) and the ability to use the internet (β=1.87; 95% CI=0.02 to 3.72) were significant independent predictors of higher overall scores.

Conclusion: Digital payment methods were associated with higher health workers' perceived job satisfaction, motivation and performance. Public health stakeholders need to promote the use of digital payments to maximise their positive influence on health workers.