Digital Payment System in Malawi: Improving Incentive Management for Immunization Campaigns

DIGITAL PAYMENT SYSTEM
A CASE OF MALAWI
  
Dr Mike N. Chisema
National EPI Manager
MBBS, MPH, Dip EH
.
INTRODUCTION
Human resource incentive are important for quality Supplementary Immunization Activity
campaigns e.g. Polio
Innovative ways of payment that reduces inefficiencies during payments critical
Payment of beneficiaries through bank account or mobile phone numbers (mobile money)
is one innovation
All types of payment can be made:
Payment of DSAs
Payment of lunch allowances
Payment for fuel
Payment for services .i.e. refreshments during seminars 
REQUIREMENTS AND PROCESSES
Beneficiary should have functional bank account or registered phone number
Beneficiaries should submit their full details, name, National identity very
important
Account details/mobile money details should be verified
For mobile money, verification is done by telecommunication companies
(Airtel or TNM)
Verification may take 24-48 hours
Always include mobile money charges
Money transferred into mobile wallet of the beneficiary .i.e. vaccinator, volunteer
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1.
Wild Polio Case Detection
2
Fund Mobilization (GPEI through WHO&UNICEF
3
3
4
Learning operationalization digital payment system
Receipt of Technical and political support
5
Training of  Community Health Care workers -SIA
6
Registration Process of community health workers
7
Verification of contacts of community health workers
8
Approval of Contacts
9
Payment of allowances
Start
F
e
b
2
0
2
2
ROUNDS 1-5
End
Payment of allowances
PAYMENT FOR PROCUREMENT/SERVICE
Requires the company/business to be registered in the WHO system
Registration includes bank details
The system registers only businesses that are registered with the registrar
general of Malawi
Payment is issued after the service is offered
C
o
v
e
r
a
g
e
Children under 15 years were vaccinated 
9,495,318 (107%)
Children under five years were vaccinated 
3,629,202(98.6%)
LQAS: 20/29 (69%) of Lots passed at 90% coverage band compared to
72% in RD4 2022.
Target population for next round 
9,859,061
Total budget $5,695,565
Admin Data: 0-<15yr Coverage Rate
7
Nationally, 
107.1%
 of the target group (0-<15 yrs) have been vaccinated. 27/29 districts
achieved the expected target of 
≥95%.
Lot Quality Assurance Sampling Results (1/2)
8
69%
 Lots (20/29) passed
the LQAS as against the
target of at least 80% of
lots. 
Of the total 1,740 sampled
eligible <5 children, 104
(
6%
) missed the
vaccination.
Majority of the missed
children 
(24%) 
were
identified in CHIRADZULU
district
Failed Lots and missed children
Selected Settlements with missed children
S
a
m
p
l
e
 
o
f
 
a
c
t
i
v
i
t
i
e
s
Briefing meetings
Trainer of trainers
Immunization delivery training
Microplanning
Actual vaccination and mop up activities
In process/end process monitoring of the campaign
Lot Quality Assessment Sampling survey
Supervision
The other activities to do with Social Mobilization and Supply chain
logistics are done by UNICEF and paid by cash
R
a
w
 
s
t
a
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f
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P
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c
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p
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n
Total vaccination teams                                                  
18239
Vaccinators                                                                       
18239
Total recorders                                                                 
18239
Total Supervisors                                                               4486
Total teams paid                                                              36479
Total people paid                                                             
40965
The transmission of payments have been made we 100% success rate
18239 Social mobilizers and 1520 SM supervisors paid via cash (UNICEF)
DIGITAL PAYMENT SYSTEM
ADVANTAGES
Money goes direct to the beneficiary
Reduces the risk that come with
handling hard cash
Convenient
Cheaper
DISADVANTAGES
Requires account/mobile details
before payment
May result to unnecessary delay if no
cooperation
Requires all beneficiaries to have
either account number or phone
number registered on mobile money
services
May pay to wrong numbers and not
easy to reverse
Payment by default and not who
worked at times
SUCCESSES
We managed to pay  11,000 vaccinators and recorders during the three
rounds of polio vaccination campaign in all 29 districts
Used the same system to pay during oral cholera vaccination campaign in
8 districts
Initial payment yields over 99% success rate with few returned due to
mismatches or wrong account details
CHALLENGES
Submission of wrong account or mobile details
Mismatches on mobile details that usually lead to delay in payment
The system requires cooperation of everyone including mobile service
operators
Resistance from some quarters as they still prefer the old system (cash
payment)
Way forward
Continuous engagement and improvement plans for the payment
system
Ensure data base is created and only work on updating beneficiary
information
Improve on beneficiary data storage to reduce back and forth
verification and validation of individual data-time consuming
THANK YOU
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Enhancing quality in Supplementary Immunization Activities like Polio campaigns requires efficient human resource incentives. Implementing innovative digital payment systems in Malawi, spearheaded by Dr. Mike N. Chisema, is revolutionizing the way incentives are managed for beneficiaries through bank accounts or mobile money. The process includes beneficiary verification, payment integration for various services, and operational steps for successful mobile payment adoption, ensuring seamless transactions for stakeholders.

  • Digital Payment
  • Malawi
  • Immunization Campaigns
  • Incentive Management
  • Mobile Money

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  1. DIGITAL PAYMENT SYSTEM A CASE OF MALAWI Dr Mike N. Chisema National EPI Manager MBBS, MPH, Dip EH.

  2. INTRODUCTION Human resource incentive are important for quality Supplementary Immunization Activity campaigns e.g. Polio Innovative ways of payment that reduces inefficiencies during payments critical Payment of beneficiaries through bank account or mobile phone numbers (mobile money) is one innovation All types of payment can be made: Payment of DSAs Payment of lunch allowances Payment for fuel Payment for services .i.e. refreshments during seminars

  3. REQUIREMENTS AND PROCESSES Beneficiary should have functional bank account or registered phone number Beneficiaries should submit their full details, name, National identity very important Account details/mobile money details should be verified For mobile money, verification is done by telecommunication companies (Airtel or TNM) Verification may take 24-48 hours Always include mobile money charges Money transferred into mobile wallet of the beneficiary .i.e. vaccinator, volunteer

  4. Process for Operationalizing mobile payment system Process for Operationalizing mobile payment system 1. Wild Polio Case Detection 2 Fund Mobilization (GPEI through WHO&UNICEF 3 3 Learning operationalization digital payment system F e b 2 0 2 2 4 Receipt of Technical and political support 5 Training of Community Health Care workers -SIA 6 Registration Process of community health workers 7 Verification of contacts of community health workers 8 Approval of Contacts 9 Payment of allowances Payment of allowances End Start ROUNDS 1-5

  5. PAYMENT FOR PROCUREMENT/SERVICE Requires the company/business to be registered in the WHO system Registration includes bank details The system registers only businesses that are registered with the registrar general of Malawi Payment is issued after the service is offered

  6. Coverage Coverage Children under 15 years were vaccinated 9,495,318 (107%) Children under five years were vaccinated 3,629,202(98.6%) LQAS: 20/29 (69%) of Lots passed at 90% coverage band compared to 72% in RD4 2022. Target population for next round 9,859,061 Total budget $5,695,565

  7. Admin Data: 0-<15yr Coverage Rate Nationally, 107.1% of the target group (0-<15 yrs) have been vaccinated. 27/29 districts achieved the expected target of 95%. 7

  8. Lot Quality Assurance Sampling Results (1/2) Failed Lots and missed children 69% Lots (20/29) passed the LQAS as against the target of at least 80% of lots. Of the total 1,740 sampled eligible <5 children, 104 (6%) missed the vaccination. Majority of the missed children (24%) were identified in CHIRADZULU district District Chiradzulu Mzimba North Nkhotakota Nsanje Neno Salima Thyolo Balaka Lilongwe Missed %Missed 25 8 8 8 6 6 6 5 5 24% 8% 8% 8% 6% 6% 6% 5% 5% Selected Settlements with missed children Children Missed District Facility Settlement CHIRADZULU CHIMWAWA Chapamba 4 CHIRADZULU CHIRADZULU DHO Malikampenya 1 CHIRADZULU MARAVI Chibwana 3 CHIRADZULU MBULUMBUZI Chitambo 9 CHIRADZULU NAMITAMBO Nkhuku 6 Legend CHIRADZULU NJULI Lulanga 2 Rejected Accepted No LQAS Done 8

  9. Sample of activities Sample of activities Briefing meetings Trainer of trainers Immunization delivery training Microplanning Actual vaccination and mop up activities In process/end process monitoring of the campaign Lot Quality Assessment Sampling survey Supervision The other activities to do with Social Mobilization and Supply chain logistics are done by UNICEF and paid by cash

  10. Raw statistics for the Polio campaign Raw statistics for the Polio campaign Total vaccination teams 18239 Vaccinators 18239 Total recorders 18239 Total Supervisors 4486 Total teams paid 36479 Total people paid 40965 The transmission of payments have been made we 100% success rate 18239 Social mobilizers and 1520 SM supervisors paid via cash (UNICEF)

  11. DIGITAL PAYMENT SYSTEM ADVANTAGES Money goes direct to the beneficiary Reduces the risk that come with handling hard cash Convenient Cheaper DISADVANTAGES Requires account/mobile details before payment May result to unnecessary delay if no cooperation Requires all beneficiaries to have either account number or phone number registered on mobile money services May pay to wrong numbers and not easy to reverse Payment by default and not who worked at times

  12. SUCCESSES We managed to pay 11,000 vaccinators and recorders during the three rounds of polio vaccination campaign in all 29 districts Used the same system to pay during oral cholera vaccination campaign in 8 districts Initial payment yields over 99% success rate with few returned due to mismatches or wrong account details

  13. CHALLENGES Submission of wrong account or mobile details Mismatches on mobile details that usually lead to delay in payment The system requires cooperation of everyone including mobile service operators Resistance from some quarters as they still prefer the old system (cash payment)

  14. Way forward Continuous engagement and improvement plans for the payment system Ensure data base is created and only work on updating beneficiary information Improve on beneficiary data storage to reduce back and forth verification and validation of individual data-time consuming

  15. THANK YOU

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