How payment software was key to tackling the Ebola crisis How payment software was key to tackling the Ebola crisis

How payment software was key to tackling the Ebola crisis
24 Nov 2017

In the middle of West Africa’s Ebola crisis, a small tech company in Sierra Leone developed a payment solution that helped prevent the collapse of the country’s healthcare system. Its ground-breaking work has resulted in it winning the UPS International Disaster Relief category in the UK’s Business in the Community’s Responsible Business Awards, which is supported by the UK’s Department for International Development.

In 2014, the Ebola virus took hold in West Africa, hammering the economies and health systems of the hardest hit countries, Sierra Leone, Guinea and Liberia, and bringing them to a virtual standstill. By October of that year, strikes and other disruptions in Sierre Leone, resulting from a failure to pay healthcare workers, were hindering efforts to contain the epidemic. As a result, the response system became crippled and the country’s National Ebola Response Centre was spending 70% of its time trying to resolve pay disputes instead of coordinating how to prevent Ebola’s spread and lessen its impact.

In theory, paying people should be simple, but in practice there were many pressing challenges. Firstly, the number of people with bank accounts in Sierra Leone amounts to a mere 10% of the total population, with the majority of bank branches located in urban areas. Furthermore, the national ID scheme covers only 15% of the nation.

Add to this the unfortunate reality of systemic corruption at all levels of society and it becomes clear why there was an urgent requirement for an innovative and unconventional approach for distributing hazard pay to Ebola response workers (ERWs).

Hazard payment scheme

The international development community, in conjunction with the governments of affected countries, had introduced a hazard payment scheme as a last-ditch attempt to prevent the collapse of health systems in the hardest hit areas. Under this programme, the definition of ERWs, health workers and volunteers who formed the cornerstone of the global response to the Ebola threat, was extended.

It no longer simply covered frontline workers directly involved in the deadly struggle with the disease, but also health workers from all kinds of health facilities in the affected countries. In Sierra Leone, this meant that a total of 30,000 ERWs were eligible for the monthly hazard payments.

In order to ensure payment went smoothly, the initial system requirement was for a database that could store 20,000 ERW records and that was compatible with the mobile wallets workers had on their devices in the field. But undertaking large-scale payments in developing countries such as Sierra Leone is rarely straightforward. The challenges could broadly be grouped into three categories:

• The monthly turnover rate for ERWs was about 30%, with significant numbers moving across districts and work cadres. This meant that payee lists needed to be managed in a very systematic way
• Roughly 70% of the population in Sierre Leone shares 10 common surnames. This situation, compounded by the fact that the national identification system covers only 15% of the population, meant that identifying individual payees digitally was testing
• While technology and network infrastructure reaches further than it used to, it is still not always accessible or reliable, particularly in rural and remote communities.

New technology

It was also clear that, in a country so unused to digital platforms, simply introducing one would not automatically generate confidence in the hazard payment scheme. Another key issue was working out how ERWs could best be verified and tracked and also how they could log on to the system easily in order to resolve complaints or grievances around pay.

Therefore, over the course of a month, we traveled to hundreds of healthcare facilities around the country in order to verify the existence and eligibility for inclusion in the system of each ERW. We also ensured that the data held about them was accurate and complete.

The next step was to build an easy-to-use system based on cloud technology that included a core database, mobile wallets and support for facial recognition-based biometric data.

Once it was introduced, payment times immediately plummeted from over a month to an average of a week. After a couple of weeks, when people were confident they would be paid on time with no strange deductions and that they had a valid channel for complaints, the strikes stopped completely.

“Undertaking large-scale payments in developing countries such as Sierra Leone is rarely straightforward.”

Big benefits

A study conducted by the United Nations-based Better Than Cash Alliance estimated that by digitising payments to ERWs, savings of US $10.7 million were realised for the government, taxpayers, development partners and response workers – the equivalent of funding Sierra Leone’s Free Health Care Program, which caters to 1.4 million children and 250,000 pregnant women, for a year.

The system also prevented the loss of around 800 working days per month, helping to save lives during a critical time. ERWs themselves likewise saved a total of about $80,000 per month in travel costs as they were able to avoid lengthy journeys to cash payment centres.

But the project had other upsides too. For us as an organisation, the knowledge and experience gained fed into new services such as our cloud-based payroll system and digital payment aggregator, which are both designed specifically to meet the requirements and unique challenges of the West African market.

It has also given us a forum to talk about the credibility of the younger generation in coming up with solutions to some of the difficult issues that the world currently faces. And finally, it demonstrated just how much digital systems really can help to change the landscape of global humanitarian relief for the better.

 

Salton Massally is chief technology officer at iDT Labs, a technology company based in Sierra Leone that provides innovative solutions to support social and environmental change. The firm, which was set up in 2013, partners with government departments, businesses, non-profit organisations, social enterprises and foundations in a bid to directly bridge the digital divide in West Africa and increase the social impact in sectors such as telecommunications, health, water and sanitation, financial inclusion, agriculture and gender equity.

In the middle of West Africa’s Ebola crisis, a small tech company in Sierra Leone developed a payment solution that helped prevent the collapse of the country’s healthcare system. Its ground-breaking work has resulted in it winning the UPS International Disaster Relief category in the UK’s Business in the Community’s Responsible Business Awards, which is supported by the UK’s Department for International Development.

In 2014, the Ebola virus took hold in West Africa, hammering the economies and health systems of the hardest hit countries, Sierra Leone, Guinea and Liberia, and bringing them to a virtual standstill. By October of that year, strikes and other disruptions in Sierre Leone, resulting from a failure to pay healthcare workers, were hindering efforts to contain the epidemic. As a result, the response system became crippled and the country’s National Ebola Response Centre was spending 70% of its time trying to resolve pay disputes instead of coordinating how to prevent Ebola’s spread and lessen its impact.

In theory, paying people should be simple, but in practice there were many pressing challenges. Firstly, the number of people with bank accounts in Sierra Leone amounts to a mere 10% of the total population, with the majority of bank branches located in urban areas. Furthermore, the national ID scheme covers only 15% of the nation.

Add to this the unfortunate reality of systemic corruption at all levels of society and it becomes clear why there was an urgent requirement for an innovative and unconventional approach for distributing hazard pay to Ebola response workers (ERWs).

Hazard payment scheme

The international development community, in conjunction with the governments of affected countries, had introduced a hazard payment scheme as a last-ditch attempt to prevent the collapse of health systems in the hardest hit areas. Under this programme, the definition of ERWs, health workers and volunteers who formed the cornerstone of the global response to the Ebola threat, was extended.

It no longer simply covered frontline workers directly involved in the deadly struggle with the disease, but also health workers from all kinds of health facilities in the affected countries. In Sierra Leone, this meant that a total of 30,000 ERWs were eligible for the monthly hazard payments.

In order to ensure payment went smoothly, the initial system requirement was for a database that could store 20,000 ERW records and that was compatible with the mobile wallets workers had on their devices in the field. But undertaking large-scale payments in developing countries such as Sierra Leone is rarely straightforward. The challenges could broadly be grouped into three categories:

• The monthly turnover rate for ERWs was about 30%, with significant numbers moving across districts and work cadres. This meant that payee lists needed to be managed in a very systematic way
• Roughly 70% of the population in Sierre Leone shares 10 common surnames. This situation, compounded by the fact that the national identification system covers only 15% of the population, meant that identifying individual payees digitally was testing
• While technology and network infrastructure reaches further than it used to, it is still not always accessible or reliable, particularly in rural and remote communities.

New technology

It was also clear that, in a country so unused to digital platforms, simply introducing one would not automatically generate confidence in the hazard payment scheme. Another key issue was working out how ERWs could best be verified and tracked and also how they could log on to the system easily in order to resolve complaints or grievances around pay.

Therefore, over the course of a month, we traveled to hundreds of healthcare facilities around the country in order to verify the existence and eligibility for inclusion in the system of each ERW. We also ensured that the data held about them was accurate and complete.

The next step was to build an easy-to-use system based on cloud technology that included a core database, mobile wallets and support for facial recognition-based biometric data.

Once it was introduced, payment times immediately plummeted from over a month to an average of a week. After a couple of weeks, when people were confident they would be paid on time with no strange deductions and that they had a valid channel for complaints, the strikes stopped completely.

“Undertaking large-scale payments in developing countries such as Sierra Leone is rarely straightforward.”

Big benefits

A study conducted by the United Nations-based Better Than Cash Alliance estimated that by digitising payments to ERWs, savings of US $10.7 million were realised for the government, taxpayers, development partners and response workers – the equivalent of funding Sierra Leone’s Free Health Care Program, which caters to 1.4 million children and 250,000 pregnant women, for a year.

The system also prevented the loss of around 800 working days per month, helping to save lives during a critical time. ERWs themselves likewise saved a total of about $80,000 per month in travel costs as they were able to avoid lengthy journeys to cash payment centres.

But the project had other upsides too. For us as an organisation, the knowledge and experience gained fed into new services such as our cloud-based payroll system and digital payment aggregator, which are both designed specifically to meet the requirements and unique challenges of the West African market.

It has also given us a forum to talk about the credibility of the younger generation in coming up with solutions to some of the difficult issues that the world currently faces. And finally, it demonstrated just how much digital systems really can help to change the landscape of global humanitarian relief for the better.

 

Salton Massally is chief technology officer at iDT Labs, a technology company based in Sierra Leone that provides innovative solutions to support social and environmental change. The firm, which was set up in 2013, partners with government departments, businesses, non-profit organisations, social enterprises and foundations in a bid to directly bridge the digital divide in West Africa and increase the social impact in sectors such as telecommunications, health, water and sanitation, financial inclusion, agriculture and gender equity.

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