Senegal has enlisted Wave Digital Finance to digitise payments across its public hospitals, deepening the company’s role in state infrastructure even as regulatory uncertainty reshapes West Africa’s fast-growing mobile money market.
The agreement, signed last week with the Ministry of Health, will allow patients to pay for consultations, treatments and other hospital services mobile wallets, reducing reliance on cash in a system long criticised for administrative bottlenecks and weak financial controls.
“This partnership will allow us to gradually extend digital payments to all healthcare facilities,” said Ibrahima Sy, Senegal’s health minister, adding that the government intends to make electronic payments a “sustainable standard” across the healthcare system.
The move places Wave — already one of the most dominant financial technology players in francophone Africa — at the centre of another critical public service, following its rapid expansion into urban transport and everyday retail payments.
From transport to hospitals
Wave’s integration into Senegal’s public infrastructure has accelerated over the past two years. In 2024, the company partnered with Dakar Mobilité to power ticketing for Dakar’s bus rapid transit system, allowing commuters to purchase fares through its mobile application.
The system, part of the government’s flagship Plan Sénégal Émergent, has seen adoption rise sharply. Mobile ticket purchases increased from roughly 10 per cent of transactions at launch to about 30 per cent within months, according to the operator, while physical ticket sales declined steeply.
Wave has since expanded into other transport networks, including the regional express train and the state bus company, reinforcing its presence in high-frequency, low-value transactions — a segment that aligns closely with its low-fee model.
The healthcare rollout follows a similar logic. By embedding payments in essential services used daily by millions, the company is positioning itself less as a payments provider and more as a foundational layer of Senegal’s digital economy.
For the government, the appeal extends beyond convenience. Digitising hospital payments is expected to improve revenue tracking, limit leakages and reduce opportunities for fraud in a sector where cash handling has historically been difficult to monitor.
Electronic payments generate real-time data, offering administrators clearer oversight of funds collected by public facilities. In a country where public financial management remains under scrutiny, officials view such systems as a lever to strengthen governance.
Patients, meanwhile, may benefit from shorter queues and fewer procedural hurdles. Mobile money has already achieved widespread adoption in Senegal, making the transition to digital payments relatively frictionless compared with earlier attempts at public-sector digitisation.
Dominance built on price — and scale
Wave’s rise has been underpinned by a simple pricing strategy: a flat transaction fee of about 1 per cent, significantly lower than those historically charged by telecom-led mobile money operators.
Founded in 2018, the company reached unicorn status three years later after raising $200mn, becoming the first francophone African start-up to do so. It now counts roughly 11mn active users in Senegal alone, with penetration estimated at close to 90 per cent of the adult population.
Across the eight countries of the West African Economic and Monetary Union, mobile money transactions reached CFA160tn ($267bn) in 2024 — equivalent to 119 per cent of the bloc’s combined GDP — underscoring the scale of the market Wave is operating in.
The company’s share of transaction value in the region has been rising steadily, while incumbents such as Orange Money and MTN MoMo have lost ground, according to central bank data.
Wave’s growing role in public services comes at a delicate moment for the sector. In late 2025, the Banque Centrale des États de l’Afrique de l’Ouest launched an interoperable instant payments platform designed to connect banks and mobile wallets across the region.
The system, known as PI-SPI, aims to enable seamless transfers between institutions and eliminate fees for person-to-person payments within the network.
But adoption has been uneven. Wave and other large operators have been slow to fully integrate, reflecting concerns that interoperability could erode the competitive advantage of closed-loop networks built on scale and simplicity.
For Wave, the trade-off is stark: joining the platform could unlock access to bank-held deposits and broaden its reach, but it may also compress margins and weaken customer lock-in.
At the same time, the broader mobile money ecosystem faces structural challenges. Despite high transaction volumes, most users continue to treat digital wallets as transit tools rather than stores of value, with the majority of funds still withdrawn as cash.
Fintech as infrastructure
Against this backdrop, Wave’s expansion into healthcare signals a broader shift in the role of African fintechs. Rather than focusing solely on payments, leading players are increasingly embedding themselves in public infrastructure — from transport systems to hospitals — where transaction frequency is high and user adoption can be rapidly scaled.
The strategy carries both opportunity and risk. While it strengthens the company’s market position and deepens financial inclusion, it also ties its growth more closely to government policy and regulatory direction.
For Senegal, the partnership reflects a pragmatic approach: leveraging a widely adopted private platform to modernise public services without building new systems from scratch.
Whether that model proves sustainable will depend on how the balance between innovation, competition and regulation evolves in one of the world’s most active mobile money markets.