Mobile Health Technologies Are Essential for Reimagining the Future of Water, Sanitation, and Hygiene

Abstract

The new Lancet Commission on water, sanitation, and hygiene (WASH) hopes to reimagine and guide global WASH efforts. This comes at a time when unequal living conditions and global disparities in response and recovery have been highlighted by the COVID-19 pandemic and recent large impact trials have delivered mostly disappointing results suggesting the need for radically more effective interventions to improve global public health. We find ourselves at an inflection point in global WASH with an opportunity to build new approaches with potentially more equitable, cost-effective, and scalable solutions. Mobile health (mHealth) technology is an important and innovative tool for WASH advances. Yet, the use of mHealth has not been equally distributed in terms of its benefits nor is its impact guaranteed. In resource-constrained settings, where technology can increase inequalities, special attention should be paid to structural and systemic hierarchies during the development of mHealth programs along with the acknowledgment and understanding how these systems can reinforce the systematic exclusion of those most vulnerable. The WASH sector needs to adapt to a future that is innovative and inclusive with a commitment to rethinking the resources needed to enhance scope and impact. We highlight urban sanitation in Brazil as a case study to demonstrate that mHealth can support and enhance publicly funded infrastructure and to help reimagine WASH for postpandemic and beyond.

Kukaa Salama (Staying Safe): a pre-post trial of an interactive informational mobile health intervention for increasing COVID-19 prevention practices with urban refugee youth in Uganda

“…These findings corroborate research in other contexts, 8 , 9 including findings from a systematic review of digital interventions for household and community infection prevention. 28 While we did not identify mHealth interventions conducted with urban refugee youth, a study with university students in Germany informed by the Health Action Process framework focused on behaviour change techniques for handwashing and found sustained increases at the 86-d follow-up.…”

“…Reflecting on the future of WASH in the context of COVID-19, Stauber et al 8 (p.1017) describe: ‘We find ourselves at an inflection point in global WASH with an opportunity to build new approaches with potentially more equitable, cost-effective, and scalable solutions. Mobile health (mHealth) technology is an important and innovative tool for WASH advances.’ Such mHealth opportunities include interactive SMS messaging, geotagging and mapping, WhatsApp groups and user/provider feedback.…”

“…Mobile health (mHealth) technology is an important and innovative tool for WASH advances.’ Such mHealth opportunities include interactive SMS messaging, geotagging and mapping, WhatsApp groups and user/provider feedback. 8 , 9 In South Africa, for instance, WhatsApp was used to provide COVID-19 information and reply to concerns among the general public, and cellphone networks were used for contact tracing. 9 Mobile applications were also used for contact tracing by community health workers in Ugandan rural regions 10 and in a humanitarian setting in Bangladesh.…”