Why mHealth

Learn about WASHmobile and why mHealth is a cost-saving, scalable WASH tool for implementers Why mHealth

WASHmobile uses mobile health messaging to deliver lifesaving WASH guidance at a much lower cost compared to traditional outbreak responses. By targeting households at highest risk - those living near diarrhea patients - our programs can reduce disease transmission, avert millions of diarrhea cases, and strengthen climate resilience. Proven to be effective in the DRC and Bangladesh, this cost-effective approach ensures maximum impact in a competitive funding environment.

Mobile health (mHealth) interventions offer a transformative, cost-effective approach to preventing diarrheal disease in resource-constrained and humanitarian settings. Traditional “blanket approaches” to outbreak response, where water, sanitation, and hygiene (WASH) interventions are deployed broadly and in-person only after outbreaks escalate, are expensive and logistically challenging. These large-scale responses can cost up to ~0.85 USD⁽¹⁾ per beneficiary, compared to ~0.12 USD per beneficiary with targeted mobile health programs.

By contrast, WASH mHealth messaging provides a low-cost, scalable alternative that delivers timely, evidence-based guidance directly to households through mobile phones. This approach eliminates the need for resource-intensive household visits while still enabling rapid dissemination of lifesaving information on water treatment, safe storage, and handwashing practices.

Targeting those at highest risk

Outbreak response is most effective when it prioritizes populations at the greatest risk. When a diarrhea patient presents at a healthcare facility, our research in the Democratic Republic of the Congo (DRC) shows that households within 500 meters face a >12-fold higher risk of hospitalized diarrhea over the following seven days compared with the general population. Targeting WASH interventions to these “hotspot” households offers a powerful way to interrupt transmission, reduce outbreak size, and save lives.

Given that diarrhea from inadequate WASH is estimated to contribute to 54 million disability-adjusted life-years (DALYs) and 1 million deaths globally each year⁽²⁾⁽³⁾ the potential for impact is substantial. Scaled implementation of targeted mHealth-based WASH programs could avert millions of cases, reduce strain on health systems, and free resources for other critical priorities.

Building resilience in a changing climate

Climate change is expected to increase the frequency and severity of diarrheal disease outbreaks. Early alert and response systems, such as our mHealth-enabled WASHmobile interventions, build resilience by rapidly mobilizing preventive measures in the most vulnerable communities. These targeted approaches strengthen health security and represent a critical cost-saving strategy for humanitarian actors seeking to maximize impact in a competitive funding environment.

Proven partnerships and evidence base

The WASHmobile program builds on over a decade of research and implementation in collaboration with the Ministries of Health in the DRC and Bangladesh. Through the PICHA7 program in the DRC and the CHoBI7 program in Bangladesh, our teams have demonstrated that targeted WASH combined with mHealth messaging can significantly reduce diarrhea and improve child growth.

References

(1) Quattrochi JP, Coville A, Mvukiyehe E, et al. Effects of a community-driven water, sanitation and hygiene intervention on water and sanitation infrastructure, access, behaviour, and governance: a cluster-randomised controlled trial in rural Democratic Republic of Congo. BMJ global health 2021; 6(5).

(2) Wolf J, Johnston RB, Ambelu A, et al. Burden of disease attributable to unsafe drinking water, sanitation, and hygiene in domestic settings: a global analysis for selected adverse health outcomes. Lancet (London, England) 2023; 401(10393): 2060-71.

(3) Troeger C, Blacker B, Khalil IA, et al. Estimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory infections in 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet infectious diseases 2018; 18(11): 1191-210.

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