WASHmobile is a mHealth platform that delivers WASH mobile messages directly to households at highest risk for diarrhea (e.g. diarrhea patient households) and in areas at high risk for diarrhea outbreaks. The program leverages digital mobile-based behavior-change tools including voice, Interactive Voice Response (IVR), and SMS messages to promote handwashing with soap, safe drinking water treatment, and safe drinking water storage. Promoted WASH mobile-based tools are adaptable depending on the context.

Targeting WASH to those living near diarrhea patients offers a cost-effective approach to reduce diarrhea outbreaks by reaching those at highest risk. This contrasts the traditional “blanket approach,” which waits for large outbreaks before deploying broad, in-person interventions that are costly and time-consuming. mHealth messaging provides a low-cost, scalable method to alert communities to public health threats without the need for resource-intensive visits. This is particularly important given the global funding crisis for WASH interventions and development.

WASHmobile has been implemented in both the Democratic Republic of the Congo (DRC) and Bangladesh. This program was designed through community centered formative research and tested in randomized controlled trials >5,000 participants. It began as the CHoBI7 program in Bangladesh and was later adapted and expanded as the PICHA7 program in the DRC in partnership with the Ministry of Health.

WASHmobile targets high-risk populations for diarrhea and diarrhea outbreaks. This program is healthcare facility initiated with an alert of a diarrhea patient and/or diarrhea outbreak. In the healthcare facility a promoter delivers a WASH module and WASH kit to diarrhea patients. WASHmobile voice and SMS messages are then sent from a doctor at a local hospital to diarrhea patient households and to those in the community where diarrhea outbreaks are occurring. Chlorine e-vouchers are also sent by SMS to these households to redeem chlorine tablets for free at local shops and pharmacies to increase chlorination behaviors.

Diarrhea patient households receive weekly WASH voice, IVR, and SMS mobile messages over three months after patient admission and an e-voucher for free chlorine tablets redeemable at a designated local shop or pharmacy. Households in diarrhea outbreak areas around diarrhea patients receive voice and SMS mobile alerts over 7 days from the same doctor, advising them to use oral rehydration solution for diarrhea, maintain handwashing with soap, and treat drinking water, accompanied by a similar e-voucher for chlorine tablets redeemable at a designated local shop or pharmacy.

Mobile health promotion greatly reduces the cost of WASH delivery, lowering operational costs and logistical challenges. This “light-touch” makes this WASH mHealth program feasible to scale in diverse and hard-to-reach populations. Process evaluations of both PICHA7 in the DRC and CHoBI7 in Bangladesh showed high rates of receiving, listening to, and interacting with mHealth messages, indicating the potential for widespread message delivery in diverse contexts.

Randomized controlled trials of the WASHmobile programs have shown significant reductions in healthcare facility visits for diarrhea, diarrhea prevalence, and child stunting, and sustained improvements in handwashing and water treatment behaviors up to 12 months after intervention.

We have evaluated WASHmobile impact rigorously through randomized controlled trials and longitudinal surveillance. We measure chlorine and E. coli in stored water and the presence of soap in cooking and latrine areas through unannounced spot checks and handwashing with soap behaviors through structured observation. The health outcomes we assess are diarrhea (caregiver report and analysis of stool and blood for diarrheal diseases) and child growth (anthropometric measurements). Our articles on WASHmobile impact are published in rigorous, peer-reviewed journals (see our Resources page).

This will vary by context. Delivering messages through mobile phones costs a fraction of in-person household visits. By reaching those highest at risk immediately after exposure, WASHmobile prevents disease at lower cost and with higher scalability.

Costs typically include message delivery through mobile operators, community sensitization, and minimal training for local staff or vendors. Funding can come from public health budgets, humanitarian response funds, or partner organizations. Because the system builds on existing mobile infrastructure, implementation is generally fast and cost-efficient. The WASHmobile team does not provide funding for project implementation.

Yes. WASHmobile is designed to be adaptable. Message content, language, and delivery channels can be tailored to different cultural contexts and rural, urban, IDP settings.

We recommend that each implementation begins with a pilot that tests and refines WASHmobile based on the needs of different communities and settings.

Yes. All WASHmobile training materials, message libraries, and implementation tools are available under a Creative Commons open-source license. Visit our Resources page for downloadable documents. Additional implementation documents will be available soon.

Key preconditions include:

• Partnership with mobile network operators to send location-based push notifications as voice calls and SMS messages

• Basic mobile network coverage in the target area to ensure participants can receive voice calls and SMS messages (cellular internet is not needed)

• A mobile messaging platform to automate delivery of WASHmobile voice calls and SMS messages (drip campaigns), such as engageSPARK

• Partnership with the Ministry of Health or a local health authority to identify high-risk households for diarrhea through healthcare facility diarrhea case surveillance

We recommend starting by reviewing our Operational Guide and the Resources page to better understand how to implement WASHmobile, as well as reviewing the full the FAQ section.

We are happy to meet with you and provide guidance on how to implement WASHmobile. Please send us a message on the Contact Us page.

This will depend on the scope of the project you plan to implement. We recommend at least 3 months to pilot WASHmobile delivery in your context before large-scale program delivery.

Beneficiaries receive SMS, voice calls, and IVR messages that promote key WASH behaviors.

Messages are sent to diarrhea patients and their household members, as well as nearby households when diarrhea outbreaks occur.

E-vouchers are digital coupons sent by SMS that allow participants to redeem essential WASH products—such as chlorine tablets or soap—free of charge. Each voucher includes a unique code that can be validated by a participating shop or pharmacy using an SMS shortcode (no internet required). Once the e-voucher is used, the code is automatically marked as redeemed. This system makes it easy and secure for households and vendors to use WASH e-vouchers. In WASHmobile, both diarrhea patient households and those in diarrhea outbreak areas receive e-vouchers for chlorine tablets.

WASHmobile uses the engageSPARK messaging platform, which allows scheduling of SMS, voice, and e-voucher messages in multiple languages and mobile networks.

IVR messages are short, pre-recorded voice calls that allow participants to interact by pressing numbers on their keypad. In WASHmobile, these calls share simple WASH-related questions - such as when to wash hands with soap or how to treat drinking water. Participants press “1” or “2” in response to a question and immediately receive an automated reply with the correct answer.

WASHmobile partners with mobile network operators and the engageSPARK platform to send automated SMS and voice messages to phone subscribers in diarrhea outbreak areas. Messages are typically sent around 8 p.m., when most families are at home and can easily receive them. The geographic area is defined by each program’s needs. For example, WASHmobile sends e-vouchers for free chlorine tablets to households within 500 meters of a diarrhea patient’s home, a high-risk area for diarrhea outbreaks. In areas with limited network coverage, community health promoters can also register households manually by collecting phone numbers door-to-door to ensure everyone is reached.

WASHmobile is designed to operate even in areas with limited connectivity. When mobile network coverage is unreliable, messages can be scheduled for delivery during times of stronger signal, or households can be enrolled manually by community health promoters. In these cases, promoters visit households door-to-door to collect phone numbers and help ensure that SMS, voice and IVR messages, and e-vouchers reach all intended recipients when connectivity improves.

Each WASHmobile e-voucher includes a unique code that can only be used once. When a participant presents the message at a participating pharmacy or shop, the vendor sends the code to a secure shortcode number to verify its validity. The system automatically confirms whether the voucher is valid and immediately marks it as redeemed once used. This secure, automated process—managed through engageSPARK via SMS or WhatsApp—helps prevent duplication and ensures that vouchers are distributed and tracked accurately.

You can view peer-reviewed articles, reports, and implementation guides on the Resources page of this site.

Yes. All materials are available under a Creative Commons Attribution–NonCommercial 4.0 license. You may use or adapt them for non-commercial purposes with proper acknowledgment. See the How to Cite page of this site.

Formative research is the first phase of WASHmobile program development. It includes developing mobile message content with target beneficiaries, piloting the intervention, and setting up the mobile platform for message delivery. This process ensures that WASHmobile delivery is culturally acceptable, easy to understand, and appropriate for the context where it is being delivered. It also helps identify and address potential barriers to WASHmobile implementation early on, supporting smooth and effective program delivery.