ArticleTropical medicine and health2026
Process evaluation for the delivery of a water, sanitation, and hygiene mobile health program: randomized controlled trial of the WASHmobile PICHA7 program.
Article in Tropical medicine and health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05166850 (Evidence Based Targeted Water Sanitation, and Hygiene Interventions to Reduce Cholera in Hotspots in the Democratic Republic of the Congo), which is not on this map. Not yet cited in PubMed.
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Evidence Based Targeted Water Sanitation, and Hygiene Interventions to Reduce Cholera in Hotspots in the Democratic Republic of the Congo
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12 authors.
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Abstract
backgroundDiarrhea outbreaks including cholera have reached global highs this year. In the Democratic Republic of the Congo (DRC), there are estimated to be over 93 million diarrhea episodes annually. Effective and scalable water, sanitation, and hygiene (WASH) interventions are urgently needed to reduce diarrheal diseases in the DRC. Mobile health (mHealth) reminders have been shown to reduce disease morbidity and increase health-protective behaviors. Therefore, WASH mHealth programs present a promising approach to improve WASH behaviors.
methodsThe WASHmobile Preventative-Intervention-for-Cholera-for-7-days (PICHA7) program is a targeted WASH intervention combining voice and SMS mHealth messages and quarterly in-person visits delivered to diarrhea patient households in DRC to reduce diarrheal diseases. During the randomized controlled trial of WASHmobile, 1196 participants received weekly WASHmobile program voice, Interactive Voice Response (IVR) quiz, and text messages over 12 months. Outcome indicators included % of unique voice, IVR, and text messages received (fidelity) and % of unique messages fully listened to (dose), assessed using the engageSPARK mobile message platform, and program reach to households assessed through monthly follow-up visits.
resultsEighty-four percent of households received unique text messages and 90% of unique voice and IVR messages were answered. Households reported receiving a WASHmobile mHealth message in the past 2 weeks at 72% of surveillance visits (844/1177). Seventy-four percent (309/418) of participants reported sharing a WASHmobile mHealth message with another person at least once.
conclusionThese findings show high fidelity, dose, and reach of mobile message delivery in the WASHmobile mHealth program. This study demonstrates the feasibility of delivering the WASHmobile PICHA7 program in eastern DRC and provides important insights for delivering WASH mHealth programing in low- and middle-income countries globally.
trial registrationNCT05166850.
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