Revolutionizing Water and Sanitation Access Through Digital Innovation
In our rapidly evolving world, digital technologies have emerged as powerful tools to transform the landscape of water, sanitation, and hygiene (WASH) service delivery. By harnessing the potential of these innovative solutions, we can tackle longstanding challenges and empower communities to take charge of their own health and well-being.
Empowering Consumers Through Digital Health
Over the past decade, the global health landscape has undergone a remarkable transformation, driven by the growing accessibility and adoption of mobile technology. This digital revolution presents an unprecedented opportunity to make healthcare more personalized and accessible, especially in low- and middle-income countries (LMICs) where fragile health systems have been further strained by the COVID-19 pandemic.
Population Services International (PSI), a leading global health organization, has been at the forefront of this digital health revolution. Through their Digital Health vision, PSI aims to improve consumer health and well-being by leveraging digital technologies to increase access and personalize the delivery of quality information, products, and services throughout the life course.
One of the key pillars of PSI’s Digital Health strategy is to “Leverage mobile technology in the hands of consumers to power their health journey.” This involves empowering individuals with digital tools that enable them to become active participants in managing their own health, including access to water, sanitation, and hygiene services.
For example, PSI has developed a suite of digital health technologies that are revolutionizing WASH service delivery. These include:
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Electronic Medical Records (EMRs): EMRs enable clinics to digitally gather, save, and retrieve patient health information, including data related to WASH services. This not only streamlines clinic operations but also allows for seamless data transfer to national health information systems, improving data-driven decision-making.
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Health Network Quality Improvement System (HNQIS): HNQIS is an open-source Android app that helps assess, improve, and monitor the skills of health workers when delivering WASH services. By providing tailored support and identifying areas for improvement, HNQIS ensures that consumers receive high-quality WASH services.
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District Health Information System 2 (DHIS2): DHIS2 is an open-source management information system that PSI uses to collect, manage, and visualize data across a single platform. This comprehensive system helps to increase data-informed decision-making and facilitates the integration of WASH data into broader health system planning and monitoring.
These digital health solutions not only empower consumers but also strengthen the resilience and responsiveness of WASH service providers, enabling them to better meet the evolving needs of their communities.
Bridging the Digital Divide in WASH Service Delivery
While the promise of digital technologies is undeniable, the reality is that many communities, especially in LMICs, still face significant barriers to accessing these transformative tools. Addressing this digital divide is crucial to ensuring that the benefits of digital innovation reach those who need it most.
One innovative approach that PSI has championed is the use of digital locator tools. These digital solutions enable healthcare consumers to promptly find high-quality, affordable WASH products and services when they need them, overcoming the challenges of navigating fragmented health systems.
By integrating digital locator tools with other cutting-edge technologies, such as artificial intelligence (AI)-powered symptom checkers, PSI is creating a seamless and accessible digital ecosystem that connects consumers to the WASH services they require. This not only improves health outcomes but also enhances the overall efficiency and responsiveness of the WASH sector.
Strengthening Health Systems Through Data Integration
Robust health management information systems (HMIS) are the cornerstone of strong health systems, guiding decision-making, resource allocation, and the well-being of individuals and communities. However, in many LMICs, health systems continue to grapple with a fundamental challenge: fragmented data and limited effective data use for decision-making.
To address this issue, PSI has implemented innovative solutions that leverage the power of digital technologies to integrate and streamline WASH data within broader health information systems. By adopting standards like the Fast Healthcare Interoperability Resources (FHIR), PSI is enabling seamless data exchange between consumer-facing digital tools and the larger health ecosystem.
This integration not only enhances the quality and reliability of WASH data but also empowers health authorities to make more informed, data-driven decisions. As a result, WASH service delivery can be more effectively planned, monitored, and optimized to meet the evolving needs of communities.
Moreover, the integration of WASH data with broader health information systems strengthens the overall resilience of health systems, allowing for better coordination, resource allocation, and emergency response during public health crises, such as disease outbreaks.
Partnering for Sustainable WASH Solutions
Driving sustainable change in the WASH sector requires a collaborative approach, where government, private sector, and civil society stakeholders work together to create holistic and scalable solutions. PSI has been at the forefront of this multi-stakeholder engagement, leveraging its expertise and global network to catalyze transformative change.
One such example is the USAID Transform WASH (T/WASH) initiative in Ethiopia, where PSI has been leading the implementation of a market-based sanitation approach. By integrating market forces and supporting the growth of local businesses, T/WASH has successfully driven the uptake of affordable, quality sanitation products and services at the household level.
The project has trained more than 500 small businesses, including community masons and construction-related enterprises, equipping them with the technical know-how, operational capacities, and marketing skills needed to build sustainable, thriving WASH enterprises. This approach not only creates job opportunities but also fosters a self-sustaining ecosystem of WASH service providers, ensuring long-term access and affordability for communities.
Recognizing the importance of an enabling policy environment, T/WASH has also worked closely with the Ethiopian government to examine and address the barriers that influence household uptake of basic WASH services. This includes advocating for targeted sanitation subsidies, tax reductions to increase affordability, and improved access to loan capital for businesses seeking to expand their WASH offerings.
By seamlessly integrating digital technologies, market-based solutions, and policy advocacy, the T/WASH initiative has demonstrated the power of a multi-pronged approach to driving sustainable WASH service delivery at scale. This model serves as a blueprint for other countries seeking to leverage the transformative potential of digital innovation within the WASH sector.
Empowering Communities Through Self-Testing and Self-Care
Building on the successes and insights gained from its groundbreaking work in HIV self-testing, PSI is now actively applying this approach to better integrate self-care into the health system, starting with hepatitis C and COVID-19.
Self-testing has emerged as a powerful tool to increase access to integrated, differentiated, and decentralized health services, accelerating prevention, care, and treatment for various diseases, while also increasing health system resilience against public health emergencies.
The Unitaid-funded HIV Self-Testing Africa (STAR) initiative, led by PSI, played a pivotal role in informing the normative guidelines of the World Health Organization (WHO) and shaping policies at the country level. As a result, more than 108 countries now have reported HIV self-testing policies, with an increasing number of countries implementing and scaling up this approach to complement and partially replace conventional testing services.
Leveraging this expertise, PSI is now conducting research to identify specific areas and populations where the adoption of hepatitis C and COVID-19 self-testing could significantly enhance testing uptake and coverage. This research serves as the foundation for developing targeted strategies and interventions to expand access to self-testing, ensuring that individuals have convenient and timely options for testing and are linked to care, treatment, and prevention services through differentiated approaches.
By empowering individuals to take an active role in their own health, self-testing not only improves access to critical services but also strengthens the resilience of health systems, particularly during times of crisis when conventional service delivery is disrupted.
Bridging the Gender Gap in WASH
Addressing the unique challenges and barriers faced by women and girls in accessing WASH services is a crucial aspect of PSI’s digital health innovations. Through initiatives like the VIYA social business model, PSI is revolutionizing women’s health by harnessing the power of technology to provide convenient, discreet, and enjoyable tools for making informed choices about their bodies and their WASH needs.
VIYA utilizes a locally rooted, globally connected approach, partnering with pharmacies, providers, and communities to deliver a range of sexual and reproductive health products and services, including those related to WASH. By incorporating consumer insights throughout the product and service design process, VIYA ensures that its offerings not only meet the needs of women and girls but also exceed their expectations.
In rural Ethiopia, PSI’s Smart Start initiative has taken a community-based approach to addressing the barriers faced by women and girls in accessing WASH services. By linking financial well-being with family planning through clear and relatable messaging, Smart Start empowers young couples to make informed decisions about their WASH needs and their overall health and well-being.
The initiative’s network of dedicated Navigators engage with women in their local communities, providing counseling and referrals to healthcare providers. Recognizing the transformative potential of digital technologies, PSI has recently digitized the Smart Start counseling messaging, expanding its reach and effectiveness in connecting clients to the WASH services they require.
These initiatives demonstrate how digital innovations, combined with a deep understanding of community needs and gender-responsive approaches, can help bridge the gap in WASH service delivery and empower women and girls to take charge of their own health and well-being.
Strengthening Community Health Workers Through Digital Solutions
Community health workers (CHWs) are the critical lifelines in their communities, providing essential WASH services and education. Ensuring they have the necessary training, support, and equipment is essential to keeping communities safe and healthy, especially in the hardest-to-reach contexts.
In Mali, where access to formal health services remains challenging, the U.S. President’s Malaria Initiative (PMI) Impact Malaria project, led by PSI, has been supporting the Ministry of Health’s community health strategy by training and supervising CHWs to deliver localized WASH services.
To enhance the performance and competencies of these CHWs, PSI has designed and implemented a digitized supportive supervision system. This includes developing a standardized supervision checklist, utilizing a methodology for selecting CHW sites to visit, and providing on-the-spot coaching and mentoring based on direct observations of the CHWs’ WASH service delivery.
The data collected through this digital supervision system not only helps to improve the basic competencies of CHWs but also provides valuable insights that inform broader WASH programming and policy decisions. By integrating CHWs into the digital ecosystem, PSI is ensuring that their vital contributions to community-level WASH service delivery are recognized, supported, and amplified.
Fostering Collaboration and Innovation
Driving sustainable change in the WASH sector requires a collaborative approach that brings together diverse stakeholders, including government, private sector, and civil society. PSI has been at the forefront of fostering these multi-stakeholder partnerships, leveraging its expertise and global network to catalyze transformative change.
One such example is the USAID Transform WASH (T/WASH) initiative in Ethiopia, where PSI has been leading the implementation of a market-based sanitation approach. By integrating market forces and supporting the growth of local businesses, T/WASH has successfully driven the uptake of affordable, quality sanitation products and services at the household level.
The project has trained more than 500 small businesses, including community masons and construction-related enterprises, equipping them with the technical know-how, operational capacities, and marketing skills needed to build sustainable, thriving WASH enterprises. This approach not only creates job opportunities but also fosters a self-sustaining ecosystem of WASH service providers, ensuring long-term access and affordability for communities.
Recognizing the importance of an enabling policy environment, T/WASH has also worked closely with the Ethiopian government to examine and address the barriers that influence household uptake of basic WASH services. This includes advocating for targeted sanitation subsidies, tax reductions to increase affordability, and improved access to loan capital for businesses seeking to expand their WASH offerings.
By seamlessly integrating digital technologies, market-based solutions, and policy advocacy, the T/WASH initiative has demonstrated the power of a multi-pronged approach to driving sustainable WASH service delivery at scale. This model serves as a blueprint for other countries seeking to leverage the transformative potential of digital innovation within the WASH sector.
Conclusion
In the face of persistent challenges in the WASH sector, digital technologies have emerged as powerful tools to transform service delivery and empower communities to take charge of their own health and well-being. Through initiatives like digital health solutions, locator tools, data integration, self-testing, and community health worker support, PSI has been at the forefront of leveraging these innovative approaches to improve access, quality, and sustainability of WASH services.
By fostering collaborative partnerships, advocating for enabling policies, and amplifying the voices of the most vulnerable, PSI continues to pave the way for a future where digital innovation unlocks the full potential of WASH service delivery, ultimately improving the lives of millions around the world. As we move forward, the lessons learned and the successes achieved will serve as a blueprint for other organizations and governments to follow, propelling the WASH sector towards a more equitable, resilient, and sustainable future.
