By Priscilla Chomba-Kinywa

“Did you know, there are more cellphones in the world than there are toilets?!”

You’ve heard this before, maybe from a friend during lunch one day, as you compare your phones with one another.

However, when you think about it, it’s more than just incredible – it’s concerning. What this means is that while barriers to sharing the pie that is information technology are knocked down every day, almost 2.5 billion people still do not use improved sanitation. In sub-Saharan Africa, 44 percent of the population still use either shared or unimproved facilities and over 25 percent still practice open defecation – an ecologically and physically dangerous practice that contributes to the spread of destructive diarrheal diseases, particularly in women and children under five.

But now for the good news: Organizations globally have figured out how to use the ubiquity of cellphones to help address these sanitation gaps. Actually, they’ve been testing them for ages now, but one example of great success comes from my country, Zambia, where the UNICEF WASH program has partnered with Akros, an innovative organization driven to address disparities in health equity.

One of the biggest challenges in tackling sanitation is monitoring the real-time impact of the interventions taking place – everything from building toilets and recording if they’ve being used to checking on the availability of handwashing stations. This is where mobile phones come in to save the day – or even better, save the data.

Before I attended the training of 45 community champions held in Central Province in November 2013, I could not have predicted the amazing pace at which the various communities would adopt the M2W (Mobile-to-Web) monitoring system for the Community-Led Total Sanitation (CLTS) intervention. Through coordination with the Zambian government and Akros, over 1,000 champions were initially trained in using mobile phones to send data back to a central web database on measurable sanitation and hygiene indicators, such as the quality of a toilet, the coverage of an area, and if the town reached open-defecation free status. This information is received in real-time and disseminated through the open source DHIS2 platform (meaning that ANYONE can use it – try it out!).

mHealth, WASH Program, Zambia
mHealth, UNICEF WASH Program, Zambia

I attentively watched those champions, many who traveled from their distant communities, gingerly press the buttons on the phones and start entering sample data as part of the training. Their curiosity was exciting and their dedication, heartwarming.

mHealth, WASH Program, Zambia
mHealth, UNICEF WASH Program, Zambia

Since then, these same champions have not only mastered the system but have documented one million new users of improved sanitation, contributing to the majority of the two million new users calculated by the end of 2014.

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mHealth, UNICEF WASH Program, Zambia

Akros’ work gained attention everywhere and people had something to say about it:

“One of the most innovative and potentially transformational aspects of the project is the mobile-to-web performance management system. This not only improves reporting efficiency, timeliness and reliability, but also empowers a network of stakeholders with information they need to perform. Decision-making is enhanced, accountability improved, and advocacy strengthened. Taking into account lessons learnt in rolling out the system in 15 districts, as well as sector interests and the development of a sector management information system (MIS), the system should be expanded to all 47 project districts”
– DFID, Annual Review Report, April 2014

“The mobile-to-web monitoring platform demonstrates significant innovation working at scale. It is being used in 23 districts to monitor progress on key sanitation indicators and will be expanded to pick up water supply elements. We saw how District Councils were using it to present data and monitor progress on open defecation free (ODF) status in villages, and they were using it as a basis for taking corrective action.”
– Sanjay Wijesekera, UNICEF Chief of Water, Sanitation, and Hygiene, Programme Division

“This [system] appears to be the most active and effective Monitoring & Reporting process in rural Zambia at present and is proposed to be the basis for scaling up to all Districts. In addition, in 20 of the 46 districts, data transmission and consolidation is operated through a very efficient and cost-effective mobile-to-web system using the open source DHIS2 platform with the support of Akros.”
– African Development Bank, Project Appraisal Report, April 2014 

I’m excited to celebrate this impressive milestone with Akros and the Zambian government, and I applaud the tireless work of the men and women on the ground every day making this idea a reality!

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