A New Mobile Health App Is Helping Low-Income Communities Take Control of Sanitation

An international group of researchers is developing a mobile health app designed to help people living in resource-limited communities improve sanitation in their own neighborhoods. The project is being co-led by Professor Christine Stauber from the Georgia State University School of Public Health, along with collaborators in Brazil and the United States, and it focuses on giving residents practical tools to report sanitation problems and encourage healthier living environments.

At its core, the project recognizes a simple but powerful idea: people who live with sanitation challenges every day are often the ones best positioned to identify problems, yet they are rarely given effective ways to report them or influence infrastructure decisions.

A Five-Year, Million-Dollar Research Effort

The project is supported by a five-year research grant worth up to $1.1 million, allowing the team to take a long-term, community-centered approach. Rather than deploying a ready-made digital tool, the researchers are working directly with residents to shape how the app looks, works, and communicates.

The main research site is an informal community on the outskirts of Salvador, Brazil, a large coastal city where many neighborhoods lack consistent sewer connections and reliable sanitation infrastructure. Over the course of the study, the researchers will carefully evaluate whether the app can encourage households to connect to sewer systems, improve reporting of sanitation issues, and ultimately support better public health outcomes.

Why Sanitation Is a Public Health Priority

More than 10 percent of Brazil’s population lives in informal urban communities, often called favelas. These densely populated areas are frequently built without formal planning, which means sanitation systems are incomplete or entirely absent.

Poor sanitation exposes residents to serious health risks. Standing wastewater and open sewers can lead to bacterial infections such as leptospirosis, while stagnant water creates breeding grounds for mosquitoes that spread dengue, Zika, and chikungunya. These diseases are not just inconvenient or short-term illnesses; they can have lasting impacts on families, healthcare systems, and local economies.

By targeting sanitation directly, the researchers hope to address a root cause of disease transmission, rather than only responding after outbreaks occur.

Introducing the +Mais-Lugar App

The mobile app developed through this project is called +Mais-Lugar, with “Lugar” meaning “place” in Portuguese. The name reflects the app’s focus on helping people document and improve the places where they live.

Using a smartphone or other mobile device, residents can photograph sanitation problems such as open drains, broken pipes, flooding, or damaged sewer connections. These reports are uploaded through the app and then classified using artificial intelligence, helping the research team and service providers understand patterns and prioritize responses.

A key goal of the project is to ensure that the information collected does not just sit in a database. The team is working with local water and sanitation service providers so that data from the app can be integrated into existing operations and maintenance systems. This step is crucial for turning community reports into real-world action.

Designed With the Community, Not Just for It

One of the most important aspects of the project is its collaborative design process. The researchers did not assume they knew what residents needed. Instead, they gathered direct feedback from users, which led to several practical changes.

Based on early testing, the app now includes voice recording features, making it easier for people with limited literacy to submit reports. WhatsApp integration was added because messaging apps are already widely used in the community, lowering the barrier to participation.

Another significant addition was anonymous reporting. The research team found that traditional reporting systems often discourage people who are not formally connected to the sewer network. Allowing anonymous submissions helps ensure that everyone, regardless of their housing or infrastructure status, can report sanitation issues without fear or hesitation.

The Role of Mobile Technology in Sanitation

Mobile phone access is widespread, even in low-income communities, and this creates opportunities for cost-effective and scalable solutions. Instead of relying on infrequent inspections or complex complaint systems, sanitation problems can be reported in real time, directly from the people experiencing them.

Mobile health technologies like +Mais-Lugar also shift the balance of power. They give residents a way to participate in decision-making, rather than being passive recipients of infrastructure projects that may or may not meet their needs.

This approach reflects a broader trend in public health research that emphasizes community engagement, transparency, and shared responsibility.

A Strong International Collaboration

The project builds on years of collaboration between U.S. and Brazilian researchers who study disease transmission in densely populated urban environments. Alongside Professor Stauber, the project is co-led by Federico Costa, an associate professor at the Institute of Collective Health at the Federal University of Bahia and a researcher at Fiocruz, one of Brazil’s leading public health institutions.

This long-standing partnership has allowed the team to combine local expertise with advanced research methods, ensuring that the project remains both scientifically rigorous and socially relevant.

Connecting Sanitation to Disease Surveillance

The sanitation app project is part of a larger body of work focused on water, sanitation, and hygiene. In a recently published study in the journal PLOS Water, the same research team explored how wastewater monitoring of human mitochondrial DNA could be used as an early warning system for detecting inflammation linked to infectious diseases.

This type of monitoring could help public health officials identify emerging health threats before symptoms appear widely, especially in tropical and subtropical regions where infectious diseases are more prevalent. Together, these projects highlight how sanitation, technology, and disease surveillance can work hand in hand.

Broader Implications Beyond Brazil

While the current study is centered in Salvador, the researchers are clear that the lessons learned could be applied far beyond Brazil. Many cities around the world, including in the United States, face sanitation challenges in underserved neighborhoods.

By demonstrating that community-designed mobile tools can improve reporting and engagement, the project offers a potential model for other regions looking to modernize sanitation systems without enormous infrastructure costs.

Why This Research Matters

Sanitation is often invisible until it fails, yet it plays a critical role in health, dignity, and quality of life. Projects like +Mais-Lugar show how thoughtful use of technology can amplify community voices and help bridge gaps between residents and service providers.

Rather than treating sanitation as a purely technical problem, this research recognizes it as a social and public health issue, one that requires trust, participation, and collaboration.

As mobile health tools continue to evolve, initiatives like this one may shape how cities respond to sanitation challenges in the years ahead.

Research Reference:
https://journals.plos.org/water/article?id=10.1371/journal.pwat.0000225