Digital Interventions for Improving Water, Sanitation, and Hygiene Practices in Asian Settings: A Scoping Review

Abstract Digital technologies are increasingly being used to promote water, sanitation, and hygiene (WASH) behaviors. However, evidence on their outcomes in Asian settings remains fragmented. This review aimed to map and synthesize evidence on digital approaches targeting WASH behaviors and to describe the knowledge, behavioral, health and implementation outcomes reported in Asian settings. A scoping review was conducted following the Arksey and O’Malley framework and PRISMA-ScR guidelines. PubMed, Scopus, Google Scholar and Embase were searched for studies published between 2018 and 2024. No protocol was prospectively registered. Studies conducted in Asian settings and reporting WASH-related outcomes were included. Data were extracted, coded, and analyzed using descriptive and thematic approaches. Seven publications were included, with most conducted in Bangladesh and India. Digital approaches primarily included mobile applications, SMS, interactive voice response systems and video-based education. Improvements in knowledge were commonly reported, while behavioral findings were variable. Limited evidence suggested favorable health-related outcomes, including reductions in diarrhoeal disease and improvements in household stored-water quality. Reported outcomes and uptake appeared to vary according to behavioral design, contextual adaptation, delivery platform, and equity-related barriers. Digital interventions show potential to improve WASH-related knowledge and behaviors. Reported outcomes appeared to depend on theory-informed design, sustained engagement, 25 contextual adaptation and equitable access; however, the heterogeneity and methodological limitations of the available evidence prevent firm conclusions about effectiveness.