The Global Free Urinalysis Social Innovation Project (GFUSIP): turning existing public toilets into a new entry point for urine health monitoring — a first site validating unstaffed uroflowmetry as a scalable community model

Poster presented at the Geneva Health Forum Conference 2026 (10–12 November 2026, Campus Biotech, Geneva). Abstract #196, track: Health promotion and community engagement. Presenting author: Wen-Hui Kuo. Corresponding author: contact@gfusip.org (GFUSIP – Global Free Urinalysis Social Innovation Project, gfusip.org). Introduction and Objectives. Must preventive health measurement happen inside a clinic? Urine is cheap and informative to measure, but delivering it through hospitals costs the user time and money, reaches only those who present, and leaves no routine population monitoring. Uroflowmetry, the standard objective assessment of lower urinary tract function, is mature and inexpensive yet almost confined to urology clinics, reached only after symptoms drive someone into the health system. Since May 2024 the Global Free Urinalysis Social Innovation Project (GFUSIP) has built a different entry point: free, routine urine measurement in everyday public space. Male uroflowmetry is the first of a planned series extending to women and to other urine tests such as liver and kidney indicators; existing public toilets are the test bed. 2. Methodology. In March 2025 a fully automated, unstaffed uroflowmetry unit (Taiwan FDA Class I, to our knowledge a national first) was installed in a men's public toilet in a local health authority building, southern Taiwan. Its built-in urinal lets testing happen during ordinary toilet use. The service is free, walk-in, unstaffed, automated and community-based. On-screen consent precedes each test; the flow curve appears during voiding and a report follows immediately, advising a physician if abnormal. No diagnosis is given. The authority provided venue, utilities and cleaning from existing staff at no new public cost; GFUSIP provided the device and back-end system. Only users who then scanned a QR code and entered age, residence, height and weight left analysable data. 3. Results and Discussion. By August 2026 the station had recorded over 3,000 uses; 302 users (9.9%) completed the form. 71.2% were aged 50 or under, close to the inverse of the national claims profile, where only 21.1% were under 50. Among 221 interpretable records with voided volume ≥150 mL, maximum flow fell below the conventional 15 mL/s referral threshold in 41-47% of men in every age band (p=0.77); among those aged 50 or under, 44.0% were below 15 mL/s and 20.1% below 10. This is not prevalence: the threshold is meant for symptomatic men in clinics, and single uncontrolled measurements in an unselected population inevitably yield high abnormal rates. What changed is the entry point: participants need not become patients first. However, nine tenths did not complete the form, and the design cannot distinguish no phone, unfamiliarity with scanning, or unwillingness; the subsample favours smartphone users, and the age comparison is between service pathways, not disease distributions. 4. Conclusions. Removing the clinic barrier revealed another at the data layer: digital participation. The first site shows that free, walk-in, unstaffed uroflowmetry runs reliably in an existing public toilet and has the conditions to scale; the host authority has proposed adding a thermal printer to lower it. The next stage extends the model to more public spaces, with transport hubs and airports under discussion, and adds a women's station and further urine tests. We invite local governments, health authorities, research institutions, facility operators and industry partners to build the next site with us.