Leveraging AI to bridge healthcare gap: Inside India’s maternal mHealth revolution

By improving access to life-saving information, CHAHAK empowers women to make informed decisions about their health and the well-being of their children. Its success underscores the transformative potential of AI in creating a fairer, healthier world.

Maternal and child health in developing countries faces persistent and critical challenges. According to the World Health Organization, nearly 800 women die each day due to preventable complications related to pregnancy and childbirth. Despite advancements in healthcare, many communities lack access to vital information that could save lives. Mobile health (mHealth) programs, which deliver health information via mobile phones, have emerged as a powerful tool to bridge this gap. These programs aim to educate and empower women with critical knowledge about prenatal care, infant immunizations, and family planning.

One such initiative, Kilkari, stands as a beacon of hope. Launched by India’s Ministry of Health and Family Welfare (MoHFW) and ARMMAN, a leading non-profit organization, Kilkari is the world’s largest maternal mHealth program. It sends weekly automated voice messages (AVMs) to pregnant women and new mothers, delivering essential health information in regional languages. Currently, Kilkari serves over 4.3 million active beneficiaries across 28 states and union territories, with a cumulative reach of 53 million women and children.

Despite its scale and ambition, Kilkari faces a major hurdle: beneficiary engagement. Approximately half of its participants stop listening to messages within six months of enrollment. Factors such as inconvenient call timings, shared phone usage in households, and the sheer scale of operations pose significant barriers. This disengagement undermines the program’s ability to achieve its mission of improving maternal and child health outcomes.

To address these challenges, a groundbreaking study titled "Leveraging AI to Improve Health Information Access in the World’s Largest Maternal Mobile Health Program", published in AI Magazine, introduces CHAHAK - an AI-powered intervention system. Developed by researchers from Harvard University, Google Research, and ARMMAN, CHAHAK promises to revolutionize engagement in Kilkari by leveraging advanced algorithms to optimize resource allocation and improve beneficiary retention.

CHAHAK: Harnessing AI for public health

CHAHAK, which means “chirping of birds” in Hindi, is a sophisticated AI-driven system designed to enhance Kilkari’s impact. It focuses on two primary challenges: optimizing the timing of AVM delivery and planning targeted interventions for beneficiaries at risk of disengagement. By addressing these issues, CHAHAK seeks to ensure that vital health information reaches underserved women effectively and consistently.

• Time Slot Optimization: CHAHAK uses non-markovian time-series bandits—a machine learning approach—to analyze call logs and identify optimal time slots for sending messages. Unlike Kilkari’s current random scheduling, CHAHAK personalizes call timings based on beneficiary behavior, increasing the likelihood of answered calls.

• Intervention Planning: The system prioritizes beneficiaries for additional support, such as visits by Accredited Social Health Activists (ASHAs) or automated call reminders. These interventions are allocated based on CHAHAK’s predictive analysis of listenership patterns, ensuring resources are used efficiently.

Groundbreaking results

The impact of CHAHAK on improving maternal health engagement was evidenced through a rigorous analysis of real-world data from 4,000 beneficiaries in Odisha, India. The results demonstrated the system's remarkable effectiveness in addressing key challenges faced by Kilkari, the world’s largest maternal mobile health program.

Improved Call Success Rates: CHAHAK’s ability to align call schedules with individual user preferences significantly enhanced the efficiency of Kilkari's outreach. By optimizing the timing of Automated Voice Messages (AVMs), CHAHAK reduced the average number of retries needed to reach beneficiaries from 4.86 to just 2.5 per week. This reduction not only minimized resource wastage but also ensured that messages were delivered more effectively, maximizing the reach of the program's critical health information.

Increased Engagement: The system’s targeted interventions proved highly effective in boosting overall engagement. Visits by Accredited Social Health Activists (ASHAs) resulted in a 16% increase in listenership, offering a personalized touch that resonated with beneficiaries. Meanwhile, automated call reminders contributed to a 5% increase in engagement, highlighting the value of consistent, timely prompts. Together, these interventions created a synergistic effect, significantly enhancing the overall impact of Kilkari’s messaging.

Dropout Prevention: Perhaps one of CHAHAK’s most noteworthy achievements was its success in reducing program dropouts. Beneficiaries at risk of disengaging were identified and prioritized for interventions, preventing 33% more dropouts compared to control groups. This ensured that a larger number of women continued to receive life-saving health information, particularly in underserved and marginalized communities.

These outcomes underscore CHAHAK’s transformative potential to elevate Kilkari’s effectiveness. By improving outreach efficiency, fostering deeper engagement, and retaining beneficiaries in the program, CHAHAK is poised to create a lasting impact on maternal and child health. Its success also demonstrates the scalability of AI-driven interventions, paving the way for broader adoption across similar public health initiatives.

The broader vision

CHAHAK’s innovations extend beyond Kilkari. The system’s multi-action, non-markovian approach offers a blueprint for other large-scale public health initiatives. From chronic disease management to elder care, CHAHAK’s methodology could be adapted to various domains where resource optimization and personalized interventions are critical.

The team behind CHAHAK envisions a phased deployment, beginning with a cohort study in a single state before scaling the system nationwide. With ARMMAN’s goal of expanding Kilkari to 70 million beneficiaries within seven years, CHAHAK is set to play a pivotal role in achieving this ambitious target.