Inputs from ASHAs to shape AI-enabled training platform for cervical cancer screening in Assam

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The field experiences of about 110 Accredited Social Health Activists (ASHAs) will help design an Artificial Intelligence-enabled training platform and a multilingual voice chatbot to strengthen cervical cancer screening and community counselling in rural Assam.

The George Institute for Global Health India and Cachar Cancer Hospital and Research Centre in southern Assam’s Barak Valley will develop digital tools based on these ASHAs’ inputs. They shared their day-to-day challenges with a team of trainers, doctors, programme coordinators, researchers, and technologists at a workshop in Silchar.

The workshop, organised recently, was part of a three-year pilot study on leveraging AI for more effective cervical cancer screening funded by the Indian Council of Medical Research.

The ASHAs discussed the day-to-day challenges they face, the support that would actually help them, and how technology could make their community visits and counselling easier.

During the workshop, the ASHAs reviewed 155 common questions people ask about cervical cancer and screening. They used a simple voting system to identify which questions came up most frequently in the field, raised by women, husbands, family members, and others in their communities.

According to experts who conducted the workshop, the exercise highlighted that the questions ASHAs face most often in the field are not always the same as those considered clinically important. They said these insights will inform the development of a chatbot knowledge base that addresses both priority health information needs and the practical concerns ASHAs encounter during their work.

“This workshop started with a simple principle: technology for ASHAs should be designed with ASHAs. Their experience of explaining screening, responding to concerns, and finding answers in real time will guide the language, content, and functions of this AI platform. We aim to develop clinically validated support that fits their work, rather than adding another digital burden,” Anita Gadgil, principal investigator of the project and senior research fellow at The George Institute for Global Health, said.

The workshop also explored the ASHAs’ comfort and confidence with digital technology. Younger and middle-aged ASHAs said they regularly use mobile phones to report, communicate, and access information. ASHAs in the older age groups said they find digital tools and language more challenging but expressed a strong willingness to learn and become more confident about using them.

ASHAs also mapped out their career paths, including training, staying sharp on what they have learned, counselling women on pregnancy or childbirth concerns, walking people through test results, and making the right referrals. Through this process, many ASHAs recognised their knowledge gaps and discussed using tools like flipcharts to brush up when needed.

The ASHAs further highlighted the value of voice-based interactions in the local language, simple-language content, and search functions that reflect how ASHAs naturally ask questions. They also suggested features such as short audio-visual lessons, frequently asked questions, reminders, quizzes, and progress tracking.

Cervical cancer is a major health concern in India, and gaps in awareness and screening continue to get in the way of early detection. ASHAs often bridge that gap, reaching women in their communities, explaining what screening involves, and connecting them to care.

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